| PostIndependent.com

Community policing with compassion in the Roaring Fork Valley

Mind Springs’ Kat Buesch adds her thoughts to a group discussion during a Pitkin Area Co-responder Teams training at the Basalt Fire Department in El Jebel on Thursday. (Kelsey Brunner/The Aspen Times)

Change in the field of law enforcement is happening. Garfield County Sheriff Lou Vallario has seen it.

For most of his 34-year career in law enforcement, mental health just wasn’t part of the equation in Vallario’s training experience. A violation of the law led to handcuffs; a crime was a crime. A hard-line approach to law enforcement didn’t leave much flexibility — or support — for those experiencing mental distress or a behavioral health crisis.

That isn’t the case anymore, which is a a point of pride for Vallario and other law enforcement officials in the valley.

“So many law enforcement agencies have opened their eyes and shifted to realizing, this isn’t the good old days where all we do is chase criminals,” Vallario said. There is also recognition now that for those experiencing a behavioral issue, “these people might be acting out criminally, but they’re not necessarily criminal.”

The Longevity Project


The Longevity Project is an annual campaign to drive discussion about what it takes to live a long, fulfilling life in our valley. This year’s project focuses on mental health. The Glenwood Springs Post Independent and The Aspen Times are partnering over the next month, and we will explore topics in mental health including resources (Aug. 26), substance use (Sept. 3), suicide prevention (Sept. 9) and law enforcement (this story).

Our project culminates with a panel discussion at noon Sept. 20 in Rifle or at 6 p.m. on Zoom (formerly in Aspen) with local leaders and speaker Kevin Hines. For more information or to register for the local events, go to PostIndependent.com/longevity.

An award-winning global speaker, best-selling author, documentary filmmaker and suicide prevention and mental health advocate, Hines has reached millions with his story of an unlikely survival. Two years after he was diagnosed with bipolar disorder, he attempted to take his life by jumping from the Golden Gate Bridge. Since the Golden Gate Bridge opened in 1937, thousands of people have tried to kill themselves by leaping. Only 34 have lived, and he is one of them.

Due to a high COVID-19 transmission rate in Pitkin County, the evening event that originally had been set for in-person will be free and hosted virtually on Zoom; registration is still required and donations are encouraged.

Attendees who purchased tickets for the Aspen event may contact Samantha Johnston at sjohnston@aspentimes.com for a full refund. If a refund is not requested, the donated funds will be used to help offset the speaker fee.

“We deal with a lot of people with a lot of issues that aren’t necessarily criminally related,” he added, “but again, we’re the ones out there at three in the morning, and we’re the ones that people call. … We’re part of the community too.”

Officers, lawmakers and community members are now more aware of the role mental health plays in a person’s behavior; they’re also more supportive of equipping first responders with the tools necessary to handle those situations, Vallario said.

One of those avenues is training; another is the emergence of co-responder programs that dispatch mental health clinicians to support law enforcement on calls related to behavioral health.

It’s a relatively recent shift in Vallario’s eyes, with awareness growing in the past five years, he said.

Aspen Police Department’s approach to mental health and community policing is evidence of that: Police Chief Richard Pryor secured funding from the city in 2016 for the department’s first human services officer, a position designed to connect people to behavioral health resources rather than place those people in the criminal justice system.

Aspen Human Services Officer Braulio Jerez (right) leads one of the weekly meetings at the Intercept Lot encampment for residents of the camp and case managers to discuss updates with the camp on Thursday, April 8, 2021. (Kelsey Brunner/The Aspen Times)

“It has evolved for sure, now four years in, because of the abundance of resources that we have in our valley — I think the system has become way more robust,” said Braulio Jerez, who has held the position for a couple of years. (Andy Atkinson, who originated the role, was “instrumental” in shaping how it served the community, Jerez said.)

The initiative has worked well enough that the department just brought on a second human services officer this month. Both officers are core members of the Pitkin Area Co-responder Teams (commonly referred to as PACT), a program that provides training and support for officers and includes mental health professionals to respond alongside law enforcement for some calls.

Human Services Officer for the City of Aspen, Braulio Jerez, speaks during a Pitkin Area Co-responder Teams training course at the Basalt Fire Department in El Jebel on Thursday. Jerez works as a HSO in conjunction with PACT as a dedicated officer for mental health, substance abuse, the senior population and homelessness. He has been in this position for 2 years. (Kelsey Brunner/The Aspen Times)

The initiative involves mental health clinicians from the county as well as a peer specialist and a case manager from Mind Springs Health, plus officers and deputies from Aspen, Snowmass Village and Pitkin County law enforcement agencies; it launched in 2019 after securing a $1.5 million grant from the state. Similar co-responder programs exist throughout the Roaring Fork Valley as partnerships between local agencies and the Aspen Hope Center.

It’s not that mental health was an entirely foreign concept a decade ago, Basalt Police Chief Greg Knott said. But now, there are a lot more resources to help first responders address it.

“Mental health issues and concerns have always been there,” Knott said. “We’ve just not had the ability to set up systems and provide resources, as we have in the past few years, to really make that the focus and make it collaborative efforts among mental health providers and law enforcement and (emergency medical services) and the hospital.”

Detox Manager for Recovery Resources Collin Kenney, takes notes during a group discussion during a training for Pitkin Area Co-responder Teams at the Basalt Fire Department in El Jebel on Thursday, Sept. 16, 2021. (Kelsey Brunner/The Aspen Times)

Hiring for compassion, training for success

In Snowmass Village, building a police department equipped to help people experiencing a mental health crisis starts with “you’re hired.”

“We try to choose the right person to become a police officer: someone who exhibits patience, compassion, empathy, just in natural day-to-day life, that makes them a good officer and prepares them for dealing with those mental health challenges that we come across with out on the street,” Snowmass Police Chief Brian Olson said.

Still, it’s no substitute for intensive programs such as mental health first aid and crisis intervention team training, the likes of which are now the norm in departments throughout the valley.

Notes are displayed during a training for Pitkin Area Co-responder Teams at the Basalt Fire Department in El Jebel on Thursday, Sept. 16, 2021. (Kelsey Brunner/The Aspen Times)

Olson recognizes that need for training and puts it into practice. Every member of the Snowmass Police Department, including patrol officers, community response officers and the front office manager, has completed crisis intervention training.

Jenny Lyons, a county mental health program administrator who focuses on PACT, considers the crisis intervention program to be the “gold standard” in law enforcement training; the 40-hour intensive week-long program gives officers the tools to help those experiencing mental health crises.

Other departments in the valley, like the Aspen Police Department, also have trained all of their officers in the program; PACT is even hosting two single-day “CIT 2.0” refresher courses this week, according to Lyons.

Tiffany Crist, a clinician with Brower Psychological Services, addresses the training room during a training for Pitkin Area Co-responder Teams at the Basalt Fire Department in El Jebel on Thursday, Sept. 16, 2021. (Kelsey Brunner/The Aspen Times)

And many of those who haven’t yet cleared that all-trained mark are actively working toward a goal of 100% participation in the crisis intervention program, including the Basalt Police Department and Garfield County Sheriff’s Office. An eight-hour mental health first aid program offers a primer for officers in some departments, too.

A dollar spent, a million saved

A program as intensive as crisis intervention team training comes with a price tag that can total tens of thousands of dollars for one session.

PACT, which administers crisis intervention and mental health first aid training sessions for members of the team and other community partners, is a major source of that funding in the upper valley. The program spent $25,000 for a one-week crisis intervention training in the 2021 fiscal year; the one-day refresher courses happening this week cost about $6,000, according to mental health program administrator Jenny Lyons. PACT also contributed around $1,400 for mental health first aid training last year, she said.

Other sources of funding — and expenses — can vary from department to department and depending on the location of the training. At the Basalt Police Department, for instance, Chief Greg Knott said crisis intervention training itself comes at no cost to the agency but the hotel and per diem spending associated with sending one officer to an out-of-town session totals $1,065; that doesn’t include salaries, transportation or other costs.

It hasn’t been difficult convincing local elected officials to support these trainings come budget season, according to Garfield County Sheriff Lou Vallario. Investing in officer training and co-responding clinicians can save governments in the long run.

“A dollar spent on training could potentially save us a million dollar lawsuit,” Vallario said.

But with conversations about mental health response happening frequently outside of training sessions too, Knott emphasized that it’s near-impossible to quantify the scope of the effort by dollars spent on training alone.

“We’re always talking about mental health. … It’s always in the forefront,” he said.

The crisis intervention training goes well beyond lectures in a classroom setting, Olson said. Actors stage possible scenarios in real time and behave just as someone in a crisis might.

“The training is long, it rattles your nerves, it makes your eyes well up with tears — it’s just super powerful, and it was amazing,” Olson said. “I haven’t heard anybody go through it who hasn’t been moved, and who didn’t learn an awful lot.”

The controlled environment gives instructors the opportunity to hit pause and check in with participants; a scenario going south might be followed by a prompt to take the situation in a new direction, teaching participants how to adapt and learn from their missteps while they’re still in a space where the stakes are much lower than they are out in the field.

“Sometimes we learn the most when we fail,” Olson said. “It hurts, but when we fail, we understand most specifically what it is we need to do better. Sometimes, when we get it right, that doesn’t leave a long, lasting impression.”

Collaborating on co-response

Still, training is only one side of the coin. A 40-hour program may be the “gold standard” in ensuring officers are better equipped to handle crisis calls, but it’s hardly an all-encompassing program, nor one that can provide an equivalent to the years professional clinicians and counselors spend earning their qualifications.

“You have to understand that law enforcement officers signed up to be cops, not to be crisis workers,” Vallario said, “and that’s why we rely so heavily on the people that signed up to be crisis workers.”

Hence those co-responder initiatives, which are implemented at agencies throughout the valley to offer mental health resources on the scene and after the call in an effort to better serve people struggling with their mental health.

Funding comes from a variety of sources, including state grants, backing from local municipalities and support for nonprofits who work in tandem with law enforcement.

There is also a community benefit in the outcomes of co-responder programs that can’t be qualified by a dollar amount, officials say.

“If we provide the proper health care for them, and the resources to get them on a different path, … I think that we’re going to have a better community than that old way of the revolving door, arrest, jail, arrest, jail, and never getting anything resolved,” said Kirk Wheatley, the newly hired Aspen Police Department human services officer.

He’s been in law enforcement for nearly two decades and just transitioned to the human services role; he said his own training was an “eye opener” to a way of policing that focused less on arrests and more on understanding.

“I think it’s just continual education,” Wheatley said. “I believe the more that we educate ourselves on the people that we’re really dealing with out there, probably the less calls we will have as a department and the less people will be thrown in jail that … shouldn’t be in jail to begin with.”

These co-response programs are “community policing at its finest,” said Jenny Wood, the director of criminal justice services in Colorado’s Office of Behavioral Health.

She sees three positive outcomes from the growing popularity of such initiatives: “It’s going to increase officer satisfaction, community satisfaction. … and divert people from getting involved with the criminal justice system when they really just need health care.”

“It really brings people back to why they became police officers,” Wood said.

Programs vary from community to community. But at the core are two components: on-scene support and after-the-fact follow-ups to ensure individuals get help and support beyond the moment of an immediate crisis.

The resources from PACT have been “tremendous,” said Aspen Police Department’s Jerez, who frequently works with the mental health professionals supported by the program.

“Honestly, it would make this job so much more difficult if I didn’t have (mental health professionals) alongside me, because the reality is, we’re not mental health clinicians, we’re not mental health providers,” Jerez said. “We get a pretty good understanding (of mental health) just with time within the department, with our training, but to make those calls and pinpoint a diagnosis, let’s say, on an individual — it’s not something I’m qualified to do.”

BY THE NUMBERS

Data from the Pitkin Area Co-responder Team shows just how well a program like PACT can work when it combines trained officers with professional mental health workers.

Of the 259 behavioral health-related calls the team recorded in the first two quarters of 2021, nearly every event was addressed by an officer with mental health first aid or Crisis Intervention Team training and the vast majority of incidents — nearly 80% — were resolved on scene.

