Senate Bill 195 and the Road to Better Mental Health for Kids

On a cold day in April, the House Committee on Health and Insurance convenes in a packed gallery. Meighen Lovelace takes her seat before the panel. Even in the basement of the State Capitol, the space is imposing: chandeliers hanging from the ceiling, rich paneling on the walls. But she doesn’t look shaken. She’s told this story many times.

“I didn’t take my daughter seriously at first when she started talking about suicide,” she begins. “I thought, ‘You're 7 years old. You don’t know what it is to want to die.’ But I was the one who rescued her when she tried to end her life.”

After a suicide attempt

Now 8, Meighen's daughter started showing signs of mental health challenges when she was a baby. Services in rural Eagle County, where Meighen lives, are sparse. After her first suicide attempt, an ambulance rushed her three hours to Children's Hospital Colorado in Aurora. She immediately tried again. After that, she was in the hospital for six weeks.

“They told me I couldn’t stay in Eagle County,” Meighen tells the committee. She offers a bitter laugh. “We don't have money to relocate. To leave our support system. Eagle County averages one suicide attempt per day. We live in constant fear. This isn't the way for families like mine to live.”

And yet many of them do, and not just in Eagle County. All over Colorado, families live a variation of Meighen’s story: they can't keep their kids safe, and so children spend months on end in residential treatment centers or inpatient care units, many of them neither designed nor equipped for long-term care.

“We have no comprehensive mental health system in Colorado,” says Heidi Baskfield, Children's Hospital Colorado’s Vice President of Population Health and Advocacy. “If a child has cancer, families know where to go to get help and how to get it. With mental health, we have a fragmented set of programs, caregivers don’t know how to access the services that are available, and the programs are so limited that many don’t have access at all. This bill is how we begin to change that.”

Surrendering custody to get mental health treatment

Jim Wiegand's son was found by police on a January day when he was 4 years old, wandering Colfax Avenue in underwear and flip-flops. Jim and his wife adopted him a few months later. They knew it would be hard at first, and it was. But their son got better. Therapy helped. Wounds healed. Then he hit puberty.

“The trauma dam opened,” Jim tells the committee.

The Wiegands had faced challenges, but not like this. Multiple runaways, suicidal threats, hospitalizations. Then came the violence.

The family has four adopted kids, in addition to their three biological children, now grown. They couldn't keep them safe at home. Their son's school recommended day treatment, but insurance wouldn't approve it.

After months of denials and appeals, they opened a case with the Department of Human Services and surrendered custody of their son. Only then would the state cover the cost of getting him the help he needed. He's been in treatment since August.

“We want our son back home,” Jim says. “It's heartbreaking.”

The cost of a broken mental health system

It's also expensive for the state, Jim notes before the House Committee. Had his son gotten day treatment approved when he needed it, the extraordinary cost of round-the-clock care might have been avoided. Now it's a crisis. And the Wiegands are far from alone.

Suicide is the leading cause of death for kids ages 10 to 24 in Colorado. Children's Colorado alone has seen a 600% increase in child and youth admissions for attempted suicide in the last decade.

“At various times when the state was struggling, we've stepped up and said, ‘We'll cover what you can't,’” says Baskfield. “So our care teams sometimes have kids living with us for months on end — often to the kid's detriment. Our teams basically came to us and said, ‘We can't keep doing this.’”

A first step: Partners for Children's Mental Health

And so, with support from generous donors, Baskfield and her advocacy team worked closely with care teams to develop Partners for Children's Mental Health. Based on a model that’s worked in other states, the organization functions as an umbrella for any agency or nonprofit in the state with a stake in kids' mental health.

The first and most tangible result of their work: Senate Bill 195 that passed in the State Senate and the House, with testimony from Meighen and Jim.

“I mean, I know how this goes,” Meighen says after the hearing, chatting with Jim in the hall. “Small, incremental change. But it's hard, too, because my daughter may not live for small, incremental change.”

Jim nods. “I'm doing this for kiddos down the road.”

“Wraparound” mental healthcare

Kate Hartman was a bit of a tricky baby, says her father, Mike, but it wasn’t until she was in preschool that they really got concerned. A first visit with a psychiatrist eventually led to diagnoses: sensory integration disorder, anxiety, ADHD.

“When your kid doesn't have typical behavior, it can get frustrating,” says Mike.

“Isolating,” adds Hope, Kate’s mom. “But we also have private insurance and flexible schedules, and we’ve had great access to psychiatry, occupational therapy, speech therapy, special skills, feeding therapy. We've done everything we could to help her flourish and thrive, and we’ve seen so many positive results.”

Many of those services came through Children's Colorado, and over time, Hope got involved with the hospital's Family Advisory Council, a group of parents and staff working together to improve the patient experience. It was there that she started to realize her own experience was less than typical. Families couldn't navigate the system. Many weren't even making it to the front door.

Kids in crisis often go untreated. The vast majority of children who attempt suicide have seen a primary care provider within the last six months. With standardized mental health screening, maybe those kids would get identified and connected to treatment. Senate Bill 195 does just that.

And for kids and families in the midst or aftermath of crisis, the bill would provide Medicaid funding for “wraparound” intensive care coordination services to help the child and family reintegrate.

“Think about a kid on a ventilator,” says Baskfield. “You don't just send them home. You have supports like in-home nursing, durable medical equipment, ongoing training — none of which we provide to kids with mental health issues. And those kids are no less worthy of help.”

“If the number-one cause of death in children were seatbelt use,” Hope remarks, “We'd be doing a lot more about seatbelts than we've been doing about mental health.”

A new beginning for youth mental health in Colorado

Hope wanted to do something about it. Kate did, too. So at 11 years old, she testified about her experience before the Senate Committee on Health and Human Services.

“It was exciting and nerve-wracking,” she says. “But they treated me really well. I'd encourage others to share their stories. The world isn't going to reject them for who they are. That's something I realized. When you share your story, the stigma is over.”

But she's not stopping there. Now, on a makeshift stage in the atrium of Children's Colorado in Aurora, Kate and her sister Lucy, 8, hand out superhero capes to the House and Senate sponsors of the bill, which passed on a 52-13 vote on the House floor. And after a few remarks and cape jokes, the Governor, decked out in his signature suit and running shoes, takes up his pen.

There's a moment of silence. Kate is beaming ear to ear.

“And it's the law of Colorado,” the Governor declares.

The advocacy team applauds. They shake hands and share a few laughs with the lawmakers who came to see it through. They have cookies. Then they head back to their desks and get to work.