Mental Wellness in the Mountains

It’s a jersey that will never be worn again, a chef’s knife that will forever remain in its sheath, a snowboard that unknowingly took its last run, a pet that waits at home for their owner to never return and classmates that will not get to accept their diploma with their friend by their side. The agony associated with losing a loved one to suicide materializes in unimaginable ways. In intimate communities like our own, the space we take up, or the void we leave, is felt so closely by all. Grief and pain live in the wake of tragic loss, something our community is all too familiar with.

“When one person dies by suicide, research shows that about 135 people are directly exposed to that incident, and about 11 of them have significant impacts on their daily life because of that loss,” explains Erin Ivie, executive director of SpeakUp ReachOut, a nonprofit in Eagle County dedicated to suicide prevention.

Many of us carry multiple jobs, are self-starters, multi-sport athletes and so much more. We feel the need to meet expectations of “life in paradise.” But, what if your view of paradise is blocked by substance abuse, mental and behavioral health issues, high cost of living, burnout or any of the other — very real — struggles residents of our region face?

With the lofty demands of mountain-town life, we tend to forget the important role we play in the day-to-day of our small communities. You may not know it, but you could be someone’s favorite barista, waiter, cashier or friendly face at the grocery store, the bit of extra joy in their everyday that keeps them going. When your presence is no longer there, the barren space you left will never be filled the same way again. It’s a vicious cycle of loss and pain.

In most of the states that make up the mountain west, there is strong sense of, potentially toxic, independence woven into the culture. Add in a lack of mental and physical health care, isolated communities, increased access to firearms, lack of housing, substance abuse and a massive wealth gap. You can’t forget the, often invalidating, feeling of someone saying, “How could you be sad? You live in Colorado!” And that is how you fall into the scenario mental health experts refer to as the “paradise paradox” of the mountain west – home to the highest rates of suicide in the country.

THE WORST YEARS ON RECORD

Thirteen people in Eagle County lost their lives to suicide in 2017 (an increase of eight from 2016) and 14 in 2018 as cited by the Center for Disease Control on cdc.gov. These abnormally high rates were double the historical norm according to the Colorado Center for Health & Environmental Data. Statistics provided by Vail Health show, from 2012 to 2017, visits to the Vail Health Emergency Department for behavioral health-related causes increased by 465%, and visits related to substance use increased 332% in that same timeframe. Our youth were also deeply impacted, with three times more middle schoolers reported to have made a suicide plan than years prior. In a
close community like the Vail Valley, these painful ripple effects were and are still felt, and changes needed to be made.

THE SHIFT

In fall of 2017, with a landslide win of 73%, Eagle County voters passed ballot issue 1A to allow the tax revenue generated from the sale of recreational marijuana to directly support behavioral health programs throughout Eagle County. Vail Health stepped in to help with the allocation and support of this funding, thus the creation of Eagle Valley Behavior Health (EVBH) in 2019 and their commitment of $60 million over 10 years.

Prior to the involvement of EVBH, behavioral health services existed in the county but needed some help themselves. EVBH recognized the direct connections these nonprofits have within the community. They knew that the best way to connect with the community was to connect through the community.

“We’re really excited to be working with the nonprofits that have the expertise in behavioral health prevention and crisis and that we are able to support them financially and with infrastructure, so they can continue to do the great things that they do,” shares Dana Erpelding, senior director of operations for Eagle Valley Behavioral Health.

According to Ivie, Colorado and other mountain west states are largely made up of rural communities; with that comes a higher number of firearms in these regions. Though owning a firearm does not mean you are going to die by suicide, Ivie adds, it does put you at higher risk.

“We are addressing that with our program called the Colorado Gun Shop Project,” Ivie explains, “where we educate our firearm retailers, firearm advocates, firearm instructors and range owners about how they can have conversations around safe storage. The conversation isn’t about the right to bear arms but about what to do when people are in crisis and how to keep them safe.”

It is no secret that the traditional rhetoric of suicide prevention and firearms historically do not share common views. By finding neutral common ground on the safe storage of firearms and the identification of suicidal warning signs, organizations like SpeakUp ReachOut are able progress across traditionally differing sides for more wide-spread change.

PEER SUPPORT

At the center of most suicidal thoughts is the feeling of being a burden to those around you. Peer support addresses that at the core by putting trained volunteers in contact with those in-need within the community. For decades, we have seen successful examples of peer support in organizations like Alcoholics or Narcotics Anonymous — support groups where people can connect with others who have been in their shoes and understand their experience.

But, in a place where many residents are already stretched thin with multiple jobs due to cost of living — a contributing factor to the suicide rates in and of itself — how do we ensure peer support is available and being utilized? Erpelding says EVBH is dedicated to working with the state to establish sustainable funding, making full- time peer support available.

