The first time Anna Vaine was diagnosed with a mental health condition, she was 8 years old.

The Summit High School graduate learned she had generalized anxiety disorder. Since then, the now 19-year-old has been diagnosed with chronic depression, social anxiety disorder, obsessive-compulsive disorder and attention deficit hyperactivity disorder.

After her first diagnosis, Vaine visited a therapist in Summit County but stopped shortly thereafter.

“I stopped going not because I didn’t need it but because the therapist I went to and the things I was doing weren’t serving me in the way I would have liked,” Vaine said. “I stopped going for a while, and then I started looking for services again when I was 15. That’s when I started noticing a lot of the struggles that people have mentioned with getting care in Summit.”

Vaine’s experience accessing mental health care was a multiyear process that included hundreds of miles of driving, a few different therapists, four psychiatrists and 13 medications. It wasn’t — and still isn’t — an easy process, and her experience took a toll not only mentally but also physically.

To start, the process of finding a therapist was challenging due to Summit’s limited options. This became even more difficult when Vaine began searching for a psychiatrist.

Vaine said a previous doctor referred to her chronic depression as “medication resistant,” making it complicated to find something that worked. What she needed was specialized care that didn’t exist in Summit County. On top of that, she needed a psychiatrist who could treat adolescents, which further shrank the local pool of providers.

According to Jen McAtamney, executive director of Building Hope Summit County, the county still has limited options regarding psychiatry and medication management, including only one psychiatric nurse practitioner and two psychiatrists.

Vaine ended up seeing four psychiatrists, one of whom was in Vail and another in Denver, before she found the right fit.

Her story isn’t unique. For anyone struggling with their mental health, one thing is certain: There are limited resources in Summit County to get help.

Though the community has made strides in recent years, local experts agree there is considerable work to be done to increase access to care across the board.

Access to care

Summit County’s limited mental health resources are a reflection of the state’s access to behavioral health care.

According to Mental Health America, Colorado ranks 31 out of 50 states in terms of its access to care. States that have a ranking of 13 or below are considered to have relatively more access to insurance and mental health treatment.

Breaking it down further, the organization reports that Colorado ranks 13 in terms of mental health workforce availability with a ratio of 280-to-1 residents to health care workers. But it still has work to do in terms of delivering care. The state ranks 28th in terms of adults with a mental illness that reported an unmet need.

According to the organization, individuals seeking treatment but still not receiving needed services face the same barriers that contribute to the number of individuals not receiving treatment, such as no insurance or limited coverage of services and lack of available treatment types.

To mitigate some of these challenges, the Colorado Department of Public Health and Environment released a strategic plan for improving behavioral health for the next five years. Released in January 2020, some of the goals include increasing funding opportunities for behavioral health services and developing a center to provide 24/7 care for people with behavioral health conditions.

It’s commendable that the state is taking steps to increase equitable access to mental health resources, but if it still has a lot of work to do, then how does this access to care play out locally?

Overhauling the system

In the past five or so years, Summit County has made significant strides in the mental health arena to provide the basics, such as talk therapy and emergency crisis response. But Assistant Summit County Manager Sarah Vaine — mother of Anna Vaine — said the road getting here was rocky.

In 2019, Mind Springs Health, one of the county’s few resources for mental health care, lost its state contract, leaving a gaping hole in providing emergency care services as well as clinically managed detoxification and withdrawal management. Sarah Vaine noted that Mind Springs still has a presence in Summit but said this event caused a ripple effect in the community.

“It was pretty bumpy, and I think there was a group of us that felt responsible for that,” Sarah Vaine said. “It felt rough to everyone. I would argue that the system that we have now is much more responsive, and we’re seeing great results from the transformation that occurred out of that crisis.”

When Mind Springs was awarded its contract with Rocky Mountain Health Plans, it was expected to respond to emergency calls in rural counties, including Summit, within a couple of hours and complete an assessment. But barriers such as infrastructure needs, a wide geographic area and funding made the system inefficient.

Sarah Vaine noted that many community members were frustrated at the time with how services were being carried out. These crisis services were supposed to keep individuals out of the emergency room and out of jail, which wasn’t always happening.

Part of the gap in services was eventually filled by the Systemwide Mental Assessment Response Team led by the Summit County Sheriff’s Office.

Now the goal of keeping individuals struggling with mental health issues out of the emergency room and out of jail has largely been attained. When the sheriff’s office receives a mental health call, it dispatches a plainclothes officer and a clinician. The program launched in January 2020 and has seen huge success.

Substance use treatment lacking

So what about those who are struggling with substance use disorders? Summit County Commissioner Tamara Pogue and Sarah Vaine agree the county is severely lacking in treatment options.

