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How to mitigate the impacts of traumatic brain injuries in an aging population

Every year, an estimated 1.5 million people in the United States are diagnosed with a traumatic brain injury (TBI). For some, they may experience a mild concussion. For others, the impacts of brain injuries can be long-term or even deadly.

For those in the age group 65 years or older, the impacts of brain injuries can be the most severe when compared to other age groups. According to the National Library of Medicine, an estimated 80,000 people in this age group visit an emergency department each year with concerns of brain injury. 

One doesn’t need to be in the NFL or participate in extreme sports to endure the harmful affects a brain injury can have on the body. A simple fall, for some, can change the rest of their lives in the a blink of an eye.

Falls are the leading cause of TBI-associated death in the United States for women over 75 years old and men over 85 years old.

“Falls are one of the most common reasons why older adults get brain injuries,” said Krista Fox, occupational therapist at Aspen Valley Hospital. “And, it’s usually falls from just a standing height.”

The National Institute of the Aging estimates that one in four people ages 65 or older will experience a fall every year.

While no one can predict a fall, there are plenty of preventative measures one can take to better protect themselves.

According to Fox, there are three main areas to focus on when preventing accidents that could lead to TBI:

1.) Biologic

This population may experience muscle weakness, changes in their vision, changes in sensation of their feet, or alterations in equilibrium. With this, it’s recommended to see a physician if you notice any changes in your balance. In addition, physical exercise is highly recommended in order to build muscle and improve joint, tendon, and ligament flexibility, according to the National Institute of the Aging.

2.) Behavioral

Inactivity in this age group is a cause for concern when thinking about how to prevent falls. When someone is inactive, they may have slower reaction times, making falls more likely when active. By cultivating an active lifestyle, one can improve their overall health and balance.

3.) Environmental

Decluttering one’s home can significantly prevent falls. In addition to maintaining an organized space, it’s highly recommended that this age group make alterations to fall-proof their home. This can include having hand rails on both sides of a stair case, getting rid of rugs, and keeping electrical chords out of walkways. These small alterations may seem like insignificant improvements, but they can help save one’s life.

For more tips on how to fall-proof your home, read The National Institute of Age’s tip guide.

What to do if you’re a caregiver of an elder

While experiencing a traumatic brain injury is a significant injury, those who may have a TBI may not even know an injury has happened. One can experience brain fogginess as a symptom of their brain injury or not remember that a fall had occurred, making it challenging to recognize the severity their accident.

According to Fox, if you’re a caregiver of someone who may be significantly impacted by TBI’s, it’s important to ask questions like: “Have you fallen in the last year?” and “Do you have concerns with your balance?”

If you’re concerned that someone you know in this age group may have fallen, she recommends to bring them to a doctor.

“We always recommend that if you have concerns about falling as an older adult, or have concerns for a family member, to see your physician get physical therapy because it is clinically shown to help people,” she said.

Activities for seniors in Aspen

In addition to keeping in mind the three areas to prevent falls, seeing a doctor if you have concerns with your balance and coordination, there’s also groups for those 65 years or older can participate in here in Aspen to improve their overall health.

Pitkin County Senior Services Center offers balance, yoga, tai chi classes and more to seniors. Aspen Recreation Center offers a fitness program designed for seniors called Silver Sneakers.

To reach Kristen Mohammadi, call 304-650-2404 or email kmohammadi@aspentimes.com.

Traumatic brain injuries in the High Country: Nadine Adamson’s hopeful recovery

Editor’s note: This is the third of a weekly series The Longevity Project, a collaboration between The Aspen Times and the Glenwood Springs Post Independent.

In 2016, Aspen resident Nadine Adamson, 66, spent the Fourth of July in Aspen enjoying the parade in front of Jerome Hotel. The following day, however, changed her life.

On July 5, 2016, she was riding her bicycle on her way to pick up groceries from City Market. She was going to attend a potluck later that evening. She can recall her grocery list: organic spinach, berries, and nuts. What followed was a blur.

She learned years later that she biked her way across the river. She imagines she was taking in the beautiful mountainous terrain and perhaps lost sight of what was in front of her. On her way back from the store, she catapulted over the handle bars of her bicycle.