Most of the remainder were transferred to an emergency medical department and a small percentage were transferred to centers for substance use withdrawal management; there were zero reported critical incidents or arrests, according to reports provided by Jenny Lyons.

Plus, thanks to the follow-up baked into co-responder programs, some frequent callers to dispatch are dialing less often because they’re now connected to support systems that can better serve them through mental health challenges, said Colorado co-responder program manager Emily Richardson.

Between Basalt and Parachute, many agencies contract with Aspen Hope Center for support from the local nonprofit’s crisis clinicians. The nonprofit crisis center also supports survivors and first responders throughout the valley in the aftermath of critical incidents that involve serious injuries or fatalities and offers confidential counseling for first responders struggling with their own mental health.

Aspen Hope has been operating mobile crisis and co-response programs since 2010, years before other similar initiatives cropped up throughout the state, according to executive director Michelle Muething. (Whereas co-responder programs happen in tandem with law enforcement, the mobile crisis program offers standalone services under the Aspen Hope umbrella.)

Some early co-responder programs emerged in Colorado around 2013 and 2014, but it wasn’t until 2017 that the concept “went gangbusters” and began growing exponentially aided by state legislation, said the state’s co-responder program manager Emily Richardson.

Even so, “you can’t just put a policy on paper and say ‘bam, it’s implemented,’” Muething said. “It takes time and a whole lot of effort.”

Mental health professionals and first responders come from “two very different cultures,” Muething said. But once the cogs click into place, a strong connection between the groups helps ensure the success of the co-responder collaborations.

“Our partnerships and relationships are vital. … We know how to do this dance on-scene where they know when to let us step forward, we know when to step back and they step forward,” Muething said.

A “culture shift” in law enforcement

Richardson also sees another benefit to the co-responder collaboration: It just might be contributing to a positive “culture shift” in the way first responders view resilience and well-being by putting them in frequent, close contact with mental health professionals.

“Having a colleague close who is a therapist, who they can see is a fine person, isn’t psychoanalyzing them every second of the day and is knowledgeable about this stuff, I think that it just builds into the culture,” Richardson said.

Many of those who have been in the field for any extended period of time can attest to the challenges of the job and challenges — personal or professional — that come with seeking help.

Confidential peer support systems have been fundamental in the effort to shift the way first responders cope with the stressors of a job that can and does involve facing traumatic situations head-on. The programs allow first responders to get support without fear that they’ll be misunderstood or that disclosing their mental health struggles could jeopardize their job; some agencies contract with Aspen Hope Center for those programs.

Aspen Hope has a couple of staffers, Muething included, who can bring their understanding of first responders to debriefs and counseling sessions with local agencies. Several departments also contract with Code-4 Counseling, an organization that specializes in mental health support for first responders.

Support for — and participation in — these programs comes from those in the highest ranks. Vallario said he believes “you have to have support from the top;” Knott said that when the officer check-in program began at Basalt Police Department he was “the first one through the door.”

“In my career, 25 years prior to that I had never walked through that door to speak with a trained person, and it was incredibly beneficial, and it was incredibly helpful, and I continue to go today,” Knott said.

The tides are changing now, flowing toward a law enforcement culture that is now more open to the idea of seeking mental health support, Knott said.

“We don’t do what has been historically done in law enforcement in my career of, you know, just go to the call and go home,” Knott said. “We really worry about the mental health, we really take that seriously of our officers and our deputies.”

And at the Garfield County Sheriff’s Office, the agency has hosted a multi-day “mental body armor” seminar twice in the past five years to highlight the importance of seeking help, Vallario said.

Teaming up

Law enforcement agencies are hardly alone in their embrace of mental health resources and support.

It’s a collaborative effort among public safety agencies in the valley who are equipping their first responders with the tools to help themselves and others when it comes to mental health, officials emphasize. It’s not uncommon for dispatchers, paramedics, firefighters and police officers to deal with the same difficult calls, and the teams will debrief together afterward, said Chief Scott Thompson from the Roaring Fork Fire Rescue Authority.

At Roaring Fork Fire, mental health crisis support is a section of the standard paramedic curriculum, according to Thompson. And those “CIT 2.0” trainings offered by PACT this week were open to upvalley law enforcement as well as other community partners like the Roaring Fork Fire and the Aspen Fire Department, according to mental health program administrator Jenny Lyons.

There is likewise support and advocacy for mental health resources for first responders themselves.

“I’ve been very vocal about it, and I think the people that lead our peer support within our department are very vocal about it,” Thompson said. “You know, none of us are tough-skinned enough that nothing will bother us. We all realize that we’re all human, and we’re going to get bothered because we see things that we shouldn’t see, we experience things that we shouldn’t experience.”

Like Vallario and Knott, Thompson also sees a shift in the way first responders address mental health.

“All those things are learning pieces and parts that bring us to making sure that our people are supported, and that what happened to us in the past doesn’t happen to the new generation of firefighters and paramedics and the police officers,” Thompson said.

When Vallario started his law enforcement career more than three decades ago, there was no support system for first responders coping with trauma; the mentality was that “you’re bulletproof and you can’t be affected by this,” he said.

“What happens is, we deal with these traumatic events that, being human, affect us too,” Vallario said. “There’s nothing in our training that makes us numb to these things.”

He has seen firsthand the consequences that come from that mentality and from the barriers — time, resistance, embarrassment, fear, a lack of resources — that accompany it.

“We say we put it on the shelf,” he said. “OK, then something else happens, we put it on the shelf, and whether that’s a three-year, five-year, 20-year thing, eventually your shelf breaks, and that’s when we start losing law enforcement officers to substance abuse, gambling, divorce, suicide, because we weren’t able to intervene at the time we should have intervened.”

The way Vallario sees it, a culture shift that embraces mental health is indicative not only of the attitudes within law enforcement agencies but also of a willingness from lawmakers to create the financial backing and legislation for something that “wouldn’t have even been a topic 10 or 15 years ago.”

“It’s snowballing,” Vallario said.

And it’s happening outside the world of law enforcement just as much as it is within the field, according to Aspen Police Department Assistant Police Chief Linda Consuegra.

“We all want to think that we’re strong, we don’t need any help,” Consuegra said. “And I think hopefully with our support program, the check-ins, we start to normalize that. And it’s just having conversations, right? … This is the struggle that everyone has.”

kwilliams@aspentimes.com

Dialing in

If someone is an immediate risk to themselves or others, call 911.

Additional crisis support is available via the Aspen Hope Center and Colorado Crisis Services.

Aspen Hope Center: Call 970-925-5858 for the Aspen Hopeline or 970-945-3728 for the Garfield Hopeline.

Colorado Crisis Services: Call 844-493-8255 or text “TALK” to 38255.

kwilliams@aspentimes.com

Survivor calls suicide attempt ‘the greatest mistake of my life’

Suicide attempt survivor Kevin Hines stands on the Golden Gate Bridge in San Francisco. In the 21 years since his attempt, Hines has traveled across the country to speak about his experience.
Kevin Hines/Courtesy photo

“I jumped.”

“It was the single worst action of my entire life,” Kevin Hines said. “The millisecond my hands left the rail, I had an instantaneous regret for my actions. It’s 100% recognition that I had just made the greatest mistake of my life, and it was too late.”

Hines is one of fewer than 40 people who have survived a jump from the Golden Gate Bridge and one of fewer than 10 who have regained full mobility. Since his suicide attempt in 2000, Hines has built a career on sharing his story in the hope that others struggling with mental health issues find solace in the fact that they aren’t alone and that help awaits them.

But it’s a lifetime of seeking help that has gotten Hines to where he is today.

The Longevity Project


The Longevity Project is an annual campaign to drive discussion about what it takes to live a long, fulfilling life in our valley. This year’s project focuses on mental health. The Glenwood Springs Post Independent and The Aspen Times are partnering over the next month, and we will explore topics in mental health including resources (Aug. 26), substance use (Sept. 3), suicide prevention (Sept. 9) and law enforcement (this story).

Our project culminates with a panel discussion at noon Sept. 20 in Rifle or at 6 p.m. on Zoom (formerly in Aspen) with local leaders and speaker Kevin Hines. For more information or to register for the local events, go to PostIndependent.com/longevity.

An award-winning global speaker, best-selling author, documentary filmmaker and suicide prevention and mental health advocate, Hines has reached millions with his story of an unlikely survival. Two years after he was diagnosed with bipolar disorder, he attempted to take his life by jumping from the Golden Gate Bridge. Since the Golden Gate Bridge opened in 1937, thousands of people have tried to kill themselves by leaping. Only 34 have lived, and he is one of them.

Due to a high COVID-19 transmission rate in Pitkin County, the evening event that originally had been set for in-person will be free and hosted virtually on Zoom; registration is still required and donations are encouraged.

Attendees who purchased tickets for the Aspen event may contact Samantha Johnston at sjohnston@aspentimes.com for a full refund. If a refund is not requested, the donated funds will be used to help offset the speaker fee.

Born and raised in San Francisco, Hines said his mental health issues stem from a traumatic infancy, in which he had a difficult home life and his brother died. Hines said he developed abandonment issues and a severe detachment disorder.

At 9 months old, he was fostered by the Hines family, which later adopted him when he was 4 years old. Hines credits them with saving his life.

“They gave me a future and stability and opportunity,” he said. “Growing up in the Hines household was a beautiful thing. We wanted nor needed for anything, all because of how hard (they) worked.”

In his new home, life was much more stable than with his birth parents, who he said sold drugs just to put a roof over their heads. But the lingering effects of his previous environment coupled with genetics continued to impact Hines as he grew up.

The Longevity Project


The paradise paradox

How Colorado’s High Country is responding to a staggering increase in demand for mental health care in the wake of the pandemic.

• Aug. 27 | A cry for help: Hardships of mountain living contribute to above average suicide rate

• Sept. 3 | Party town: How an alcohol-centered culture is impacting the community’s mental health

• Sept. 10 | Crime or crises? Police see early success with measured response to mental health emergencies

• Sept. 17 | Finding help: Mental health services struggle to meet growing demand in rural Colorado

Throughout the years, Hines had ups and downs and said mental health issues were always present. At 17, he was diagnosed with bipolar disorder — the same diagnosis he said his birth parents received — with psychotic features. Hines said he had manic highs and dark depressions, paranoid delusions, hallucinations and panic attacks.

Before his diagnosis, Hines called himself an eclectic teenager who had many interests. He was a skilled wrestler, played on the football team and participated in his school’s theater department.

“I really enjoyed life, and I was thoroughly excited for what was to come,” he said. “And then at 17 1/2, it all kind of came crashing down, and I developed a mental illness.”

Hines said his family started to pick up on signs that he might have a mental illness, but they didn’t know what to do about it.

“I was not telling anybody how severe my symptoms were, so I would see things and hear things that no one else could see or hear,” Hines said. “I kept it to myself. I would have paranoid delusions, and I wouldn’t tell anybody.”

Shortly after an outburst at school, Hines said his mother took him to see his first psychiatrist. Hines said the next two years were a “rocky road” as he tried to find medicine and a dosage that could help.

Leading up to the moment on the bridge, Hines said he felt self-loathing and heard voices telling him he had to die. On Sept. 25, 2000, at 19 years old, Hines jumped from the Golden Gate Bridge.

After the U.S. Coast Guard pulled him from the water with a broken back and other serious injuries, Hines began a long, intensive road to recovery, both physically and mentally.

In the 21 years since his attempt, he has continued to seek out care with a new psychiatrist. He’s also been admitted into a psychiatric hospital nine times, with the latest stay in 2019.

Kevin Hines speaks at Pine Grove Behavioral Health & Addiction Services in Hattiesburg, Mississippi. Since his suicide attempt in 2000, Hines has traveled the country to speak about his experience with mental health.
Kevin Hines/Courtesy photo

About six months after his attempt, Hines began publicly speaking to others about his experience. The first time was at his former school, where he spoke to more than 100 seventh and eighth grade kids.

“I still had my back brace and my cane,” Hines said about injuries he suffered in the fall. “I read a speech from the page, dropping page by page to the floor, crying and shaking the whole time. It was very raw.”