Summit Women’s Recovery offers gender-focused intensive outpatient care and medically assisted treatment, and Mind Springs offers medically assisted treatment as well as group and individual therapy.

Just last year, the county struck a deal with Recovery Resources, a nonprofit based out of Aspen, to provide substance use treatment options. Though a step in the right direction, Sarah Vaine noted that the county is still in need of more intensive services.

“(It) is classified as a social detox, which just means that we don’t have clinicians in there,” she said. “There’s no nurses. There’s no medical people. They’re peers — well-trained people with lived experience supporting folks while they get to a sober place and then make decisions about what their next move is going to be.”

The community still does not have inpatient or intensive withdrawal management services, but community leaders are trying to get these services offered.

On the horizon

Thanks to the passing of a 2018 ballot measure known as Strong Future, the county has more than $2 million to spend on mental and behavioral health services, and the fund will accrue an additional $2 million per year.

Right now, the county does not have overnight intensive care or what’s called step-up or step-down care, which is intensive outpatient therapy. Sarah Vaine and the Strong Future committee are working to contract services from Front Range Clinic, which could offer a whole host of services that can be customized to fit a particular community’s needs. Sarah Vaine said the clinic’s services could be offered in the county as early as this fall.

The introduction of a contractor like Front Range Clinic would be groundbreaking for the community, in large part because it could offer critical services the community desperately needs. In combination with the SMART Team and Recovery Resources, Summit County would be taking a vital step in the right direction toward accessible mental health care.

For now, those who need more acute care are sent to West Springs Hospital in Grand Junction or to Denver.

In addition to working with Front Range Clinic, the county is also planning to launch a healing hub startup that will be housed in the Medical Office Building in Frisco. Sarah Vaine said some of the services that’ll be offered at the healing hub before year’s end include medication-assisted therapy and DUI classes as well as intensive case management, navigation services, intensive outpatient programming, peer supports, support and treatment groups, individual therapy and more.

Other services the county would like to offer include crisis stabilization and respite, withdrawal management, walk-in support and more.

A network of services

In the meantime, community partners are working to fill gaps in care.

One of the longest-running resources for behavioral health is Summit Community Care Clinic, which started offering mental health services in 2006. The clinic’s offerings include school-based counselors and integrated care, meaning all intake forms include questions regarding a patient’s mental health. A few years ago, the clinic also launched its medically assisted treatment program for those struggling with substance use disorders.

Perhaps one of the biggest turning points in terms of mental health awareness was the inception of Building Hope Summit County. The nonprofit launched in 2016 after longtime resident and philanthropist Patti Casey died by suicide. The organization was incubated at the Family & Intercultural Resource Center, and the two entities developed the mental health navigation tool, which helps individuals find mental health resources.

Kelly McGann, access to care manager for the resource center, explained that the navigation tool is intended to provide a wraparound approach to individuals whose mental health issues might stem from other community issues, such as housing and child care.

The service is provided through a partnership with Building Hope, which hosts outreach and information campaigns. One of the organization’s cornerstone programs is its scholarships, which offer therapy sessions to individuals who can’t otherwise afford them. Currently, there are about 71 providers who accept these scholarships.

Building Hope also hosts community and group events focused on connecting an otherwise isolated community, including a group called The HYPE that offers programming for youths ages 12-18. From 2017 to 2020, the organization has hosted nearly 200 events in which over 3,000 people have participated.

Peak Peak Health Alliance is also in the business of making access to care easier. The nonprofit was incubated by The Summit Foundation, and when it launched on its own in 2019, one of its priorities was to make behavioral health more affordable to residents. According to the organization’s Director of Outreach Elise Neyerlin, all but two of its health plans have a zero dollar outpatient therapy co-pay for an unlimited number of sessions. Peak Health has also worked to increase the number of in-network independent providers from seven to 54.

Vision for the future

Had there been more resources when she was exploring her options, Anna Vaine said navigating the local mental health industry would have been much easier. Particularly, she’d like to see more psychiatry and talk therapy providers based in the county.

“I feel like that was the biggest thing: There just weren’t any options,” she said. “I think our therapists up (here) are great, and I think they’re going to be great for a lot of people. But it would have been great to see even more options for therapy or just more places where you can find resources, even outside the county if we don’t have it.”

In the future, Sarah Vaine said she’d like for the county’s new healing hub to be a one-stop shop where individuals can walk in and access whatever resources are needed in that moment. She believes it’s a level of immediate care that will transform the county’s mental health arena.

“We want it to be: Everyone knows here’s where you go,” Sarah Vaine said. “Walk right over there, into that door, and there’s going to be someone there to help you. That’s my vision for it.”