Her head hit the street first; the front of her skull fractured.

“My whole body flew over the handlebars,” said Nadine, who was 59 at the time.

“I was riding a bike without a helmet, which is something I can’t emphasize enough: Always wear a helmet when you’re riding a bike,” she said. “No matter how old you are, wear a helmet.”

Her friend, David, was bicycling home from work and found her lying on the ground. There was blood coming from her head and mouth. Her eyes were rolling back in her head.

She was rushed to Aspen Valley Hospital. Then, she flew in the Flight For Life helicopter to St. Anthony’s Hospital in Lakewood.

She was later told the doctors didn’t think she would live.

“I’m sure maybe with all the different vital signs that the doctors took, that’s why they really didn’t know if I’d survive the flight or not,” said Nadine. “Thank goodness I did. God had better plans for me.”

She has three daughters, one of whom took a photo of her while she was in the hospital.

“All I could think of was right away is how I must have scared my three daughters horribly,” said Nadine, after seeing the photo.

However, after the feeling of horror set in, she let out a chuckle. The metal rod coming out of her head reminded her of a television show she used to watch as a child called “My Favorite Martian.”

She spent two weeks at St. Anthony’s Hospital. Then, she was transferred to Craig Hospital in Denver.

In recovery, she had to go back to relearning the basics. She spent over a month relearning to walk. She relearned how to use the left side of her body, as she couldn’t quite open her left hand.

Learning to drive was one of the most lengthy recovery-processes, taking over a year. Her driving therapist, Lizzy Ransbottom, later told her that her treatment process inspired a new program at Aspen Valley Hospital.

“She said, and because of that, we’ve helped hundreds of people that have had TBI, accidents, or strokes,” said Nadine. “They’ve been able to incorporate that program to help several people. So, I think that’s a huge blessing.

“I’m so thankful and grateful for that.”

Despite the long recovery process, the devastating injuries, she knows her recovery is a miracle.

Nadine Adamson at St. Anthony’s Hospital following her bicycle accident.
Courtesy photo

Bicycling and Traumatic Brain Injuries

While many may think of brain injuries in connection to football, bicycling is actually the type of recreation in which traumatic brain injuries most commonly occur, according to The American Association of Neurological Surgeons. 

Nadine is one of an estimated 596,972 U.S. residents who went to the emergency department during the time 2009 through 2018 for bicycle-related TBIs.

While we cannot predict when an accident may occur, wearing a helmet while riding your bicycle has been proven time and time again as a way to mitigate the impacts of bicycle-related injuries.

According to a meta-analysis of 55 studies, “The use of bicycle helmets was found to reduce head injury by 48%, serious head injury by 60%, traumatic brain injury by 53%, face injury by 23%, and the total number of killed or seriously injured cyclists by 34%.”

Despite the benefits of wearing helmets, many still do not wear helmets while riding their bicycles. The Centers for Disease Control and Prevention surveyed 4,170 U.S. residents in the summer of 2012 and found that only “29% of adults and 42% of children always wore a helmet.” 

Colorado ranked No. 6 in the country in The League of American Bicyclists’ 2022 “report card” of the most bicycle-friendly states. Despite the popularity of bicycling here, Colorado state law does not require the use of helmets while riding a bicycle.

Exercise as Medicine

While Nadine was in recovery, her doctor told her that she would likely not be able to return to her long career as a real-estate agent in the Denver area.

“I have to agree with him on it when I think about it now,” said Nadine. “I think there was a lot more healing needed to happen over the next couple of years.”

Fortunately, she had another part-time career that she was told she encouraged to continue, teaching Zumba.

During her last week as an inpatient at Craig Hospital, her therapist scheduled her to instruct a Zumba class. Some of her friends from the Denver area, patients, and therapists came to the class, which was scheduled to be only 30 minutes long.

After instructing the class, Nadine learned she had led the class for 45 minutes, 15 minutes more than she anticipated.

“I handled it, and I think that they were pleasantly surprised that I did that so good,” she said. “I said, you know, that’s amazing.”

Now, six years following the accident, she instructs Zumba once a week in Aspen.

“It’s a happy thing,” said Nadine. “It just makes you feel really good.”