“We want to continue to build that network of peers to be even greater, so anybody that wants that service can find someone in the community that they really connect with,” explains Erpelding.

Local restaurant owners Samantha Bizsantz and Lindsea Stowe were directly impacted by the loss of a dear friend by suicide in 2022. The duo modeled a great example of community involvement and a form of peer support with their Service Industry Mental Health Series and the creation of @vailmentalwellness. Bizsantz and Stowe collaborated with organizations in the Valley and peer advocates from EVBH to establish an array of workshops for community members to gather, learn about behavioral well-being, self-harm warning signs, healthy coping mechanisms and what they can do to help those in need.

“We are not the experts on mental health by any means, or the saviors, but we wanted to provide the space, physically and emotionally, for people to work through it,” says Bizsantz.

By working with leaders within their industry, Bizsantz and Stowe were able to provide a space for their community to connect, heal and grow, all while honoring a friend lost far too soon.

“I’ve had two managers [in the industry] this season reach out for resources,” shares Stowe. “I feel like the message is out in a really good way. We know where the resources are, and we’re happy to get them to the right people. I think the biggest thing we can do at this point is say there is a need. If we can be advocates, I think other people will see they can be, too.”

Karen Jarchow is the founder of Vail Valley RIDE, a mountain bike program based in Eagle that uses the bike as a tool to nurture a child’s holistic health. The program’s community endured the heartbreaking loss of a teen rider to suicide in February 2023, and Jarchow says there is a deep need for more mental health and wellness for local kids and the community as a whole.

“The evolution of Vail Valley RIDE has directly resulted from my own healing path,” Jarchow shares. “As I learn new ways to nourish my holistic self, I find ways to bridge these lessons to the valley youth through mountain biking. At its core, we are using the bike as a tool for a child’s holistic health. Riding a bike provides many physiological benefits, such as healthy muscles and lungs. Bikes further provide nourishment for our mental, emotional and spiritual health. When riding, the thought scribbles of our mind start
to lineate, and we feel more comfortable talking about our emotions.”

CHANGES TO COME

From the grocery stores to the housing crisis, it is clear that lack of resources is a consistent issue in the Vail Valley. This was mirrored within the health industry in a lack of both physical and behavioral health clinicians in the area.

Vail Health has broken ground on the Precourt Healing Center, a 28-bed in patient behavioral health facility in Edwards due to open in 2025.

“We don’t have as many physical health providers compared to urban areas, and we also don’t have as many mental health providers,” explains Erpelding. “That’s something we’ve been really trying to tackle.”

The Wiegers Mental Health Clinic opened in January 2023 in the Edwards Community Health Campus as the main location for outpatient services through Vail Health’s EVBH providers.

Additionally, Vail Health has broken ground on the Precourt Healing Center, a 28-bed in-patient behavioral health facility in Edwards due to open in 2025. This facility will allow those in need to seek out and receive help closer to home by providing direct access to clinicians between Grand Junction and Denver. The main goal for the Edwards facility is to not just provide a medical building but also address the need for a better supported community in the form of an epicenter for care of all types.

By treating mental and behavioral health in the same way as physical health, we are able to knock down the stigma one rung at a time. Colorado Mountain Medical (CMM) is doing just that by working with EVBH on their Integrated Behavioral Health (IBH) program. This program places a licensed behavioral health clinician at CMM. When all patients come in for their physical health visits, they are now asked to fill out a form focusing on the status of their behavioral health. If the patient’s response flag concern, a licensed clinician is on site to address the issue at the time of the visit.

This supports and implements the “no wrong door” approach. As Erpelding explains, “If you’re going to see a doctor, we want to make sure they are assessing your full physical and mental health needs.”

Since the IBH program was established, it has drastically decreased the amount of M1 Holds within the community.

“A M1 Hold is when someone is in such an acute behavioral health crisis that they have to be sent to an in-patient hospital,” Erpelding explains. “They are able to identify those individuals earlier and provide them with the wrap around services and care that they need to keep them out of needing to go for a hospitalization.”

The Wiegers Mental Health Clinic opened in January 2023 in the Edwards Community Health Campus as the main location for outpatient services through Vail Health’s EVBH providers.

Since the launch of the IBH program in April of 2022, according to EVBH, 564 interventions have occurred, over 100 safety plans were created for those in need and 40 M1 transfers were diverted to other care. With an average cost of $25,000 per patient for each M1 Hold, the implementation of the IBH program has truly redirected hundreds of thousands of dollars back into the pockets of our community.

The Wiegers Mental Health Clinic opened in January 2023 in the Edwards Community Health Campus as the main location for outpatient services through Vail Health’s EVBH providers.