In Colorado, a state where more than 30% of residents report experiencing mental health challenges, leaders across healthcare, education, government, and advocacy are grappling with a shared question: how can they better support the mental health of Coloradans?
At a recent roundtable in Denver, Marathon Health convened a group of experts to explore the current state of mental healthcare in Colorado. They discussed what’s working, where gaps remain, and what becomes possible when care is more fully integrated.
Moderated by Keith Dennis, president and publisher of the Denver Business Journal, the panel brought together Dr. Aisha Rousseau, Chief Strategy Officer for the Colorado Behavioral Health Administration, Vincent Atchity, President and CEO of Mental Health Colorado, Dr. Todd Lambert, Superintendent of Littleton Public Schools, and Krista Beckwith, Vice President of Population Health and Wellness at Marathon Health. Together, they discussed how Colorado is working to expand access to mental healthcare for its growing population.
Additional perspectives from Karen McGowan, Executive Director of the Denver Department of Public Health and Environment, and Liz DeMatteis, Chief Marketing Officer at Marathon Health, added important context, highlighting both the progress being made and the systemic challenges that persist.
From rising demand for behavioral health services to ongoing barriers to access, one theme stood out: improving mental health outcomes will require a more connected, human-centered approach to care, one that treats the whole person, not just isolated symptoms.
There's power in moving away from treating a symptom in a part of the body and starting to treat a whole person.
President and CEO, Mental Health Colorado
Barriers to mental healthcare access in Colorado
While Colorado has made meaningful progress in expanding behavioral health services, access to care remains a work in progress. State leaders, healthcare providers, and community organizations increasingly recognize that overall health is deeply connected to mental health, and that improving outcomes requires sustained investment in both.
Even so, access barriers persist.
Long wait times delay treatment
One of the most pressing challenges is the time it takes to access care. Long wait times continue to delay treatment, even for individuals who have already experienced a crisis. In some cases, families face delays of 60 to 90 days before they can connect with a mental health provider, leaving them to manage ongoing risk without consistent clinical support. These gaps can increase the likelihood of relapse, emergency interventions, or worsening symptoms.
Workforce shortages further compound the issue
Colorado, like many states, faces a growing shortage of behavioral health clinicians, limiting the system’s ability to meet rising demand. Even as new access points, such as crisis lines and walk-in centers expand, the availability of licensed providers has not kept pace, creating bottlenecks across the care continuum.
Challenges in care navigation and coordination
For many individuals, understanding where to go for help (and how to move between different levels of care) can be overwhelming. Disconnected systems often require patients and families to act as their own care coordinators, increasing the risk of missed follow-ups and poor outcomes.
Together, these barriers highlight an important reality that expanding access is only one part of the solution. Ensuring that care is timely, coordinated, and connected will be essential to improving mental health outcomes across Colorado.
Efforts to improve mental healthcare access
Despite higher-than-average rates of mental health challenges, Colorado stands out significantly: its residents have consistently demonstrated a strong commitment to expanding behavioral health access. Voter support has played a critical role in shaping the state’s approach, backing programs and policies aimed at improving mental health outcomes.
Investment translated into meaningful progress
The state has launched a statewide 988 mental health crisis line, expanded access to free therapy for teens and adults, and built out a network of 24/7 walk-in crisis centers. These efforts are helping more people access care when they need it most, and panelists pointed to steady improvements in mental healthcare in Colorado.
Despite these investments, the state continues to face a paradox: while access to care has improved, outcomes remain among the worst in the country, raising a critical question: are improvements in access alone enough?
As Karen McGowan noted, while Colorado has made significant investments in mental healthcare, the next challenge is integrating that care earlier, before individuals reach a crisis point. This involves a shift from reactive, high-cost interventions to proactive, preventive approaches that address the root causes of mental health challenges.
Across the panel, speakers emphasized the importance of policies and partnerships that support whole-person well-being. That includes addressing the social, economic, and environmental factors that shape health outcomes, prioritizing everything from housing stability to education and financial security. Improving mental health at scale, they agreed, requires a broader, more coordinated approach.
Integrated care: the clear next step
At the heart of the discussion was a clear takeaway: treating mental and physical health as separate issues doesn’t reflect how people actually experience their health.
“Our systems are set up to treat parts of a person, not the whole,” said Vincent Atchity. “But health, by definition, is about wholeness.”
