Guest Opinion: Judy Amabile: A deeper reality

I recently attended a Boulder Police Department town hall. People with urgent concerns around homelessness, drug addiction and crime came to seek relief. They described what they are seeing in their neighborhoods: open air drug use, camping garbage, stolen bike parts, discarded needles, human waste. But this conversation was different. It didn’t start and end with demands that police alone do something.

This time, I saw people grappling with a deeper reality: The prevalence of high acuity mental illnesses (schizophrenia and other psychotic disorders) and/or substance misuse disorders (methamphetamine addiction, for example) will never be fixed by policing and incarceration.

Coming to terms with the tangible link between serious mental illness and homelessness is timely. Colorado has an opportunity to make real progress on these issues by allocating a wave of federal dollars from the American Rescue Plan Act.

I was just appointed to the state’s new Behavioral Health Transformational Task Force, which will allocate $450 million of these federal funds. My first priority is to create more inpatient treatment facilities for people with high acuity disorders, who currently are languishing in our streets and jails.

People in active psychosis cannot rationally volunteer themselves to get treatment, services, or support. These disorders require intervention. Right now, no one is intervening. No one but our criminal justice system.

For many of the most severely ill, inpatient medical treatment is the only meaningful option. They need to be in a hospital or residential care facility for an extended period to become stable, and then transition back into society.

From there, they need ongoing wrap-around services including help with medications, housing, job supports and other services. Group homes and sober living facilities are important step-down resources for recovery.

Chronic, widespread homelessness has grown around us insidiously since the 1980s. Back then, we had more mental health hospital beds than we do today. That’s despite our population doubling from 3 to 6 million people.

A minimum of 50 beds per 100,000 people is considered necessary to provide minimally adequate treatment for individuals with severe mental illness. In Colorado, we have about 10 beds per 100,000.

Individuals with severe mental illness are four times more likely to be incarcerated than treated. People wait in our jails for treatment, getting sicker and less sane. It’s terrible in every respect — it’s immoral, inhumane, and incredibly costly.

The least expensive, most effective, and only real solution is to treat people. Federal, state, and county governments have roles to play.

At the federal level, we have $450 million to spend. These federal dollars are a one-time opportunity. If we spend the money wisely to create a robust infrastructure for mental health care, we can make transformational change. I will be working hard on the Behavioral Health Transformational Task Force this summer and fall to achieve these goals.

At the state level, we have to look closely at the intersection of the criminal justice system and mental health. If we have good treatment options for people, they can engage with diversion programs and stay out of the system. I’m also on Colorado’s Mental Health Disorders in the Criminal Justice System Committee, which is working on these and other strategies.

Additionally at the state level, better policies around workforce development for mental health providers are urgently needed. We need less bureaucracy around credentialing, financial and educational incentives to draw people to the field, and ways to improve job satisfaction (like allowing people to spend more time doing patient care and less time on paperwork). All of these things would create a more robust provider network.

At the county level, we need to secure ongoing funding for the mental health facilities we create. For the past year, I’ve been working with a group of concerned citizens on a 2022 ballot measure for a mental health tax. Across the state, counties are stepping up by voting to tax themselves to fund mental health care. Boulder County should, too.

We’re experiencing a critical mass of homeless people with untreated, serious mental illness and addiction disorders. Jail has never been a good solution; in fact it grows these problems.
If we make better policy choices up front, and spend money wisely, we can make transformation change that will help people with mental illness off the streets and out of jails.

Together, we can create a new and better normal, where seeing someone suffering on our streets is no longer an everyday occurrence, but a rare and terrible thing that summons our compassion and action.

Judy Amabile is the Representative for House District 13. She is a former member of the Daily Camera Editorial Advisory Board.