In addition to the emotional health benefits of Zumba, her doctor told her by teaching and participating in Zumba classes, she was creating new pathways in her brain.

“A neurologist at Craig Hospital showed me a scan they had of my brain, and there were two different dark areas there, and he said, ‘That will never come back,’” said Nadine. “So, to regain everything, to learn to adapt, learning to walk, and all that, plus the dancing and Zumba, it’s all really good because it’s building new pathways in my brain.”

The Longevity Project:

Brain Health & Injury 

The Longevity Project is an annual campaign to help educate readers about what it takes to live a long, fulfilling life. This year’s project will focus on the critical and relevant topic of brain health after injury.

Our panelists are experts in treating concussions and TBI. They will share the latest research, treatments, physical therapies and how concussions impact aging. Whether for themselves or someone they know, attendees will learn useful takeaways for optimizing brain health after injury.

WHEN: Nov. 10

WHERE: TACAW, The Arts Campus at Willits Willits

TIME: 5 p.m. Meet and Greet; 5:30-7 Panel Discussion

For ticket information: click here!

Nadine’s hopeful recovery

Nadine said her name translates to “hope” in French, in line with the kind of person she is and her preservation through her accident.

During the challenges of her recovery, she was frequently asked about her emotional state and whether she experienced depression or feelings of hopelessness. But, she always tried to look on the positive side of things.

“I’m a happy person,” she said. “I’m mainly just so grateful and thankful.”

She credits God, the neurologists and doctors, as well as the treatments available to her recovery.

To reach Kristen Mohammadi, call 304-650-2404 or email kmohammadi@aspentimes.com.

Preventing concussions in sports and the road to recovery if it happens

You can help prevent traumatic brain injury

Be sure to wear a helmet or appropriate headgear whenever you or your children:

  • Ride a bike, motorcycle, snowmobile, scooter or use an all-terrain vehicle;
  • Play a contact sport, such as football, ice hockey, or boxing;
  • Use in-line skates or ride a skateboard;
  • Bat and run bases in baseball or softball;
  • Ride a horse; or
  • Ski or snowboard.

Helmets should be age-appropriate, fit properly, be well-maintained, be worn consistently and correctly and be appropriately certified for protective use.

While there is no concussion-proof helmet, a helmet can help protect your child or teen, and adults, from serious brain or head injury. Even with a helmet, it is important to avoid hits to the head.

Source: Centers for Disease Control and Prevention

Returning to play after a concussion

A concussion is a type of mild traumatic brain injury caused by a forceful blow or jolt to the head or body that disrupts how the brain normally works. A person does not need to be knocked out or lose consciousness to have a concussion.

Many parents wonder if it is safe for their young athlete to return to playing football, soccer, lacrosse or other sports after a concussion. An appropriately trained health care provider can answer these questions and provide guidance on when it is safe and sensible for an athlete to return to sports.

Athletes should not be allowed to continue playing sports, including practices and conditioning, while recovering from a concussion for a variety of reasons:

Recovery time: In one study among high school athletes, athletes who were immediately removed from play after a concussion recovered twice as fast as athletes who continued to participate.

Worsening symptoms: Strenuous activity soon after a concussion has been associated with worsening symptoms.

Increased risk: Parents and young athletes should be aware that a second head injury while an athlete is recovering from a concussion can increase the risk of complications, including the potential for worsening symptoms and longer recovery.

Catastrophic brain injuries, such as those that result in death or permanent neurologic injury, are extremely rare in youth sports. Nevertheless, it’s important to understand that they can happen so that they can be identified immediately and appropriately managed.

Source: Children’s Hospital Colorado

The Longevity Project: Traumatic brain injury and concussion protocols in youth sports

Editor’s note: This is the second in a weekly series called The Longevity Project, a collaboration between The Aspen Times and the Glenwood Springs Post Independent. Read part 1, “Traumatic Brain Injuries in the High Country” in the Oct. 17 Post Independent.

Every high school sports sideline, courtside or team box in Colorado has an extra-special set of eyes and ears on the action.

While the coaches and players focus on trying to call or make the best play, athletic trainers are close by intently focused on the heads themselves.