If you go

What: The Longevity Project with speaker Kevin Hines, a suicide attempt survivor and mental health advocate. The talk will be preceded by a discussion about mental health with Summit County Sheriff Jaime FitzSimons, Building Hope director Jen McAtamney, parent Heather Gard and Centura Health behavioral health director Doug Muir.

When: 6-8 p.m. Tuesday, Sept. 21

Where: Riverwalk Center, 150 W. Adams Ave., Breckenridge

Tickets: $25 at SummitDaily.com/longevity

When he was finished, the students asked him questions, and he felt like he made an impact. That impact was evident when he got a call shortly thereafter from the school asking him to visit again. Awaiting him were 120 letters from students thanking him for presenting. Some students even wrote that they were having thoughts of suicide, and those kids were screened and given the help they needed.

It is a moment that sticks with Hines years later.

“It feels amazing,” he said. “It was the first time I spoke, and it had that kind of an impact. My dad looked at me when he read the letters, and he said, ‘Kevin, we have to do this however, wherever possible.’ And we never stopped.”

By 2008, Hines turned his speaking engagements into a full-time job. He stays busy by traveling the country speaking about mental health and his personal experience. He continues to hear from audience members about how sharing his story has kept them from attempting suicide and encouraged them to seek help. By 2017, he was speaking more than 300 times per year.

In addition to coordinating speaking engagements, he has written a memoir titled “Cracked, Not Broken: Surviving and Thriving After a Suicide Attempt” and produced a documentary called “Suicide: The Ripple Effect.” He’s currently working on a new graphic novel called “Hope Dealers” as well as producing a docuseries called “The Journey.”

Hines is speaking at an event capping The Longevity Project at 6 p.m. Tuesday, Sept. 21, at the Riverwalk Center, 150 W. Adams Ave. in Breckenridge. Tickets are $25 and include a glass of wine, beer or soda, and food. For tickets and more information, visit SummitDaily.com/longevity.

Suicide does not discriminate in Roaring Fork, Colorado river valleys

Peer support coach Vanessa Lane works from her desk at Mind Springs Health in Glenwood Springs.
Chelsea Self / Post Independent

Pitkin and Garfield counties share some bleak trends.

Over 120 deaths by suicide occurred between 2015 and 2021 within these two Western Slope neighbors, according to data compiled by the Colorado Department of Public Health and Environment and the Garfield and Pitkin county coroners.

Throughout Colorado, 7,295 people have died by suicide between 2015 and 2020 (2021 numbers are not yet available).

The Centennial State saw 1,294 deaths by suicide in 2020, or roughly 22.47 deaths by suicide per 100,000 people.

In the same year, Garfield County saw 31.64 deaths by suicide per 100,000 people. Pitkin County saw 22.51 deaths by suicide per 100,000 people.

“It doesn’t matter how pretty it is where you live or how much money you have,” Pitkin County Chief Deputy Coroner and Investigator Audra Keith said. “I think that people have problems everywhere and struggle with mental health, and stuff that goes on in the world definitely affects people’s mental well-being.”

Yet one inspiration drives everyone toward wellness: hope.

The tenacity of hope is proven through the stories from those who’ve lived it.

They come from all over the Roaring Fork and Colorado river valleys. Personal stories of overcoming depression, isolation, anxiety and instrumenting the dark experience as octane to help as many people as they can.

Helping to create such outcomes are the professionals, specialists and volunteers of Garfield and Pitkin counties. They’re on the frontlines combating what seems to be an endless, oftentimes invisible war destroying many people’s lives.

Their underlying message?

Reach out, talk to someone, understand that it’s OK to seek help. The fight is well worth it.

The Longevity Project


The Longevity Project is an annual campaign to drive discussion about what it takes to live a long, fulfilling life in our valley. This year’s project focuses on mental health. The Glenwood Springs Post Independent and The Aspen Times are partnering over the next month, and we will explore topics in mental health including resources (Aug. 26), substance use (Sept. 3), suicide prevention (today) and law enforcement (Sept. 17).

Our project culminates with events Sept. 20 in Rifle (noon) and Aspen (6 p.m.) with a panel discussion of local leaders and speaker Kevin Hines. An award-winning global speaker, best-selling author, documentary filmmaker and suicide prevention and mental health advocate, Hines has reached millions with his story of an unlikely survival. Two years after he was diagnosed with bipolar disorder, he attempted to take his life by jumping from the Golden Gate Bridge. Since the Golden Gate Bridge opened in 1937, thousands of people have tried to kill themselves by leaping. Only 34 have lived, and he is one of them. For more information or to register for the local events, go to PostIndependent.com/longevity.

‘TELLTALE SIGN’

Glenn Lee started giving away all his possessions. Anything that meant something to him was gifted to someone else.

“That was a huge telltale sign that something was not right,” Vanessa Lane, his daughter, said.

Then, two days before the birth of his first granddaughter, the 45-year-old Lee took his own life, and then Lane found herself fatherless at the age of 21.

“There is an incredible sadness that takes over,” Lane, who grew up in Denver and moved to the Roaring Fork Valley when she was 28, said. “There is self-blame. Could we have done more, and what did we not do right?”

Now a peer recovery coach with Mind Springs Health in Glenwood Springs and a sitting member of the Zero Suicide Committee, Lane uses her own harrowing experiences with suicide to prevent it from happening to someone else.

Though the tragic event in Lane’s life birthed self-isolation as she spent the next 10 years battling anxiety and depression, the power of conversation prevailed.

It started with her mother.

“My mother was always someone I talked to about this,” Lane said. “When people die with the idea of this as their only solution, it hurts my heart. I was thinking that I was gonna take what I was suffering from when I was a kid, and I just want to talk about it and talk about it.”

Peer support coach Vanessa Lane at Mind Springs Health in Glenwood Springs.
Chelsea Self / Post Independent

Lane said face to face conversations with other people who are suffering makes a difference.

“You’re worth talking about,” she said. “Let’s talk about why you feel this way.”

When it comes to exhibiting signs in relation to suicide, no one fits into the same category and nobody suffers from the same thing, Lane said.

People do, however, commonly share one action when they’re in the midst of suffering: prolonged, uninterrupted isolation.

Oftentimes, Lane said it’s especially men who struggle in seeking help. They either fear the stigma or simply do not trust the counselor with the information.

But there are other signs to look for.

In Lane’s experience, when someone casually brings up suicide in conversation, that’s a red flag worthy of intervention.

“I think just somebody even talking about it or threatening, whether it’s to get attention, it doesn’t matter what it is,” she said. “That is enough of a red flag to have that conversation.”

In addition to talking about suicide, exhibiting risky, out-of-character behavior or vocalizing self-negativity also deserve a helping hand, Lane said.

Because the grief never ends, Lane said. It’s always there.

“But I feel like if you can get out and help someone else that is suffering, it makes it better … it makes it better,” she said. “The sense of missing them never goes away, but getting out there and doing something makes a world of difference.”

PRACTICING THE DISCIPLINE

Allison Daily is well acquainted with loss.

Daily’s brother, Rod Snyder, died by suicide in 1990. At 24, she was the one to receive the phone call, and she was the one who relayed the news to her parents.

Daily said this tragedy is a big reason why she’s director of Pathfinders, a nonprofit focused on helping people during times of grief and loss.

She’s facing that prospect of loss again now. Her father isn’t doing well. His heart is starting to go out. Doctors recently put him on a pacemaker and defibrillator. Meanwhile, Daily’s husband, Art, died in December 2020.

And Daily’s mother has macular degeneration. She can’t see, making it difficult for her to care for her ailing husband.

Daily said she was the one to initiate an end-of-life conversion with him. They discussed funeral services and various loose ends.

“It’s a discipline in what I do,” she said. “I’ve had to really practice what I talked to others about and really go deep. Actually, what’s beautiful about it is that it’s enabled me to be able to help and support so many people on a deeper level than I ever have been able to.”

Daily puts these heartfelt skills to work with the bereaved after a suicide occurs.

Her motivation is for people to not run from their feelings but to process what’s taken place, she said. Because when Snyder took his own life, Daily said she ran away from her feelings for a while.

“There’s usually guilt involved. There’s people who saw the person last, or they had the last conversation or they had a fight beforehand, so they feel that responsibility,” Daily said. “I don’t try to take those feelings away, because people’s feelings are real. But what I try to do is help them process into where they can get to a place where they’re more comfortable.”

Processing involves talking about the relationship the bereaved had with that person, Daily said.

It can give them an avenue for forgiveness, Daily said, and for “trying to help them to take steps forward to live from a place of loving themselves and honoring that person, instead of staying in the anger.”

Suicide elicits strong feelings, Daily said — ones that can come to a head when they’re bottled up.

“We have such judgment around mental illness or mental conditions,” she said. “But for myself and my brother, I started to really understand where he was at. Did that make it OK that he did that? No. But at least now I understand more of where he was coming from and why he made that decision.”

“It’s a really lonely existence when we do that,” she said. “When we bottle things up and we don’t talk with someone or we don’t get the help that we need, then it just leaves room for really disastrous or explosive decisions.”

CURBING THE TRENDS

Mason Hohstadt is preparing for something big: The Out of the Darkness Western Slope Walk.

The fundraiser, done in correlation with the American Foundation for Suicide Prevention, is slated for Sept. 25 in Glenwood Springs. Registration is 9 a.m. and groups will begin walking at 10 a.m. People can also register online.

Anyone is invited to come to the Glenwood Springs Community Center and walk for something that has affected many people throughout the Western Slope. The route comprises Midland Avenue and walking over the pedestrian bridge.

“We utilize those dollars to get more people trained to give those types of training and education out into the community,” Hohstadt, chair of the Garfield County Suicide Prevention Coalition, said. “Most of the time, most of the people who walk are survivors of loss.”

Sept. 25 will also see Aspen host a similar fundraising event: Hike, Hope, Heal. Late registration starts at 10 a.m. at Mollie Gibson Park. The walk begins at 11 a.m.

Additional race information can be found at AspenStrong.org/hike-hope-heal.

Garfield County Suicide Prevention Coalition started in 2006 to “meet the ever-increasing number of suicides that happened in Garfield County,” Hohstadt said.

The effort was something Hohstadt felt compelled to join based on personal experience.

“I’ve been thinking about this the past couple days,” he said. “I have mental health struggles on my own. I have been feeling isolated, feeling left behind — all of those things.”

Hohstadt, a former public health worker in Denver who devoted academic and grad school work to researching HIV, AIDS and Hepatitis C, is driven by a passion to help others.

This is especially true when it comes to suicide.

Hohstadt said the coalition is working on an individual level to help people understand the resources available — and access them.

“One in five people are going to have a mental health challenge in their life,” he said. “That’s a very conservative number; 70 million people in this country will have a mental health challenge or issue in their lifetime.”

“So,” Hohstadt added, “how do we as public health (organizations), which does have a focus and a framework for helping population level, get to a place where we can really move the needle to help people understand?”

The work, however, never ends, Hohstadt said. The mission is to make the shift from the idea of being an outcome organization to a more holistic approach.

“All of these things are interconnected,” he said. “The work will never end it, but it probably will not always look like it does right now.”

Number of deaths by suicide in Pitkin, Garfield counties between 2015 to 2021

Garfield County

2021: 10

2020: 14

2019: 24

2018: 19

2017: 10

2016: 12

2015: 11

Total: 100

Pitkin County

2021: 2

2020: 4

2019: 6

2018: 0

2017: 7

2016: 0

2015: 3

Total: 22

Major signs of suicide contemplation

• Isolation

• Erratic, uncharacteristic behavior

• Mentioning suicide in conversation

• Vocalizing self-negativity

Initiating the conversation

Starting a conversation with someone you suspect is going through a tough time shouldn’t just start with the question, Are you OK?

Garfield County Suicide Prevention Coalition Chair Mason Hohstadt said the person being asked could reply, “I’m fine,” and that’s that.

Instead, use observation to your advantage. If someone you know isn’t participating in normal, daily activities, ask about that. If someone you know is doing something uncharacteristic, ask about that.

You haven’t been out mountain biking with me in awhile, why is that? You’re drinking or using more drugs, why is that? You’ve missed church the past five Sundays, why is that?

“‘I’m worried about this for you,’” Hohstadt said. “Then you can move that conversation to, ‘Are you thinking about hurting yourself?’”

