TELLURIDE, Nov. 12, 6:37 p.m.  – The Telluride region covers a large area, not only geographically but demographically. And with that spread come a wide range of mental health issues, as well as the services available to treat them.

The Center for Mental Health, a private nonprofit organization, is the largest mental health care provider in the region, serving six counties with an emphasis on providing low-cost care. The center maintains offices in Telluride, Norwood and Nucla, and has counselors in most of the schools. With sliding-scale fees and a fee-reduction program to reduce costs even more, CFMH reaches a broad cross-section of the public, and also provides mental health services for Medicare and Medicaid patients.

“We hope that there’s no one who goes without mental health care because they can’t afford it,” said Janie Sorenson of CFMH.

Services include free crisis intervention, available 24-hours a day; substance abuse treatment; and group and individual therapy.

But even with its comprehensive coverage, the center may not reach everyone who needs it, and the results are surprising – and disturbing – to many area residents.

“The suicide rate in our area is way off the charts,” Sorenson said. “Colorado is seventh in the nation, and western Colorado is one of highest areas in state.” There have been 24 suicides in the state so far this year. “Suicide numbers are grossly underreported,” Sorenson said. “Insurance companies and families often don’t like a death to be reported as suicide. But at the same time, that number is more than double last year’s number.”

The center has founded a Suicide Prevention Coalition to identify ways to deal with the issue. At the same time, CFMH is initiating an outreach program to ensure that people who most need their services have access to them.

“The typical suicide victim is male, aged 19 to 60. We don’t know exactly why that is, maybe the pressures they face, or the fact that many are away from home a lot. We’re very interested in finding out the connection,” she said. To reach those men, the center wants to start taking their program to job sites.

“It’s very difficult to engage men in our programs,” Sorenson said. “We went to the mines near Paonia to present our services, give them a number to call when they need help. That’s the only way we’re going to get the job done. They won’t come to us. We need to go to them.”

In conjunction with the Telluride Foundation, the center is also working on a multi-media marketing campaign to spread the word about mental health issues and available treatment.

Gary Steinbach, health care administrator for the Telluride Foundation, said educational vignettes will be developed on subjects such as “suicide prevention, depression, anxiety, addictive behaviors, child abuse, and domestic abuse – and distribute them widely in dentists’ offices, doctors’ offices, schools, libraries, that sort of thing.”

The marketing campaign is part of an action plan devised during the Telluride Foundation’s Sept. 26 Mental Health Care Summit in Telluride. Twenty-seven people from the schools, law enforcement, health care, and mental health care fields came together to discuss the state of mental health care delivery systems in San Miguel, Ouray and western Montrose counties.

“We had a robust discussion,” said Steinbach, identifying strengths, weaknesses and ways to improve the situation. “We decided that the schools are in great shape; kids’ access to counselors and the availability of counselors is good. Also, law enforcement is doing a great job with mental health issues.”

On the other hand, summit attendees determined that there is a lack of professional psychiatry services in the town of Telluride. “Access to mental health services in Telluride is limited, because a lot of it is staged in Norwood,” Steinbach said.

Currently, Lori Raney, a psychiatrist from the Durango area, offers private psychiatric services once a week in Telluride. Otherwise, Telluriders must go to Norwood to see a licensed psychiatrist. “Starting in January, we’ll have a psychiatrist in Telluride one day every month,” Steinbach said. The Telluride Medical Center will provide complimentary space so that there is increased access to mental health care within a medical setting. The Norwood medical center already provides space for a mental health care provider.

The Telluride Foundation also identified the lack of transportation as being a major roadblock that keeps people from accessing adequate physical and mental health care. To remove that hurdle, the foundation and San Miguel County joined together to provide free transportation for people to get to and from their doctors’ appointments in Montrose and Grand Junction. To book a seat on the shuttle, call Kathy Reed at 327-0507.

“Just the distance that people have to go to access services is a problem,” said Robert Givens, CFMH’s Program Coordinator for the Telluride Region.

Additionally, the low-population density of the West End in particular won’t support quality medical health care. “Though things are fairly stable now, there’s been a lot of staff turnover in the past, and when that happens it’s hard to establish a practice,” he said.

Givens estimated that 15 to 30 percent of the general population suffers from drug use and abuse, and that 2 to 3 percent of a population suffers from chronic mental illness. “But that varies from urban to rural, and by geographic areas,” he said. “The more rural you are, the more difficult it is to get help.”

On the other hand, residents aren’t necessarily taking advantage of all the services available. “Right now we have more staff availability than we have people who are accessing the services. If we have the ability to serve 100 people, we may see 70 people,” Givens said.

And while there are differences among populations in the wider Telluride region, there are even more similarities.

“The West End seems to have a lot of drug and alcohol substance abuse, and that causes a lot of problems in families. When parents are drunk, they tend to neglect kids, and then the kids act out in school,” Givens said. “That’s our biggest problem there.”

At the same time, Susannah Smith, a clinical psychologist with a private practice in Ridgway and Telluride, also sees significant cases of substance abuse. “Substance abuse is a huge issue everywhere,” she said. “That creates problems trying to raise children. Kids know about it, and that makes it hard to try and find appropriate role models for them. Maybe the problem is a little more concentrated here because so many adults do it, and so many children know that the adults do it.”

Smith treats many of her patients for issues that are fairly common everywhere: relationship problems, anxiety and depression, family conflicts, divorce, the need for mediation, and the need for support.

Another problem that Smith sees is fairly unique to Telluride. “One of the things that really does hit Telluride more than many other areas is that there are so few opportunities for employment, and the housing shortage is such an issue. People have three jobs and can barely pay their rent. That actually produces quite a bit of stress for people, as well as stress from all the added relationships in the house. It’s a chronic issue. People have to really scrape to live here.”

Fortunately, it would seem that Telluride insulates its children from those problems fairly well. According to Lisa McClun, psychologist and counselor for the Telluride Intermediate and Elementary School, some drug abuse is present among the older kids, but her most common problems are family related: children who need help dealing with family changes such as divorce, remarriage and occasionally death.

Jessica Burress, mental health therapist for the Telluride Middle School/High School, agrees that kids of the Telluride region face a pretty standard set of challenges. “When you’re working with kids, a lot of it is developing good social skills, the typical things that families struggle with. That’s the same across the board whether in Norwood, Naturita or Telluride.” Burress noted that economic stressors in the West End can complicate problems there.

“We are really blessed with a lot of resources to support kids here,” said Lisa Andrews, counselor for the Telluride Middle School High School. “I think the kids really manage pretty well; it’s mostly a pretty happy, upbeat crowd.”

Teachers offer yet another level of support for students in Telluride. “I think that students here feel that they can really talk with their teachers,” Andrews said. “That’s who they really open up to; they get to know them so well. Kids don’t really slip through the cracks here much, someone’s always got their eye on them.”

For more information about services offered by the Center for Mental Health, call 728-6303 or 327-4449 or visit midwestmhc.org.