If a player stays on the turf, floor or ice for an extended time after a play, or gets up a little wobbly, certain concussion protocols must be followed, per state law which is now written into the rules of the Colorado High School Activities Association.

“Sometimes you see a hit or a fall, or something that might cause a concussion, and it’s our job to assess the kid from there,” said Ryan Erickson, Certified Athletic Trainer (CAT) for Roaring Fork High School in Carbondale.

“Other times you don’t see what happened, but a kid will self-report or come over and say they’re not feeling right,” he said.

Then there are times when it’s not immediately obvious to the player or the sideline staff that an injury may have occurred, or, in the heat of game battle, the player won’t speak up right away.

That’s when those eyes and ears have to be especially astute in order to keep health and safety at the forefront of youth sports.

Erickson is part of a team of CAT’s sponsored by Valley View Hospital/Valley Ortho in partnership with the Roaring Fork School District to provide preventative services, emergency care, therapeutic intervention and rehabilitation for student-athletes at Glenwood Springs, Roaring Fork and Basalt high schools.

Erickson’s work, along with Marni Barton at Glenwood Springs and Mike McCann at Basalt, covers the gamut of sports-related injuries and medical conditions. But concussions and protection against traumatic brain injuries (TBIs) through very careful “return-to-play” policies and procedures are a major focus.

Roaring Fork High School Certified Athletic Trainer Ryan Erickson keeps watch on the action during a recent game.
John Stroud/Post Independent

At National Athletic Trainers’ Association conferences he’s attended over his 18 years as a trainer, Erickson said that about a third of the overall attention is given to concussive head injuries. That includes prevention, treatment and rehabilitation.

“It’s a major topic, and there is lots of new research coming out constantly,” he said.

The texts he used in college in 2005 on the topic might as well be tossed out, but not because the people who were researching and studying it at the time didn’t know what they were doing, he said.

“They were the leaders in research and the care of concussions,” Erickson said. “It’s just that so many new things have come to light, and we need to stay up with that.”

Concussion law

The Colorado Legislature in 2012 passed Senate Bill 40, or the “Jake Snakenberg Youth Concussion Act,” named after an athlete from Grandview High School in Aurora who died after suffering a concussion during a football practice.

The law laid out a series of measures and protocols to protect young athletes from head injury during sports, including:

  • Requirements for coaches to take annual training around proper concussion protocol.
  • Immediately removing athletes from play who sustain a suspected concussion, and not allowing them to return to a game or practice the same day.
  • Notifying parents if their child has been removed from play due to a suspected concussion, and providing them with information about signs and symptoms so that they can monitor their child at home.
  • Ensuring that a health care provider evaluates the player and gives written clearance for them to return to play, including practices and games.
Glenwood Springs Demon football players practice high knee drills during a recent after school practice.
Chelsea Self/Post Independent

Kim Gorgens is a neuropsychologist, board-certified in rehabilitation psychology, and also a professor for 22 years at the University of Denver. She helped write Jake’s Law, and continues to be a brain injury policy advocate.

“At the time, Colorado was really out in front in responding to the risks due to concussions in sports,” she said. “There’s been a real push since then to quantify the risk for players, so that those in charge can make the right decisions.”

Gorgens gives TED Talks on the subject, focusing on preventative measures in youth sports, from pee-wee leagues through middle school and into high school, return-to-play policies and sharing information about DU’s biomarker studies around the long-term impacts from head injuries, including dementia and other conditions that appear with age.

“There is a lot of research on some of the poorer outcomes, so that we can better understand what confers the risk for these really terrible outcomes,” Gorgens said. “We are coming to understand youth sports brain injury from every angle, and we’re working really hard to do better by coaches, trainers and parents who are out there coaching on the sand lots.”

Sideline protocols are critical when it comes to avoiding successive concussions, which can lead to more severe TBIs.

When a suspected concussion occurs, coaches and trainers get involved by checking for any immediate symptoms and questioning the players directly involved or who might have witnessed what transpired in order to know what to look for.

“We gather the history of what happened, look for any symptoms they may have at the moment, test their balance and just generally observe them and their behavior,” Roaring Fork’s Erickson said. 

Symptoms typically include headache, dizziness, nausea, vision problems such as double vision, and sudden sensitivity to light or sounds.