IF YOU NEED HELP

Note: Resources taken from a mental health map available on AspenStrong.org

Counseling, therapy, case management

Aspen Strong

• How to get help: Call 970-718-2842 or visit AspenStrong.org.

Mountain Family Health Center

• How to get help: Call 945-2840 or visit MountainFamily.org.

Mind Springs Health

• How to get help: Call the Aspen office at 970-920-5555 or the Glenwood Springs office at 970-945-2583. Also, visit MindSpringsHealth.org.

24-hour hotlines

Colorado Crisis services

• Call 1-844-493-8255 or text TALK to 38255.

Hope Center

• Aspen: 970-925-5858

• Eagle: 970-306-4673

• Garfield: 970-945-3728

Grief and loss

• Pathfinders: 970-925-1226

Child and family

• Aspen Family connections: 970-205-7025

Family Resource Center

• Roaring Fork office: 970-384-9500

• Parachute: 970-285-5701

Servicios en español

Mind Springs Health

• Aspen office: 970-920-5555

• Glenwood Springs office: 970-945-2583

Mountain Family Health Centers

• Call 970-945-2840

Aspen Strong

• Directorio de terapeutas: 970-718-2842

Discovery Cafe

• Call 719-650-5978 and speak with Gabe Cohen.

• Email Cohen at gabe@discoverycafe.org.

• Visit DiscoveryCafe.org.

• Visit Discovery Cafe at the Colorado Mountain College Rifle campus at 3695 Airport Road, Rifle.

West Mountain Regional Health Alliance

• Call 970-429-6186

• Visit WestMountainHealthAlliance.org/covid/

Reporter Ray K. Erku can be reached at 612-423-5273 or rerku@postindependent.com

Combating a ‘disease of isolation’ with community in recovery

A large crowd gathers as people talk about their shared experiences with overdose at Crown Mountain Park during the Overdose Awareness Day event in El Jebel on Tuesday, Aug. 31, 2021. (Kelsey Brunner/The Aspen Times)
The Longevity Project


The Longevity Project is an annual campaign to drive discussion about what it takes to live a long, fulfilling life in our valley. This year’s project focuses on mental health. The Aspen Times and Glenwood Springs Post Independent are partnering over the next month, and we will explore topics in mental health including resources (Aug. 26), substance use (today), suicide prevention (Sept. 10) and law enforcement (Sept. 17).

Our project culminates with events Sept. 20 in Aspen (6 p.m.) and Rifle (noon) with a panel discussion of local leaders and speaker Kevin Hines. An award-winning global speaker, best-selling author, documentary filmmaker and suicide prevention and mental health advocate, Hines has reached millions with his story of an unlikely survival. Two years after he was diagnosed with bipolar disorder, he attempted to take his life by jumping from the Golden Gate Bridge. Since the Golden Gate Bridge opened in 1937, thousands of people have tried to kill themselves by leaping. Only 34 have lived, and he is one of them. For more information or to register for the local events, go to AspenTimes.com/longevity.

Keir Gallik can draw a straight line between his mental health history and substance use.

“I think that the mental health issues came first. I think they kind of came at a young age where maybe I wasn’t even aware enough to recognize them or put a label on them,” said Gallik, an Aspen Strong board member who is now more than five and a half years sober and living in Aspen. “They just felt as if something wasn’t quite right, and I found, at least in my case, that I had found relief in alcohol and drugs and doing what I was doing — that worked.”

Until it didn’t.

The roots of it — anxiety and accumulating traumas — were still present, and the temporary relief gained from substance use started to diminish, according to Gallik. After a few other go-arounds with in-patient treatment elsewhere, he landed at Jaywalker Lodge, a Carbondale addiction treatment center for men.

That program (which he completed, then stayed on as a staffer for a couple of years) and participation in Alcoholics Anonymous were instrumental in his recovery.

“What it did was just bring me back to a place where I could fully engage in life and, you know, be there for all the ups and the downs,” Gallik said.

Gallik is hardly alone. Far more often than not, substance use is intrinsically intertwined with mental health challenges: the two are “co-occurring” in the majority of clients who turn to recovery resource center A Way Out, said the nonprofit’s executive director Elizabeth Means.

“They go very much hand in hand, and I think it’s human nature to want to try to fix it, like, ‘OK, I’m not feeling right, what do I need?’” Means said.

Addiction recovery professionals and those in recovery themselves agree that it is rarely if ever a “one or the other” situation.

“It’s kind of like what came first, the chicken or the egg? There’s a major connection,” said MaryMike Haley, the clinical director for Aspire Recovery for Women, a Carbondale-based treatment center.

It is common for someone living with addiction to also have anxiety or depression, according to Haley; they may also be coping with trauma, or living with a “complex mental health issue” like bipolar disorder or attention deficit disorder, she said.

Those mental health conditions don’t go away when a person enters into recovery from addiction — just the opposite, sometimes, Haley said.

“When you take away drugs and alcohol, those things tend to become exacerbated, right?” Haley said. “Because their No. 1 coping mechanism to tamp down the mental health issues that are popping up — you don’t have that anymore.”

Over time, though, and with the right recovery resources, that pendulum starts to swing back to center, said Patrick Shaffer, the chief of admissions and marketing at Jaywalker Lodge.

“We see, in some cases, that (co-occurring mental health condition) be at a diagnostic level where they need continued support, through an entire treatment process, and something that they will continue to live with, and we also see it be linked directly to time away from substance use, so we can see anxiety and depression dissipate over time as somebody has more clean and sober time,” Shaffer said.

“It’s sort of not a chicken or an egg conversation anymore,” added Stefan Bate, Jaywalker’s chief of clinical operations. “It’s the chicken and the egg together.”

Co-occurring conditions are “the expectation now — it’s not the exception,” Bate said, and Jaywalker’s treatment plan takes that into account with integrated treatment.

“Doing really responsible, good mental health work, trauma work and addiction work is essential, because if someone has untreated mental health or trauma, that’s going to be their biggest precipitator to a relapse in substances,” Bate said. “And vice versa: If somebody is really struggling primarily with mental health, but they’re continuing to use substances, their outcomes for their mental health disorder are going to be … pretty poor.”

That line of thinking wasn’t always the norm in recovery, according to Bate and others in the field.

“Historical treatment really separated it: You looked at addiction treatment, you looked at mental health treatment, and you didn’t do them in a co-occurring sort of integrated way,” he said.

When Haley got sober 32 years ago at the age of 18, “There was not an awareness of the connection between trauma, mental health and addiction,” she said. So much so that she was told not to unpack some of her childhood trauma in the early stages of recovery because she was too young and because it might cause a relapse.

That’s not the case now, and certainly not at Aspire, which takes a “whole person” approach to recovery.

“That format within the addiction recovery community has completely changed, right, that we really need to address mental health stuff, that we really need to address trauma,” Haley said, “because the symptoms of dealing with those issues — I think one of the symptoms is addiction.”

Maggie Seldeen, founder and executive director of High Rockies Harm Reduction, poses for a portrait at Crown Mountain Park during the Overdose Awareness Day event in El Jebel on Tuesday, Aug. 31, 2021. “I do this work as a child of the valley in the hopes that people don't have to have the same experiences that I did. And if they do, at least they don't have to go through it alone and be criminalized by the system like I was,” Seldeen said in an interview. (Kelsey Brunner/The Aspen Times)

Maggie Seldeen, founder and executive director of High Rockies Harm Reduction in Carbondale, shares that view. It isn’t just mental health itself; stressors including housing and job insecurity are compounding challenges for those seeking recovery.

“My belief is that substance use is a symptom and not the cause,” Seldeen said. “I believe that it is, more often than not, the symptom of underlying mental health issues that have not been effectively taken care of, and so I think that if we can help people achieve stability in their housing, in their profession, in their families and help them address these really mental health issues, then we can start seeing behavioral change.”

Seldeen’s work with High Rockies Harm Reduction focuses on alleviating harm rather than exclusively seeking sobriety; initiatives include syringe access services, peer support and training on how to administer Narcan, a life-saving nasal spray that can treat opioid overdoses in emergency situations.

The goal is to keep people safe, one of many components to what Seldeen sees as a layered approach to substance use and mental health resources.

“When you have something to live for, then you have a reason to address your needs and your issues. … If we can give people the support and mental health services that they need, and that are going to be relevant to them, I think that that can really help with these substance use issues or addiction issues,” Seldeen said.

Trickle-down effect

Aspen has an outsized reputation for substance use. And the atmosphere of a work-hard then play-even-harder culture in Aspen goes well beyond the roundabout, according to Seldeen.

“There’s a trickle-down effect from the party culture,” Seldeen said.

Seldeen observed that the normalization of substance use in Aspen — especially in the restaurant industry, where the use of drugs and alcohol are particularly prevalent, she said — can flow downvalley to Carbondale or Rifle or Parachute when workers head home at the end of the day.

But an abundance of recovery and harm reduction resources in Pitkin County doesn’t flow with it, Seldeen said.

“(In Aspen), it’s viewed as not having consequences because the people using (substances) have resources, and that’s a really important point right there is that, just because you’re a millionaire, doesn’t mean you’re not using heroin or cocaine, right?” Seldeen said. “It means you have the resources to do it in a safe environment.”

That “trickle down effect” doesn’t necessarily mean that usage is the same throughout the valley, though.

The Roaring Fork Valley is no monolith. The culture surrounding substance use — and what substances are used — can vary from Aspen to Parachute or even between neighboring towns like Aspen and Snowmass Village or Rifle and Silt, according to Seldeen.

“I see how some of our communities have resources that the others don’t and vice versa, and so there’s a lot of traveling that goes on to access the right services, right?” Seldeen said.

Pitkin County Public Health’s booth is set up alongside others to provide information on mental health and substance use resources at Crown Mountain Park during the Overdose Awareness Day event in El Jebel on Tuesday, Aug. 31, 2021. (Kelsey Brunner/The Aspen Times)

Means, whose work with A Way Out focuses in part on filling the financial gaps in mental health and recovery access throughout the valley, said she sees a greater need for resources down in Garfield County than she sees in Pitkin County.

“There’s more (people) needing resources, the further downvalley we move,” Means said. “Mental illness is a pretty equitable disease that affects everybody no matter where you live, but definitely, they need more financial resources (downvalley).”

Financial challenges can complicate matters for people seeking clinical recovery resources, too. Programs like Alcoholics Anonymous and other support groups are free, but clinical inpatient treatment and some outpatient therapy doesn’t come cheap.

Insurance providers and Medicaid don’t always cover every program, including those specialized programs that might be the best fit for the individual, Means said.

Even then, the long approval process for those on Medicaid can lead to precious recovery time spent in limbo, waiting for the green light to get help, according to Means.

“It can take months to get into it,” Means said. “And a lot of times, people don’t have a month, right?”

‘The fight is all the same’

Money and insurance aren’t the only — or even the primary — barriers standing between people and the mental health and substance use support they need. A fear of judgment can be a major hurdle to clear, said Jenny Lyons, a mental health program administrator with Pitkin County Public Health.

“The sum total of it is that what we call stigma is keeping people from getting the help that they need,” Lyons said in an interview with Chelsea Carnoali, a Pitkin County mental health analyst.

Regional public health groups are working to counter that by developing messaging campaigns that focus on normalizing getting help for mental health concerns, Lyons and Carnoali said.

“It’s so interesting how our little Aspen bubble culture does fit into what our version of stigma looks like,” Carnoali said.

A lot of the work lies in reminding people that it’s OK to not be OK in a place where so many others come to escape; belonging and community in a resort town are part of the equation for places like Aspen, too.

“People (are) coming to our area, (saying it’s) so beautiful, and we should all be happy, alongside the very clear gap in income and a very clear gap of privilege or availability of resources and what that also does to mental health and sense of belonging,” Carnoali said.

The fact is that mental health struggles and substance use can happen to anyone, said Gabe Cohen, who runs the Discovery Cafe resource center in Rifle and has been in recovery from addiction since 2018.

“It doesn’t matter what county or town or city you’re in, you know,” he said. “The issues, the trauma, the struggle, the fight is all the same. … It doesn’t really matter whether you are in rural America or, you know, ritzy Aspen, Colorado — addiction’s addiction.”