Integrated care offers a path forward. By bringing mental and physical health together, providers can identify and address underlying issues earlier, often before they escalate into more serious conditions. For example, a patient managing a chronic condition like diabetes may also be experiencing depression. In a disconnected system, those concerns are treated separately, requiring multiple appointments and care plans. In an integrated model, providers can address both simultaneously, improving adherence, outcomes, and overall well-being.
Coordination is key to ensuring continuity of care
Dr. Lambert emphasized that coordination becomes especially critical when supporting the mental health of Colorado’s youth. He described a scenario in which a student, after being diagnosed with depression, experienced a suicide attempt and required hospitalization. As that student transitions back into daily life, coordination between the hospital, primary care provider, behavioral health team, and school is essential to ensure continuity of care. Without that alignment, communication gaps can increase the risk of further escalation and ongoing mental health challenges. Schools are often the first place mental health needs surface, making them a critical component of any integrated care model.
Panelists also highlighted the role integration plays in reducing stigma. When behavioral health is embedded within primary care, it becomes a routine part of the healthcare experience, making patients more likely to seek support and stay engaged in ongoing care.
The role of primary care in behavioral healthcare
Primary care providers are often the first (and sometimes only) point of contact for individuals navigating health concerns. That makes them a critical entry point for more integrated, holistic care.
“Primary care is the front door,” said Krista Beckwith. “It’s where conversations about health start, not just about physical symptoms, but about stress, relationships, and what’s happening in someone’s life.”
When providers have the time and resources to build meaningful, relationship-based care, they are better positioned to identify behavioral health needs early and connect patients to the right level of support. Early intervention can reduce the likelihood of more serious and more costly mental health challenges down the line.
Just as important as access, panelists emphasized, is trust. Even when services are available, patients may hesitate to seek care due to stigma, cultural barriers, or a lack of connection with providers.
“There’s a difference between access and attainability,” Beckwith noted. “People need to feel comfortable, understood, and supported, not just able to book an appointment.”
Building that trust requires intentional design. Panelists pointed to the importance of relationship-based care models, culturally competent providers, and care teams that reflect the communities they serve. When patients feel seen and supported, they are more likely to engage in care and stay engaged over time.
How technology is supporting integrated mental healthcare
As Colorado works to build a more connected, human-centered healthcare system, leaders are also navigating the rapid rise of digital tools and AI-driven platforms.
Across the panel, there was clear alignment on one point: technology can support care, but it cannot replace it.
Beckwith explained that many people turn to technology because they cannot access timely, trusted care through traditional systems. Unfortunately, technology can’t replace a trusted relationship with a provider.
Dr. Rousseau shared that the issue had felt especially personal in recent days. She reflected on the loss of a colleague’s son, who died by suicide after seeking support through online tools rather than reaching out to a trusted adult or healthcare provider. The experience underscored a difficult question: how might outcomes change if individuals had stronger connections to accessible, trusted, human care when they needed it most?
The opportunity lies in using technology to extend and enhance access while keeping human connection at the center. Tools like virtual primary care visits, secure messaging with care teams, digital intake and screening tools, and coordinated electronic health records can help streamline care and make it easier for patients to engage. Telehealth and text-based support can also expand access for populations who may not be able to attend traditional in-person visits.
At the same time, panelists noted the importance of maintaining clear boundaries, ensuring that patients are connected to qualified, credentialed clinicians and understand the limitations of AI-driven tools, particularly in moments of vulnerability or crisis.
Moving forward together
It's so rare for people to feel like the system is responsive. If you're able to show that you're actually there, trust follows fairly quickly.
VP, Population Health and Wellness, Marathon Health
Mental health has become a powerful driver of change across the healthcare landscape, but its impact extends well beyond the clinical setting. Employers are increasingly recognizing that the mental health challenges their employees face directly influence productivity, engagement, and overall business performance.
Panelists agreed that when employees struggle to access timely, coordinated care, the effects are felt across organizations. Conversely, when individuals have access to relationship-based primary care that integrates mental and physical health, they are better positioned to stay healthy, present, and supported.
“Employers have a critical role to play,” Beckwith said. “It starts with asking: Do you have the right front door to care for your population?”
The broader implication is clear: investing in integrated care benefits more than just individual organizations; it strengthens entire communities. Employers can improve access, reduce long-term costs, and build more resilient teams. School systems are better equipped to support student well-being. Government agencies can more effectively promote population health. And healthcare systems can deliver more comprehensive, whole-person care.
Integrating mental and physical healthcare is an essential step toward improving outcomes for Coloradans and building a stronger, more connected healthcare system.
Watch the on-demand recording of the panel session here.