“From that, it’s usually not very hard to determine if they have a concussion,” Erickson said.

But that’s not his call. A medical doctor is often on site at the game or event, or on call so that they can come and give the diagnosis.

Concussions aren’t limited to contact sports, either, he said.

“Football gets all the attention, because of the violent nature of the sport,” Erickson said. “But soccer can have as many or more concussions, and in basketball you have kids taking charges and hitting their head on the hardwood.”

Oftentimes, it’s not the initial blow from contact with another player that causes the concussion, “it’s you falling hard and hitting your head on the ground or the court,” he said.

Prevention key, but no fail-safes

A Glenwood Springs Demon football player waits his turn to run drills during a recent after school practice.
Chelsea Self/Post Independent

DU’s Gorgens is also involved on the technology side of protective sports equipment — another science that’s ever-evolving, but an area where youth sports programs have a hard time keeping up.

And it’s an area where Colorado has fallen behind other states on the prevention side, due to high equipment replacement costs and a lack of routine equipment replacement plans, Gorgens said.

Following the implementation of Jake’s Law, school districts across Colorado were able to ride a funding push to buy new, more-advanced football helmets and other equipment, such as extra-protective Guardian caps that can be used on helmets during practice. Some soccer teams also began using protective headgear.

But much of that equipment is now at or beyond its lifespan, leaving school and club sports programs to hold fundraisers to buy new equipment, Gorgens said.

“We’re having bake sales for brain health, which is sad but true,” she said.

“It is an expense, and it’s an ongoing expense. And it’s an investment that school districts, especially the smaller ones, really wrestle with,” she said.

Gorgens said there may be opportunities for high school sports programs to obtain equipment through corporate research sponsorships, similar to college and professional programs, to test some of the newer advancements. Helmets can be equipped with what are called accelerometers, which measure the G-force and provide important research data, she said. 

“Manufacturers need that field research,” she said.

A mass of Basalt High School football players work together to bring down Glenwood Springs quarterback Joaquin Sandoval during their game on Friday, Sept. 17, 2021, at Stubler Memorial Field in Glenwood Springs.
Chelsea Self/Glenwood Springs Post Independent

Glenwood Springs High School head football coach Tory Jensen said much of the protective equipment in his program is at the end of its life cycle. But even that seven-year-old equipment is far superior to what he used in his playing days, and even in his earlier coaching days at Roaring Fork High School in the early 2000s.

“We had terrible equipment when I played, and we hit 10 times harder than we do now,” Jensen said of the evolution of his sport.

“It’s a conversation that has been going on at the high school level for, what, 20 years now,” he said. “It’s a question of how we help our athletes work through playing a collision sport, and it’s difficult. As a coach, it’s unnerving when a head injury happens. You don’t want to see any athlete, or any parent, go through it.”

It’s the down side of any sport, whether it’s a collision sport like football, or even skateboarding, skiing and snowboarding, or mountain biking.

“We are a very active community, and we put ourselves at risk all the time,” Jensen said. “It’s definitely a part of our culture in this valley, no matter what you do.”

More to prevention than padding

There’s a lot more to prevention than just wearing the proper, up-to-date protective equipment.

As Erickson said, “There’s no perfect helmet.”

For Jensen’s football squad, it starts in the weight room.

“The number one thing we do to prevent those kinds of injuries is getting into the weight room and doing the strength and conditioning training you need to help your body absorb the contact that comes with football,” he said.

That can apply to any sport, really. 

A Glenwood Springs High School football player listens in during a huddle with the coach during practice on Monday afternoon.
Chelsea Self/Post Independent

“We work on the preventative piece year-round, just trying to get in the weight room as much as possible and working on our strength and conditioning, so when a collision happens you’re less likely to get injured.”

Gorgens concurs.

“Neck strength in particular is a really important predictor in avoiding head injuries,” she said. “That’s one of the reasons we’re really focusing now on the junior high kids, because they don’t have the neck muscular build yet to be able to take those hits.”

Strength and conditioning is a big part of recovery from a head injury, too. 

“The physical therapy field has really emerged as a leader in successful treatment, which runs upstream to doing more on the prevention side,” Gorgens said.