Cohen sees Discovery Cafe as a “recovery community center” with a broad definition of recovery that extends beyond addiction to include trauma, homelessness, incarceration and other challenges.

“We want everyone to know that they are loved and valued, and we leave any judgment at the door,” he said.

Connecting through lived experience

Ashley Adams thanks individuals and community members for coming out for the Overdose Awareness Day event in El Jebel on Tuesday, Aug. 31, 2021. Adams also shared her story as a loved one of someone dealing with addiction; her sister was in recovery for three years before dying of an accidental fentanyl overdose. Nearly a dozen other speakers also shared their lived experience at the event. (Kelsey Brunner/The Aspen Times)

The sense of community and belonging can be a make-or-break component to recovery, according to resource providers. It’s one that the Roaring Fork Valley is uniquely positioned to provide through outdoor recreation; the connections forged on the trails and slopes of the region can help counter what some addiction treatment professionals consider to be a disease of isolation.

“That is without doubt, I would say, the biggest struggle that people face in early- to mid-term recovery is that struggle with finding community without, you know, substances or partying,” said Gallik, the Jaywalker Lodge alumnus.

Here, he has been able to find that, partly because of Jaywalker’s emphasis on outdoor recreation. Gallik, who grew up spending time outside in his hometown of Bozeman, Montana, said Jaywalker reconnected him with the outdoors and placed him in a community of like-minded peers; it was a “game changer.”

“I was able to see people that I respected and people that I got along with really well who were doing well and who were striving to be better people and get sober and live their life,” Gallik said. “That made me think, ‘Wow, I could do that too, that’s achievable.’ It really kind of put a familiar face on this idea of getting better.”

Lived experience and peer-to-peer connection can make a world of difference in addiction treatment and recovery, High Rockies Harm Reduction’s Seldeen said.

“If we can just build trusting, compassionate relationships with people, that’s how we can get them into the services they need,” she said.

And it can be just as valuable for people who know loved ones who are dealing with addiction, said photographer Cath Adams. Her daughter Emily was in recovery for three years before she died of an accidental fentanyl overdose in 2020.

“You don’t want anybody to ever go through this,” Adams said in a joint interview with her younger daughter Ashley in their backyard in El Jebel. “And you don’t have your last goodbyes. You wake up one morning and your child’s gone, and you just really want to — you become very passionate.”

Cath founded Aperture of Hope about a decade ago as a way to help youth engage with the outdoors and face life’s challenges through what she calls “awareness photography.” It has since evolved into a peer support, recovery coaching and resource hub for those dealing with substance use.

Ashley is involved, too; the Glenwood Springs High School senior organized an Overdose Awareness Day event at Crown Mountain Park on Aug. 31 with speakers who shared their lived experience, music, an honor walk, resource booths and a training led by Seldeen on how to administer Narcan.

Maggie Seldeen holds a box containing two Narcan nasal spray doses while demonstrating how to use it at Crown Mountain Park during the Overdose Awareness Day event in El Jebel on Tuesday, Aug. 31, 2021. Seldeen, whose own mother died of an overdose, said in an interview that she hopes to get more Narcan into the community and get more people comfortable with using it in an emergency situation to prevent overdose deaths. “It's just this fear, people are afraid of doing the wrong thing. People are afraid of being liable. It's just, there's a lot on the line when a life is in your hands. … If we had had this drug, when I was a teenager, we could have saved my mother and so many other people's lives,” she said. (Kelsey Brunner/The Aspen Times)

Awareness was just one component; the event’s programming and that shared lived experience also countered that notion of a stigma surrounding substance use and mental health.

“I want the message to be known that people are more than their addiction, and everyone has a story,” Ashley said at the event. “Spreading awareness and talking about addiction should not be shameful, and everyone deserves to get the help they need; I want it to be known that you matter, no matter what others think, especially in the society we live in today.”

Ashley and Cath also planted purple flags at several locations throughout the valley this year and last to commemorate those who died of an overdose in Garfield, Eagle and Pitkin counties; there were 52 at each location for the span of 2017-2019 last year and 72 for the span of 2017-2020 this year.

For Ashley, now entering her senior year of high school without her older sister, the missed milestones are a reminder of an alternative path; her work over the last year has also strengthened her passion to help others, she said.

“She’s not going to be there when I graduate, so that’s hard, but I know everything she went through, I’m not doing the same, so in a way, she’s helped me, shown me what not to do,” she said.

The two hope their own lived experience can help others navigate the landscape of supporting a loved one with addiction and coping with the grief of losing someone to an overdose.

“I’ve seen it. I’ve been there. … I’ve learned a ton,” Cath said. “It just didn’t start when she took that pill and passed — everything before that, it was just a wealth of knowledge.”

‘Their life has meaning too’

An angel flag is set out alongside purple flags for Overdose Awareness Day at an event at Crown Mountain Park in El Jebel on Tuesday, Aug. 31, 2021. (Kelsey Brunner/The Aspen Times)

The involvement has also been a way for Cath to find healing and purpose.

“I feel like I have found the meaning of life,” she said. “Now I just want everyone to feel, when they’re suffering, that their life has meaning, too.”

The healing process looks different for everyone: those in recovery, those coping with loss, those who want to support a loved one living with addiction.

It isn’t linear, either; Seldeen wants to emphasize that to those who may feel like a relapse or a misstep along the way puts them right back where they started.

“It’s so much harder to get back on that wagon. … It doesn’t have to be this way, but it feels so much like you’re starting at square one, and you feel so powerless, and it can be so difficult to see that reality of sobriety in your own life,” she said.

But the resounding message from Seldeen and others in the recovery — aside from encouragement to seek and accept help — is that there is hope for the future.

“I had no idea how much I was going to love being sober,” said Seldeen, now two and a half years sober. “I just knew how tired I was of being the person I had been, and it was super cool to meet this new person. … Being sober is like its own kind of high to me.”

SUBSTANCE USE AND RECOVERY RESOURCES

Meetings and Gathering Places

Colorado Alcoholics Anonymous District 14 (Glenwood Springs to Aspen, Vail to Parachute)

970-245-9649 or 888-333-9649

COAADistrict14.org/meetings/

The Meeting Place (Carbondale)

981 Cowen Drive, Carbondale

MeetingPlaceCarbondale.org/meetings-1

Narcotics Anonymous Mountain West Division (Aspen, Basalt, Breckenridge, Carbondale, Eagle, Glenwood Springs, Leadville, Rifle, Vail Valley)

NAColorado.org/mountainwest/MWMeetingList.pdf

970-306-6535

Therapists, Treatment Centers and Recovery Hubs

Aspen Strong Directory

Directory.AspenStrong.org

Use the “Issues” category of the filter tool to see providers valleywide who specialize in addiction, alcohol and substance use.

Narcan Access and Training

High Rockies Harm Reduction (Carbondale)

HighRockiesHarmReduction.com

In the event of an overdose emergency, call 911.

kwilliams@aspentimes.com

Recursos de longevidad: Llegar a la comunidad latina y viceversa

Discovery Cafe Executive Director Gabe Cohen offers feedback to a member at Monday afternoon's recovery circle meeting at the Colorado Mountain College Rifle Campus.
Chelsea Self / Post Independent

Estrella Portillo sabe que buscar asistencia de salud mental inmediata en relación con la comunidad latina es un gran desafío.

Portillo, una latina de 28 años que se mudó al valle de Roaring Fork desde México cuando tenía 12 años, enfrentó estos desafíos casi de inmediato.

“He luchado contra la depresión y la ansiedad durante mucho tiempo,” dijo. Aunque se dio cuenta y comprendió cuáles eran estos síntomas mentales, se les atribuía un estigma aparentemente impenetrable. “Porque en mi familia, si has aceptado que tienes una enfermedad mental, entonces eres débil.”

La graduada de Glenwood Springs High School dijo que, de adultos a niños, los latinos son reacios a recibir la atención y los recursos adecuados que necesitan para cualquier tipo de problema de salud mental, incluido el abuso de sustancias y el suicidio.

“Vengo de una familia de inmigrantes y la salud mental es simplemente inexistente,” dijo. “Es algo de lo que no se habla en las familias latinas. Simplemente lo ocultamos bajo la alfombra.”

Portillo toma clases en Naropa University en Boulder y recientemente ha estado investigando formas de fomentar una mayor conciencia sobre la salud mental entre la comunidad hispana del valle de Roaring Fork. Su investigación hasta ahora ha descubierto barreras como la negligencia, el acceso a seguro médico y el idioma que conducen a importantes desafíos de salud mental.

NOTA DEL EDITOR: El Proyecto Longevidad (Longevity Project) es una campaña anual para promover el debate sobre lo que se necesita para vivir una vida larga y satisfactoria en nuestro valle. El proyecto de este año se centra en la salud mental. The Aspen Times y el Post Independent de Glenwood Springs se asociarán durante el próximo mes, y exploraremos temas de salud mental, incluidos recursos (hoy), abuso de sustancias (3 de septiembre), prevención del suicidio (10 de septiembre) y aplicación de la ley (septiembre 17).

Nuestro proyecto culmina con eventos el 20 de septiembre en Aspen (6 p.m.) y Rifle (mediodía) con un panel de discusión de líderes locales y el orador Kevin Hines. Como orador mundial galardonado, autor de best-sellers, realizador de documentales y defensor de la prevención del suicidio y la salud mental, Hines ha llegado a millones con su historia de una supervivencia poco probable. Dos años después de que le diagnosticaran trastorno bipolar, intentó quitarse la vida saltando desde el puente Golden Gate. Desde que se inauguró el puente Golden Gate en 1937, miles de personas han intentado suicidarse saltando. Solo han vivido 34, y él es uno de ellos. Para obtener más información o para registrarse para los eventos locales, visite: PostIndependent.com/longevity.

Discovery Cafe member Miranda Gowetski listens to feedback during the recovery circle meeting on Monday afternoon.
Chelsea Self / Post Independent

“Vienen aquí para trabajar y tener una vida mejor para sus familias o para ellos mismos, y están huyendo de algo importante, ya sea una experiencia traumática, violencia, pobreza,” afirmó. “Y todo lo que hacen aquí es trabajar. … No saben cómo darse el espacio y el tiempo para trabajar en sí mismos emocionalmente.”

“No sienten que tengan a alguien en quien confiar,” agregó.

Ver también: A medida que persiste la pandemia, aumentan las necesidades de salud mental en los condados de Garfield y Pitkin

Para algunos, también existe la barrera del idioma.

“Definitivamente creo que se necesitan más profesionales bilingües,” dijo Portillo. “Y en todas partes, desde policías hasta enfermeras, terapeutas, trabajadores sociales y solo personas que están creando conciencia—no es suficiente.”

Leslie Venegas está tratando de resolver este dilema. La latina bilingüe dirige el programa Celebrate Recovery en New Castle y es especialista entre iguales en Mind Springs Health en Glenwood Springs.

“Veo mucha necesidad de la comunidad hispana, así que me he encontrado con muchas personas que necesitan recursos,” dijo. “O no están informados o no hay muchos recursos disponibles para ellos.”

Venegas dijo que simplemente hay más recursos disponibles para la comunidad de habla inglesa.

“Y hay muchos hispanos que no hablan inglés, o que no se sienten cómodos al acudir a alguien que no tiene el mismo origen que ellos, porque somos una cultura diferente,” explicó.

Aaron Braaiz talks about his recovery at the Discovery Cafe recovery circle meeting on Monday afternoon at the Colorado Mountain College Rifle campus.
Chelsea Self / Post Independent

Celebrate Recovery es un programa de recuperación de 12 pasos basado en el cristianismo diseñado para ayudar a cualquier persona que esté luchando con “heridas, dolores o adicciones de cualquier tipo,” de acuerdo con la misión que aparece en línea. Mientras tanto, Mind Springs Health es el mayor proveedor de asesoramiento y terapia para el bienestar mental en el oeste de Colorado.

Al igual que Aspen Strong, Celebrate Recovery ofrece un servicio de llamadas 24 horas al día, 7 días a la semana para las personas que solicitan asistencia inmediata, así como opciones de tratamiento adicionales. Y con personas como Venegas al frente, ayuda a llegar mejor a la comunidad latina.

“Prácticamente me encuentro con personas que están luchando contra el trastorno por uso de sustancias o la salud mental”, dijo Venegas. “Es un tipo de sistema de apoyo que les ayuda a conectarlse con diferentes personas o sistemas de apoyo.”

“Somos un recurso realmente bueno para la gente, porque hemos estado allí,” agregó.

RECURSOS

Nota: Recursos tomados de un mapa de salud mental disponible en AspenStrong.org

Asesoramiento, Terapia, Gestión de Casos

Aspen Strong

• Cómo obtener ayuda: Call 970-718-2842 o visita AspenStrong.org.

Mountain Family Health Center

• Cómo obtener ayuda: Call 945-2840 o visita MountainFamily.org.

Mind Springs Health

• Cómo obtener ayuda: Llama a la oficina en Aspen al 970-920-5555 o a la oficina en Glenwood Springs al 970-945-2583. También, visita MindSpringsHealth.org.

Líneas directas las 24 horas

Servicios para Crisis en Colorado

• Llama al 1-844-493-8255 o envía un texto a TALK al 38255.

Hope Center

• Aspen: 970-925-5858

• Eagle: 970-306-4673

• Garfield: 970-945-3728

Dolor y Pérdida

• Pathfinders: 970-925-1226

Niños y Familia

• Aspen Family Connections: 970-205-7025

Centro de Recursos Familiares

• Oficina en Roaring Fork: 970-384-9500

• Oficina en Parachute: 970-285-5701

Servicios en español

Mind Springs Health

• Oficina en Aspen: 970-920-5555

• Oficina en Glenwood Springs: 970-945-2583

Mountain Family Health Centers

• Llama al: 970-945-2840

Aspen Strong

• Directorio de terapeutas: 970-718-2842

Discovery Cafe

• Llama al: 719-650-5978 y platica con Gabe Cohen.

• Envía un Email a Cohen a la dirección: gabe@discoverycafe.org.

• Visita DiscoveryCafe.org.

• Visita Discovery Cafe en el campus de Colorado Mountain College en Rifle al 3695 Airport Road, Rifle.

West Mountain Regional Health Alliance

• Llama al: 970-429-6186

• Visita WestMountainHealthAlliance.org/covid/

Puedes contactar al reportero Ray K. Erku al 612-423-5273 o rerku@postindependent.com.

Longevity part 3: Investing in access

Specialized labs, a new heliport and cancer treatment options are just a few of the access-to-health care improvements made both in the high country and on the Western Slope in the last two decades.

By investing in staff, facilities and transportation, Valley View Hospital in Glenwood Springs reduced its patients’ need to travel for specialized care, said Dr. Frank Laws, an electrophysiologist and interventional cardiologist at Valley View.

On the other end of the Roaring Fork Valley, Aspen Valley Hospital consolidated several health care services into one campus, providing a single destination for its patients’ care needs, Aspen Valley CEO Dave Ressler said.

Many of Colorado’s recent leaps and strides toward better, more accessible health care were facilitated in part by the state’s expansion of Medicaid under the Affordable Care Act in 2013, said Cara Welch, the Colorado Hospital Association director of communications. 

Rural hospitals provide the foundation of health care throughout the state, but on the Western Slope, those hospitals can play an even larger role when requiring special services could mean an hours-long trip to Denver or Salt Lake City, Utah.

In the rare life-or-death situation, time spent on the road can play a deciding role in the outcome. On the flip side, people with special care needs, such as oncology, cardiology and chronic pain management, often choose where to live based on the services available within the area.

These factors combined with the rising cost of health care have contributed to a growing demand outside the metropolitan centers.

“Access to care is a major issue right now,” Laws explained. “A lot is economics, a lot of it is distance, but across the board the need is the same.”

Glenwood Springs

Valley View Hospital’s heart and vascular cath lab brings patients from around the region as well as internationally.
Courtesy of Valley View Hospital

When Laws hired on with Valley View in 2006, many of the hospital’s patients were traveling to Denver or out-of-state for some of their cardiology needs, he said. 

“I was recruited to enhance Valley View’s cardiovascular services and start a cardiac catheterization laboratory (cath lab),” Laws explained. “Learning how far people had to travel for certain services and procedures was a big eye-opener when I came here.”

A cath lab is a facility with diagnostic imaging equipment used to visualize the heart’s arteries and chambers as well as treat any abnormalities found. 

As an interventional cardiologist, Laws provided the expertise needed to run the lab. Additionally, the facility drew more specialists to the hospital. Valley View’s cath lab was up and running by February 2007, just a few short months after Laws arrived. 

The hospital also built a heliport in 2006, creating the ability to ensure patients with needs beyond the services provided could receive timely care.

“Prior to the heliport construction,” Laws said, “if you needed to be transported anywhere by air, we had to take you by ambulance to the airport in Rifle and catch a flight from there.”

During a year-long sabbatical in 2014, Laws studied cardiac arrhythmia at the Tufts University School of Medicine. 

Upon returning to the Glenwood community with his newly earned expertise, Valley View was able to start treating atrial fibrillations, a chaotic arrhythmia that arises in the heart’s top left atrial cavity, Laws said.

“Atrial fibrillation is very common in the mountains because of the prevalence of sleep apnea,” he explained. 

The combination of services, specialists and equipment added since Laws’ arrival in Glenwood served to reduce travel times for patients, but also attracted new patients from around the globe.

“The fact that we have created a destination program also provides an economic impetus for the area,” Laws said. “Having these services nearby reduces stress on the patients and the family’s that often have to care for them throughout treatment.”

Aspen 

Dr. Heather Murphy conducts a “virtual visit” with a patient as part of Aspen Valley Hospital’s telemedicine services and commitment to expanding health care access throughout the area.
Courtesy of Aspen Valley Hospital

Three phases into a four-phase master facility plan, Aspen Valley has endeavored to consolidate Pitkin County’s health care services into one convenient location, Ressler said. 

“Our hospital’s vision is to foster our community as the healthiest in the nation,” he said. “We are looking at our social responsibility as a community-owned organization very differently than hospitals traditionally have in the past.”

As part of a special tax district, the hospital receives a portion of property taxes collected around Pitkin County to fund its operations. 

One of Aspen Valley’s tenets is increased access to primary care, which was a focus during its recent expansions.

“Nowadays, data and evidence better illustrate the amount of total health care costs that can be contributed to chronic conditions,” Ressler said. “By taking a more holistic approach, a primary care practice can have greater impacts on the individuals willing to manage their lifestyles.” 

Constructed in 1977, the hospital has undergone a number of expansions in recent years providing space for in-house ear, nose and throat services, expanded cardiology services, ophthalmology and primary practices.

The campus also leases space for general surgery, orthopedics, obstetrician/gynecologists, a pain clinic, rheumatology, pulmonology and endocrinology, Ressler said. 

“By locating practices here on the campus, a patient can have adequate parking, and get all of their services done in one location,” he said. “Breast health is another example of where we have expanded. Our patients used to have to travel to Denver for breast biopsies and ultrasounds.”

While the pandemic reinforced the need for quality tele-health services, Aspen Valley was investing in its long-distance health care options prior to COVID-19.

Using an electronic platform, eClinicalWorks, the hospital enhanced its abilities to track medical records digitally.

“The improvements we made to our services in the last 10 years removes barriers to care,” Ressler said.

Statewide 

Keeping Colorado’s rural hospitals open is one of the best ways to ensure residents maintain a high level of access to care, Welch said.

“We’ve seen a lot of rural hospital closures around the country, but that’s not happening here,” she said. “That is in large part because the state was quick to step up and expand Medicaid.”

A rural hospital has not closed in Colorado since the ’80s, according to the hospital association’s data.

Welch said community support and strong hospital leadership also played major roles in keeping Colorado’s hospitals open.

“Collaboration of our hospitals as a system is another factor,” Welch explained. “At times, they may compete for some business, but they collaborate in a number of ways that benefits all the hospitals throughout the state.”

Those efforts have paid off in a number of ways, particularly with reducing the need for patients to travel, Welch said.

“A lot of the higher acuity specialty care do still tend to come to the Denver Metro area,” she said. “But, all our hospitals have really focused on what services they need to provide their communities, so people don’t have to travel as far.”

Editor’s note: This is part 3 of a four-part series on longevity in the High Country. The series is being produced in partnership with the Glenwood Springs Post Independent, The Aspen Times, Vail Daily, Summit Daily News and Steamboat Pilot. Read more at postindependent.com/longevity

An unclear correlation: Colorado clinicians and researchers talk Alzheimer’s and other dementias risk, care in mountain communities

It isn’t noticeable at first, starting with changes to the brain that the brain can compensate for, meaning no real impact on day-to-day functions or cognition.

But as time passes the brain can no longer compensate for these changes and the damage it’s experiencing. Subtle problems with memory and thinking begin to pop up. Subtle turns to noticeable. Noticeable turns to inhibiting the ability to carry out everyday activities and eventually to requiring around-the-clock care.

This is the broad view progression from pre-clinical to severe Alzheimer’s disease, a degenerative brain disease that becomes worse with time and age, and is the most common cause of dementia, as explained by the Alzheimer’s Association.

In Colorado, an estimated 76,000 people are living with Alzheimer’s dementia, and that number is expected to increase 21% to 92,000 by 2025, a 2020 Alzheimer’s Association report states. As of July 2019, 14.6% of Coloradans or roughly 840,000 people were 65 or older, U.S. Census data show.

But while generally speaking it’s been shown that living in higher altitude communities in places like Colorado can lead to a more active, healthier lifestyle and even prolonged life, how does living at altitude impact and correlate with degenerative brain diseases that cause dementia, like Alzheimer’s?

In short, the answer is complicated and not well researched by scientists and clinicians, as explained by Dr. Huntington Potter, director of the Alzheimer’s and Cognition Center at the University of Colorado Anschutz Medical Campus.

“As far as I know, there isn’t a lot of evidence one way or another about high altitudes versus low altitudes for Alzheimer’s disease risk,” Potter said. “We can’t say one way or another whether high altitude is a risk factor for Alzheimer’s.”

DEMENTIA AT ALTITUDE

Alzheimer’s disease is namely the result of the accumulation of the protein fragment beta-amyloid outside of neurons in the brain and of an abnormal form of the protein tau inside neurons, as described by the Alzheimer’s Association.

These accumulations over time can contribute to the damage and death of neurons by interfering with neuron-to-neuron communication at synapses, an Alzheimer’s Association report says, and can block the essential transport of nutrients and other essential molecules inside neurons — resulting in early symptoms of memory loss, apathy and depression; later symptoms of impaired communication, disorientation, confusion, poor judgment, behavioral changes; and ultimately difficulty speaking, swallowing and walking as neuron damage gets worse.

At the Alzheimer’s and Cognition Center, which is part of both the CU Anschutz Medical Campus and School of Medicine, clinicians and researchers are dedicated to discovering effective early diagnostics, preventions, treatments and ultimately cures for Alzheimer’s disease and related neurodegenerative disorders, according to its website.

For Potter, that means looking at biomarkers or diagnostic proteins in the blood that can help clinicians predict the disease earlier; conducting projects that look at the longitudinal sort of lifespan of people with Alzheimer’s disease; and other research that can quickly be translated to better care, treatment and hopefully a cure.

Right now, the center is studying a drug called Leukine, which preliminary data shows may actually improve Alzheimer’s disease in the short term, Potter explained. The center also is studying other drugs that attack the disease, which so far are looking very promising as well.

“Leukine may be the first one we found that looks promising but we have several coming up that look promising as well,” Potter said.

“It’s been a tremendous privilege to work with all of the clinicians and scientists and scientist clinicians at the Alzheimer’s and Cognition Center, and we’re absolutely determined to make Colorado one of the places that discovers the cure for Alzheimer’s disease.”

When it comes to looking at the potential correlation between living at high altitude and the risk for Alzheimer’s and other dementia-inducing diseases, Potter and Dr. Peter Pressman of the Alzheimer’s and Cognition Center said it would take great effort, time and funding to research.