Proper conditioning is a practice Jensen said he carries into his athletic pursuits as an adult. 

“I play hockey all winter long,” he said. “It’s not really a contact sport but, yeah, there’s contact, whether that’s a collision with another player or contact with the ice.

“Think about it; a bunch of old dudes on skates, sometimes things don’t go the way you want it to.”

Staying properly hydrated during physical activity is also key to avoiding injury, including head injuries, Jensen said.

One of the things he emphasizes with his athletes is avoiding energy drinks and certain supplements, which can have the negative side effect of causing dehydration.

“Part of the concussion prevention piece is dehydration, because your brain works within a liquid base that helps protect itself from bumping into the skull,” he said. “If you’re on a two-hour mountain bike ride and crash in the last hour when you’re dehydrated, it’s going to have more of an impact on your body.”

Recovery to return

“The only healer in a brain injury is time. It just takes time,” Jensen said.

A bad concussion can sideline a player for the rest of the season, if not longer. That’s just one of the risks, he said.

The statistics coming back from the National Football League around prevention and proper recovery when concussions occur is encouraging, and something youth programs can learn from, Jensen said.

During the just-concluded NFL preseason, the league reported 70% fewer concussions than in previous years, after new safety measures were put into place.

“I think it would be silly not to follow down that path and get all of our kids doing the same things,” Jensen said.

Erickson said the brain should be treated like any other muscle that gets injured.

“You have to work that injury out, same as any other muscle,” he said.

It can take some athletes longer to recover than others, which is why the return-to-play procedures are so critical. Initially, there’s a five-day progressive return protocol, but the doctor’s advice is the last word.

“We refer to the doctor to say do or don’t return to play,” Erickson said. Initially, that may even include a doctor’s order to stay home from school for a period of time and to not engage in other activities.

“We start with light activity, then gradually increase that activity, and if the symptoms come back, then they’re not ready to return to play yet,” Erickson said. “If they clear all the steps, they’re usually ready to go.”

It’s also important to understand that no two concussions are the same, and no two people are the same when it comes to sustaining a concussion and recovering from one.

“I played a lot of rugby, and I know there are people who have coconut heads, and who can just take more than another person,” Jensen said.  

Still, “Every time you get hit in the head, it’s got to add up,” he said.

The Longevity Project:

Brain Health & Injury 

The Longevity Project is an annual campaign to help educate readers about what it takes to live a long, fulfilling life. This year’s project will focus on the critical and relevant topic of brain health after injury.

Our panelists are experts in treating concussions and TBI. They will share the latest research, treatments, physical therapies and how concussions impact aging. Whether for themselves or someone they know, attendees will learn useful takeaways for optimizing brain health after injury.

WHEN: Nov. 10

WHERE: TACAW, The Arts Campus at Willits Willits

TIME: 5 p.m. Meet and Greet; 5:30-7 Panel Discussion

TICKETS: Can be purchased online at https://events.cmnm.org/e/longevity2022

The Longevity Project: What should you do if you or someone you know may have experienced head injury?

Traumatic brain injuries (TBI) are called a “silent epidemic” because the injury impacts millions but can go undetected. Over the years, concerns for TBIs has grown, in part due to the attention paid to long-term health complications experienced by professional football players.

“For a long time, people would say to somebody, ‘You had a concussion, brushed it off. Get back out on the field, no big deal,”‘ said Krista Fox, occupational therapist at Aspen Valley Hospital.

We’ve come a long way since then. Research shows that even a mild concussion can have lasting impacts that may go away over time.

So, what should you do if you or someone you know have experienced a head injury?

The first thing you should do is call 911. The sooner an injured person receives professional medical treatment, the better.

While you wait for emergency responders, you can administer the following steps, according to Mayo Clinic:

1.) Keep the injured person still.

The injured person should be laying down, with their head and shoulders slightly elevated. If they are wearing a helmet, it is advised to not remove it.

2.) Stop any bleeding.

Apply pressure to a wound with a sterile gauze or clean cloth. If there is a skull fracture, do not apply direct pressure.

3.) Watch for changes in breathing and alertness.

Pay close attentions to changes in breath. If necessary, administer CPR.