Pressman, who is a behavioral neurologist and researcher with the center, said on top of securing and carefully selecting a large group of people living at altitude to participate in a study, researchers would also have to follow that group for around a decade to get meaningful results — which is not impossible, but not easy.

“It’s easy to fund a study for a few years. People give you money to do something for two to three years, but two to three years is not enough time for a process as slow as Alzheimer’s and dementia to really even pick up,” Pressman said. “I’m not saying that’s not possible, it’s doable, but it would take some effort.”

Dr. Brooke Allen, neurologist, founder of Roaring Fork Neurology in Basalt and medical director at Renew Roaring Fork, an assisted living and memory care center in Glenwood Springs, expressed similar thoughts.

Allen said as a part of any mild cognitive impairment or dementia evaluation, her team checks the oxygen level a patient has and considers the altitude at which that person spends most of their time.

Lower oxygen levels can certainly contribute to people experiencing confusion, dizziness and mild short-term memory issues. But outside of looking at oxygen levels and how they could be contributing to symptoms, Allen said she doesn’t consider altitude a higher risk situation.

“I’ve never really personally looked and it … but I think doing a retrospective sort of epidemiology review would probably make sense at first to even see if there’s a need to research it,” Allen said.

At Roaring Fork Neurology, where Allen and her team diagnose and treat headaches, migraines, concussions, Parkinson’s disease, dementia and other disorders of the nervous system, about 25% of the practice is treating patients with some sort of dementia or mild cognitive impairment, Allen said — a percentage that’s stayed fairly stable over the past 10 years she’s been working in the Basalt area.

This mild cognitive impairment means patients haven’t lost the ability to carry out the activities of daily living, but are having some trouble with things like using new equipment, not being able to work a remote control or having more trouble with finance calculations, Allen said.

To treat patients experiencing this mild cognitive impairment, Allen’s team first looks at risk factors like age, gender and DNA, which are not modifiable but are contributors; high blood pressure, diabetes, sleep apnea, high cholesterol, obesity, and exercise levels, which are modifiable; and B12 levels, signs of infection, a potential brain tumor or structural abnormality and oxygen levels, factors which can “reverse” the symptoms being experienced if they exist and are addressed.

But overall, Allen said she feels Roaring Fork Valley residents 65 and older tend to be much younger than their age in terms of their lifestyle, which is a positive in terms of dementia prevention.

About four years ago, Allen and her team conducted a long-term pre-clinical Alzheimer’s trial as part of the Alzheimer’s Prevention Initiative’s Generation Program, a study that looked at the effectiveness of preventative treatments for individuals between 65 and 75 who had no symptoms of dementia.

Allen said over 250 people came in to participate in the study and all generally led healthy, active lifestyles.

“I think in our valley, I’ve experienced meeting those kinds of people and not thinking of altitude as a risk factor but as a lifestyle opportunity in a rural area like ours,” Allen said of the people who participated in the recent study.

Looking at this potential correlation between living at high altitude and risk of Alzheimer’s dementia and others is not just a difficult feat for Colorado researchers — little research with concrete findings exists nationally and globally as well.

One study published in 2015 by Dr. Stephen Thielke in JAMA Psychiatry looked at deaths attributed to Alzheimer’s dementia reported in 58 counties in California to try to determine whether rates of dementia were associated with average altitude of residence. The study found that the counties at higher elevation generally had lower rates of dementia mortality.

“Oxidative abnormalities have been long proposed to be central to the pathogenesis of dementia,” the study research letter states. “One group of researchers previously found that hypoxia prevents neurodegeneration in rats in experimental Alzheimer disease and hypothesized that adaptation to induced hypoxia may prevent dementia. To our knowledge, our work is the first to find epidemiological evidence for such effects. Additional work is needed to determine whether this relationship holds in other populations.”

But beyond this study, there isn’t much conclusive evidence for or against a correlation, as emphasized by Dr. Brent Kious, a psychiatrist, assistant professor and researcher with both University of Utah Health and the school’s Department of Psychiatry.

Kious has studied the link between living at high altitude and major depressive disorder, anxiety and suicide, and said he and his research team have been interested in the impact of altitude on the incidence and median age of onset of Parkinson’s disease, but has not studied this impact or the effects of altitude on dementia risk.

However, Kious said decrements in cognitive performance due to chronic exposure to moderately high elevation might not necessarily translate into an increased risk of dementia, since the symptoms of dementia depend both on baseline cognitive performance and on pathological neurodegenerative processes.

“It is not clear whether altitude would affect those neurodegenerative processes or not, though there is some reason to think that they involve oxidative damage … so relative hypoxia might slow them,” Kious said via email. However, he went on to note that relative and prolonged hypoxia has also been associated with dementia risk, too. “In any case, a good epidemiological study of the association between altitude and dementia should control for things that might be associated with both.”

BETTER UNDERSTANDING AND ACCESS TO CARE

While there may not be good data for or against high altitude as an Alzheimer’s and dementia risk factor, there is evidence that people living in more rural communities do not have the same access to dementia care and treatment as those living in urban areas.

According to the 2020 Snapshot of Rural Health in Colorado, produced by the Colorado Rural Health Center, 721,500 people are living in rural Colorado and 19% of the rural population is age 65 or older. Rural is defined as a non-metropolitan county is no cities over 50,000 residents, the snapshot report says.

In Pitkin County, which is considered rural, 20.3% of the population is 65 or older, according to 2019 census data. And while Chad Federwitz, a gerontologist — specialist in the field of gerontology, or study of aging — and manager of Pitkin County Senior Services, says Alzheimer’s dementia and other dementias aren’t really prevalent locally and that he hasn’t seen any correlation or link between living at high altitude and dementia risk, he does know anecdotally that people may move downvalley, to Grand Junction or the Front Range if they have onset or early dementia because of lack of care resources in the upper Roaring Fork Valley area.

“Given the nature of our rural-ish community, we don’t have the same resources,” Federwitz said, referring to things like long-term assisted living and memory care options, professionals trained in Alzheimer’s disease, dementia and gerontology, and at-home caregiving service providers. “You can go to Grand Junction or the Front Range and have pages and pages of resources, as a opposed to (a handful or so) here.”

Before Federwitz started as the manager of Pitkin County Senior Services, he spent about seven years working in dementia care in the Boulder area, and is an Alzheimer’s Association community educator.

He said he feels education and access to informed and professional dementia and memory care is extremely important for Alzheimer’s and other dementia patients especially because there are still a lot of misconceptions surrounding what Alzheimer’s and dementia are, and unique challenges that come with caring for someone who has a degenerative brain disease.

Allen expressed similar thoughts, noting that a big part of dementia care and treatment is caregiver access and preventing caregiver burnout, especially with more severe states of dementia.

She said she feels a lot of times where people with dementia live in relation to their support system “matters in terms of their outcomes.” And while Allen feels there are an unusually large number of people that live in the Roaring Fork Valley that don’t have family in the valley, many people do tend to have good support networks through friends, which is important if that person is experiencing dementia.

“It really does take a village to help individuals cope with the changes happening in the brain and a lot of times that’s really picked up by a friend,” Allen said. “Oftentimes adult children of these individuals don’t live here, but we try to identify someone to support them, and there certainly are resources in the valley for homecare and private caregivers.”

But while there are some dementia care resources in the Roaring Fork Valley and other more rural Colorado communities, the Alzheimer’s and Cognition Center is working to do more to develop meaningful relationships with health care providers and dementia patients in the state’s mountain communities as part of its mission.

According to Pressman, who is heading this charge on behalf of the CU center, a lot of projects are in the planning stages and process of acquiring funding, but include virtually educating medical providers, nurse practitioners and primary care doctors on Alzheimer’s and general healthy brain aging, and mutual, participatory research with rural Colorado communities and communities of color.

Pressman explained that a lot of research related to Alzheimer’s overwhelmingly is based on middle class, well-educated, white participants. And so while researchers think they know a lot about the disease in general, they really only know about the disease related to this demographic group.

Through the center’s outreach and efforts to better connect with underrepresented communities, Pressman hopes to conduct better science and better serve the larger Colorado community.

“What motivates me is trying to do good work, trying to do good science and to makes sure our results actually represent real life,” Pressman said. “We want to make sure we’re helping everybody, not just a niche group, and that our services are available equitably to as many people as possible.”

Although there’s no clear correlation between living in higher altitude, mountain communities and dementia and Alzheimer’s risk, it is clear that as America’s aging population reaches 65 and older, these medical conditions will remain a relevant risk for seniors.

And with this continued risk and prevalence comes a need for more education, more research, more awareness and more connections surrounding the conditions, according to Federwitz.

“We all agree dementia is a horrible thing that can be overly daunting for everyone connected … but you as a person with a family member who has dementia or as a person with dementia, you’re not alone,” Federwitz said. “In my opinion and experience, there are hidden blessings. Joy can still happen. Happiness can still happen, laughter can still happen, genuine connection can still happen, even if all of those things happen in a moment.”

Editor’s note: This is part 2 of a four-part series on longevity in the High Country. The series is being produced in partnership with The Aspen Times, Vail Daily, Glenwood Springs Post Independent, Summit Daily News and Steamboat Pilot. Read more at aspentimes.com/longevity.

New procedures for old bones: Orthopedics helps aging population keep moving

Vail resident Harvey Simpson skied roughly 30 days this last season. It was a fraction of the 100-day seasons he enjoyed a few years ago, but it was, of course, an abbreviated season.

Also, Harvey is now 94 years old.

“I’m looking forward to next season,” he said. “Getting back up to 75 days again.”

For Simpson, skiing is the activity that keeps him young. And skiing is indeed, oftentimes, a young person’s sport, which no doubt helps Simpson feel young while he’s doing it. But the fact that he has some kind of activity keeping him going is the more important part, said Gini Patterson with Timberline Adult Day Services in Frisco.

“Whether you have a history of a physical impairment — we’ll call that a total joint replacement — or a mental issue like memory loss, it’s so important to stay active, mentally and physically,” she said.

Simpson has had two total joint replacements, one on each hip. He said he wouldn’t be skiing without them.

“The pain was just too great,” he said.

Following his second hip replacement, Simpson took a hard look at his technique. Now that he was skiing pain-free, would it be possible to be a better skier at 90 than he was at 80? It was, indeed, possible, said his coach, Gunnar Moberg. With a renewed focus on technique, Simpson hit the slopes with a new passion. His advice to aging skiers: “Improve your technique, and don’t fall.”

Ski racing at 85

A combination of improved technique and total joint replacement technology has made masters ski racing more competitive than ever, especially in the older age categories.

Eagle resident Charlie Hauser, bored with traditional skiing, took up the competitive side of the sport in his 70s.

Now 85, he is preparing to enter a new age category as a downhill ski racer, after competing in his last race in the 80-84 division in February. He says there’s more ski racers competing into their 80s than you might think.

“We’ve got all sorts of people with a couple of (replaced) knees or a couple of hips, or all four of them,” Hauser said. “These people just keep going.

“One of the greatest things that have happened is total joint replacements,” Hauser added. “It has taken people who would have been absolute cripples, and restored them to functionality. These people that have had total joints would not be competing otherwise, none of them.”

Hauser, himself a former surgeon, says the culture in the High Country of Colorado is different when it comes to being active.

“The orthopedists here are replacing joints because they want their patients to go back to skiing, and go back to their other activities,” Hauser said. “In other parts of the country, which aren’t as familiar with this, they’ll say ‘we’re replacing this, but you can’t ski anymore.’”

Recreation expectations

The Steadman Clinic’s philosophy, “keeping people active,” has been the company’s goal since Dr. Richard Steadman first started performing microfracture surgery in Vail in the early 1990s.
Special to the Vail Daily.

Dr. Ray Kim, an orthopedic surgeon who replaces hips and knees at The Steadman Clinic in Vail, said the expectations placed on orthopedists across Colorado’s High Country are more than you’ll find in other areas of the country or even the state.

Kim worked in Denver before moving to Vail.

“The patients that I took care of in Denver were different compared to our patients up here in the mountains,” Kim said. “Not that the folks in Denver are not active, I think in general people from Colorado enjoy recreation and are active, but I do think the activity expectations and demands of our community up here in the mountains is at a higher level. We just have a very high percentage people who are aggressive skiers, aggressive hikers, aggressive cyclists, it’s just part of the thread of our community here. People just really worship recreation.”

Kim says when patients visit him from outside of the community, often times it is because they are aware of that culture.

“We have folks that have flown in from other parts of the country and even from outside the country that understand the recreational culture here in Vail, and seek out having a knee or hip replaced because of our understanding of that philosophy,” Kim said.

Kim said that was also what attracted him to The Steadman Clinic.

“Richard Steadman’s vision of keeping people active … his whole goal was to get them back on the ski mountain,” Kim said. “And we’ve kept that tradition going over the years, in multiple different disciplines. His specialty was obviously knee preservation, but the clinic has expanded that to include everything from spines to hands to foot and ankle.”

Keeping people active

A patient with The Steadman Clinic enjoys some powdery turns on Vail Mountain during the clinic’s ski day for patients in January of 2020.
Special to the Vail Daily.

The Steadman Clinic still uses the slogan “keeping people active,” which was based on Steadman’s philosophy.

“We know there’s huge advantages to keeping people active, there’s a lot of benefits from a cardiac standpoint, from a bone density standpoint, from a fitness and weight loss standpoint, and now there’s recent studies looking at behavioral health advantages to staying active,” Kim said.

For some aging people, Patterson said a big knee or hip replacement surgery may not be possible. That’s why she embraces a philosophy based on Olympic silver medalist skier Jimmy Huega’s “can-do” effort to stay active following his diagnosis with MS.

“Do what you can do to stay active,” she said. “That philosophy applies whether you’re in your 20s and diagnosed with MS, or you’re in your 90s and your mind is not working as sharply as it used to. What can you do?”

Patterson is currently caring for a 97-year-old woman at Timberline.

“She is still physically active, and still walks,” Patterson said.

Kim said he believes that the longevity people enjoy in the mountains is directly linked to the dedication people in the high country of Colorado have to staying active.

“The higher activity level drives better health and longevity,” he said. “I just can’t find any other explanation.”

Recent suicide ‘cluster’ in Roaring Fork Valley prompts concern by officials

Public health officials expressed concern last week after four Roaring Fork Valley residents died by suicide in the past month, including three deaths in a five-day period.

“That’s a lot,” said Jess Beaulieu, Pitkin County’s mental health program administrator. “This is really unusual. It’s a cluster of suicides.”

It began with a suicide in Carbondale in late September, according to law enforcement sources and Michelle Muething, executive director of the Aspen Hope Center. However, three more deaths occurred beginning Oct. 9 with a man found in Aspen, followed by the suicide of another man Oct. 11 in Snowmass Village and a third Sunday in Basalt, according to Snowmass Village Police Chief Brian Olson, Aspen Police Officer Braulio Jerez and Muething.

“Four different people, four different ages, four different walks of life, four different life circumstances,” Muething said. “We always seek questions of why. I don’t know if there are any answers.

“Life is tough.”

Many involved in law enforcement and mental health in the Roaring Fork Valley pointed to the offseason as a possible source of emotional trauma. Social networks can break down as people’s jobs and housing are interrupted by the slow-down, leaving instability or more downtime as a consequence, Beaulieu said.

“All of that can contribute to mental illness or a lack of mental health,” she said.

Whatever the source, the problem appears to be getting worse.

Law enforcement in Aspen, Pitkin County and Snowmass Village responded to 199 mental health-related calls in the past three months, Beaulieu said.

“That is a really big number,” she said. “There were 78 calls in September, which was higher than (those in) July and August.”

Aspen Valley Hospital is seeing double the number of mental health-related cases this year over last year, Beaulieu said. And not only are the number of mental health calls rising, so is the severity, she said. Doctors are seeing more acute mental health cases requiring what is known as an “M-1 evaluation,” which means the person is unstable enough to be evaluated at the psychiatric hospital in Grand Junction, Beaulieu said.

Muething said she’s not sure how much stock to put into theories blaming the shoulder season for an uptick in suicides.

“It’s a theory,” she said. “(But) it’s not what prompted at least three of these (latest suicides) … which was mental health issues.”

The Aspen Hope Center offers emotional trauma counseling services in Garfield, Eagle and Summit counties, and none of those communities have experienced a suicide spike similar to the Roaring Fork Valley in the past month, Muething said.

“There’s a million theories about suicide,” she said. “The bottom line is if we knew how to prevent suicides, suicides would stop.”

The best way to stop a suicide is to reach out if you are worried about a friend or family member, Muething said. And if the first person you talk to isn’t receptive, keep reaching out until you find someone who is, she said.

“Become an advocate for someone you know is in trouble,” Muething said. “Don’t stop trying. Don’t assume you know someone and you think they’ll be OK.”

Suicide affects the wellness of a community as a whole, especially one as small the Roaring Fork Valley, Beaulieu said.

“I know five people who knew each of these people (who died),” she said. “Word travels quickly and it really rocks people’s worlds. It’s much more tangible and visceral than you would find in a larger, more urban landscape.

“There’s an awareness that it’s not just the suicides that are tragic, but there’s some sensitivity that this is really upsetting for those of us still here.”

Numerous resources exist for those in crisis. The Aspen Hope Center also offers trauma counseling for those left behind after a suicide.

jauslander@aspentimes.com

Longevity: Why there’s more depression, anxiety and suicide at high altitude

STEAMBOAT SPRINGS — Living in a mountain resort community above 8,000 feet certainly has its draws, but also its drawbacks. Rents are higher, affordable housing is hard to find, quality jobs are fewer and cost of living is more expensive.

All those factors contribute to the fact that high altitude living doesn’t always offer the stress-free lifestyle people are seeking or expect of a picturesque mountain community.

Steamboat Springs has a duality issue, in that, the normed behaviors of heavier drinking and drug use stand in stark contrast to an extreme focus on wellness and physical health.

Resort communities, in general, have a higher prevalence of substance use across the board, said Amy Goodwin, a licensed professional counselor and behavioral health counselor with UCHealth Yampa Valley Medical Center. That’s because of the norming trends for drug use.

The idea of being on a permanent vacation when living in resort communities contributes to a mindset that encourages indulgence patterns. Being surrounded by indulgence or overindulgence can influence what is believed to be normal behavior, she said.

Warning signs of suicide

Comments or thoughts about suicide (suicidal ideation)
Increased alcohol and drug use
Aggressive behavior
Withdrawal from friends, family and community
Dramatic mood swings
Impulsive or reckless behavior

Higher altitude can worsen mental health 

Observed behaviors and personal anecdotes suggest the initial mood experienced at altitude is euphoria followed by depression. Multiple symptoms can emerge over time, including irritability, anxiety and apathy.

That’s according to “Hypoxia,” a 1963 study conducted by Edward Van Liere and J. Clifford Stickney.

The initial euphoria is a result of increased dopamine, the neurotransmitter contributing to feelings of pleasure, when entering high altitude. Dopamine is a short-burning fire, and then it’s gone, Goodwin explained. 

“So, when the ‘Rocky Mountain high’ burns off, then what we’re left with is depleted dopamine and serotonin,” she said.

Most of the existing behavioral studies of high altitude effects, however, center on hypoxia, which is decreased blood oxygenation due to higher elevation. Studies suggest hypoxia could negatively alter serotonin metabolism, which, in basic terms, contributes to feelings of wellbeing and happiness.

Emotions, such as anxiety, grief and confusion, are more intensely felt at elevation because of the lower oxygen concentration. Serotonin helps humans put things into perspective. 

“Don’t sweat the small stuff — that’s a serotonin skill,” Goodwin said. “Without serotonin, we can’t put things aside.”

Distress signaling is an alarm, not a disease, she said.

“Whether it’s depression, anxiety, confusion or deep despair, those are alarms from our body that something is wrong,” she said.

The role of mental health providers is to help people figure out what has gone wrong when those signals arise. Goodwin stressed that people shouldn’t be afraid of those alarms but should learn to read and understand them.

Physiological effects of altitude have been studied for decades, but there have been few investigations of the associated mood and behavioral changes.

Goodwin agrees that altitude’s effect on mental health is an understudied area, with the answer to why the effects occur not being as well investigated.

“Philosophically, I think that our focus on mental health has been so much on neurotransmitters and the chemistry associated with that, that we have forgotten to look sometimes for causality,” she said. “Why can’t we look at why?”

It’s an endemic issue to the field of mental health research, she added.

“When we have the pharmaceutical companies running the research, they’re not going to be interested in altitude because they can’t give you a pill for altitude,” she said.

suicides statistics in Garfield country colorado
Statistics provided by Garfield County Public Health.

Being mindful

Cristen Malia grew up in Northern California and moved to Colorado when she was 18 years old.

Today, as a clinical mental health counselor at Minds in Motion in Steamboat, she performs human-centered therapy. The talk therapy incorporates several elements including teaching mindfulness.

Mindfulness has become a mental health buzzword. It is the psychological process of bringing one’s attention to experiences occurring in the present moment. It’s meant to focus a person on their thoughts, feelings and body sensations so as not to become overwhelmed by them.

It’s one of Malia’s main practices.

It’s about living life in the moment. Such a simple idea can have dramatic effects on a person’s mental wellbeing, Malia said.

As a longtime yoga teacher, Malia also tends to use the fundamentals taught in yoga during therapy, if a client is comfortable with that.

The mind-body connection is personally apparent to Malia, who developed Lyme disease, a tick-borne bacterial illness, while living in Colorado. Her chronic illness was intensified because of the low oxygen levels at higher elevation. Inflammation isn’t as easy to reduce at altitude.

“In my healing, I would often go to sea level and noticeably feel better there,” she said.

But it was never a mental burden because she was able to find healing at altitude by being outdoors.

“I feel that another element of my healing that made a profound effect was being able to be outside and in fresh air,” she said.

It’s a balancing act, she admitted. She realized the trade-offs she made when opting to live at altitude, specifically in Steamboat — a cost-benefit analysis, as she put it.

“Maybe the altitude compromises my oxygen intake and inflammation, but there are so many other pieces that I get benefit from,” she said of her high altitude surroundings. “There’s less emotional burden for me here because I love the mountains, I love nature, the things that Steamboat can offer.”

suicide-at-altitude

A thriving mind

Thriving at altitude isn’t just about physicality. It’s also crucial to focus on mental wellbeing.

Yoga, a globally popular practice, offers tools to encourage mental wellness. It’s not always just about postures but also learning how to breathe in an efficient and nourishing manner, said Malia, who is also a registered yoga teacher at Rakta Hot Yoga and Wellness Studio in Steamboat.

“(Breathing) impacts our nervous system and our mental health; it’s all connected,” she explained.

One of the biggest practices to enhancing mental wellness is rest, according to Malia.

“If we could all just slow down,” she said, “which is hard for people in this town to do — myself included in that. If we can rest as hard as we play, I think that would be really beneficial.”

But Malia is referring to deliberate and intentional rest. It’s not about scrolling through social media or zoning out in front of the TV, rather it’s taking a slow walk, sitting by the river, paying attention to aspens blowing in the wind.

“It’s the little things,” she said.

Mindfulness and meditation play into achieving that rest.

“The practice of mindfulness asks us to pay attention to what’s happening in our present moment experience,” she said. “When we get better at doing that … we can also get better at taking care of ourselves.” 

At that point, people become aware of what they need or come to the realization they’re going too fast or using energy unwisely.

“It doesn’t have to be in a state of meditation, but paying attention to the moment in a kind and compassionate way,” she said.

Despite the negative effects on mental health, people still flock to live in high altitude areas. That’s because, according to Goodwin, the human brain tends to focus on the positives; people want to know where to find happiness. And when considering the many aesthetics of the community and opportunities for recreation, “it would be really hard to talk the human brain out of focusing on that.”

“Hyperbaric hypoxia is a thing,” she said. “But I doubt that’s going to resonate over, ‘I can get a ski pass and hike the mountains every day.’”

24/7 Colorado Crisis Services

Local Crisis Hotline: 1-888-207-4004 or text TALK to 38255
National Suicide Prevention Lifeline and online chat: 1-800-273-8255