Applying a cold compress to a head wound is also advised to mitigate swelling.

According to Mount Sinai, it is not advised to wash a head wound that is deep, move an injured person unless absolutely necessary or shake an injured person if they seem dazed.

However, according to Fox, for some it can take a bit of time before an injured person starts to recognize that a brain injury could has occurred.

“Sometimes, it can even be that someone has had an accident or an injury, and they don’t recognize anything happened to their head,” she said. “Then, it may be a couple of days later, and they’ve got headaches, or they’re nauseated and have dizziness.”

If you’ve hit your head, it is important to watch for symptoms.

Symptoms of traumatic brain injuries, according to The Food and Drug Administration:

Symptoms of mild TBI include:

  • headache
  • confusion
  • dizziness
  • ringing in the ears
  • memory impairment
  • blurred vision
  • behavioral changes

Moderate and severe TBI can produce more symptoms including:

  • repeated vomiting or nausea
  • slurred speech
  • weakness in the arms or legs
  • problems with thinking and learning
  • death

If you notice any unusual changes after an injury, or if you suspect you may have a traumatic brain injury, contact your doctor immediately.

To reach Kristen Mohammadi, call 304-650-2404 or email kmohammadi@aspentimes.com.

The Longevity Project: Traumatic Brain Injuries in the High Country

Editor’s note: This is the first of a weekly series The Longevity Project, a collaboration between The Aspen Times and Post Independent.

Many individuals who experience traumatic brain injuries (TBI) undergo what is called perseveration, where they often repeat words or phrases. For Carbondale resident Darryl Fuller, 52, the word he clings to is “nature.”

“Sometimes he calls me nature,” Darryl’s wife, Susan Jordan, said. “Sometimes he calls other people nature. Sometimes he just uses it to fill in.”  

In the early stages following Fuller’s TBI, the word clung to was “determination.” These words choices seem to be in line with the kind of person Darryl Fuller is.

He and Susan have been living in Carbondale for over 20 years. They moved here in 2000, when Darryl took a job at Colorado Rocky Mountain School as the outdoor programming director, a title he’s held since he moved here. 

Susan Jordan (left) and Darryl Fuller (right) riding bikes.
Courtesy photo

Before the accident that led to Darryl’s TBI, on a typical weekend, Darryl and Susan would spend it biking or skiing, enjoying all the things living in the mountains has to offer.

A love of nature seems to have carved out a career and lifestyle for Darryl. 

Darryl Fuller’s traumatic brain injury

On May 21, 2022, Darryl was in a backcountry skiing accident on Cathedral Peak. He was with a friend, trying to enjoy one of the last snow storms of the season.

While walking up the peak, Darryl slid on a patch of rocks and lost a ski. He was not injured at this point. After he fell the first time, he and his friend decided to descend the peak, making their way back down the way they had come up. 

They were both being cautious and wearing protective gear, including helmets. Darryl is an experienced skier and outdoorsman, given his long career as an outdoor program director. Still, accidents can happen to the most experienced outdoor adventurers, even those who make safety a priority.

It was on their way back down the peak that Darryl fell again, sliding an estimated 1,000 feet. His friend found him lying unconscious.

Before Darryl’s friend was able to make it to him safely, others who witnessed his fall were able to reach him.

“The miracle was that there were two people, a father and a son hiking at the Cathedral Lakes Trail on May 21. Like, who does that?” said Susan. “Even locals don’t really do that.”

Darryl was airlifted to Aspen Valley Hospital, then transferred to St. Mary’s Medical Center in Grand Junction. According to Susan, he almost didn’t make it.

“He was covered with blood, his eyes were slow and he was intubated. He couldn’t talk. He was not conscious,” Susan said about her first time seeing her husband.

Darryl had broken his leg, tore the upper side of his left eye, and endured a traumatic brain injury.

He moved from St. Mary’s Medical Center in Grand Junction to Craig Hospital in Denver, where he and Susan have been since July 6.

Traumatic Brain Injuries in the High Country

Darryl is one of 1.5 million people diagnosed with a TBI this year, according to estimates from the Centers for Disease Control and Prevention. 

The number of people living with TBIs in the United States nearly equals the entire population of Colorado. According to Aspen Valley Hospital, an estimated 5.3 million adults and children living in the United States are suffering from permanent brain injuries. The U.S. Census from 2021 estimates the population of Colorado at 5.8 million.

Each year, Aspen Valley Hospital sees an estimated 2,000 people who come in with concerns of brain injuries. Concussion is the most frequent diagnosis for those patients, but even a mild concussion can lead to lasting impacts.

Austin Colbert, the sports editor and lead photographer for The Aspen Times, endured a mild concussion a handful of years ago and still has lingering symptoms. 

“I had a very light, insignificant knock on the head, and I’m still dealing with symptoms five years later.” Colbert said. “It impacts your life.”

Dr. John Hughes, who owns Aspen Integrative Medicine, described a TBI as “a bomb that explodes in the brain.” This “bomb” often goes undetected on CT or MRI scans, which makes the treatment for TBI all the more challenging.

The most common events that lead to TBIs are falls, car collisions, combative injuries or sports-related injuries. People living in rural or mountainous regions are more likely to experience a TBI than those who live in urban or eastern regions.

With this, Colorado ranks ninth in the country for TBI-related fatalities and 13th for TBI-related hospitalizations, according to Brain Injury Alliance of Colorado.

study from Craig Hospital estimates that Region 12 of Colorado, which consists of Pitkin, Eagle, Summit, Jackson and Grand counties, ranks No. 1 for TBIs when adjusted for the population.

According to a study from Craig Hospital, traumatic brain injury is more prevalent for those who live in mountainous regions, compared to urban areas or eastern regions.
Kristen Mohammadi/The Aspen Times

Like the severity of TBIs, treatment and recovery for TBI patients varies.

“I tell my patients, it’s still going to be a six- to nine-month process, even a year before they might get back to some resemblance of normal and can say, ‘Hey, I have my identity back,’” said Dr. Hughes.

“I think everybody has to have those kinds of kind of long-term expectations.”

Golden nuggets of hope

For Darryl Fuller and Susan Jordan, every day seems to get a little better.

“Every little thing is just like this little golden nugget of hope,” said Susan.

He can read, write, do math problems and more — signs that Darryl is recovering. Conversing and walking are still challenging. 

He and Susan pass the time between his treatments playing games or rolling around the hospital. 

Both of them are currently not able to work. This, along with the cost of medical treatment, is why Darryl’s sister started a GoFundMe page that is still taking donations.

Susan also started a blog on Caringbridge in which she writes journal updates on his progress. She considers the blog a good way to keep people informed and hopes that it is something they can look back on in the future, when Darryl gets better.

For now, they are still in Craig Hospital. The release date always seems to change, depending on the fluctuating recovery process.

Susan hopes Darryl will be treated in more of a residential-style treatment facility soon. 

 “As much as we’d like to get home, he’s not ready to go home,” said Susan. “So, I am super hopeful that we’re going to get Darryl back to a very high level.

“Whatever’s left, we’ll just continue to work on whatever that is.”

The Longevity Project:

Brain Health & Injury 

The Longevity Project is an annual campaign to help educate readers about what it takes to live a long, fulfilling life. This year’s project will focus on the critical and relevant topic of brain health after injury.

Our panelists are experts in treating concussions and TBI. They will share the latest research, treatments, physical therapies and how concussions impact aging. Whether for themselves or someone they know, attendees will learn useful takeaways for optimizing brain health after injury.

WHEN: Nov. 10

WHERE: TACAW, The Arts Campus at Willits Willits

TIME: 5 p.m. Meet and Greet; 5:30-7 Panel Discussion

TICKETS: Can be purchased online at https://events.cmnm.org/e/longevity2022

To reach Kristen Mohammadi, call 304-650-2404 or email kmohammadi@aspentimes.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.

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.”


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.”


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.


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.


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.”


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.”


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?’”


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 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.

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

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.

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.”


Meetings and Gathering Places

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

970-245-9649 or 888-333-9649


The Meeting Place (Carbondale)

981 Cowen Drive, Carbondale


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



Therapists, Treatment Centers and Recovery Hubs

Aspen Strong Directory


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)


In the event of an overdose emergency, call 911.