Data from a Pitkin County community mental health survey put numbers to the sentiment that local mental health advocates and providers have expressed for a long time: The stressors of living in the Roaring Fork Valley — like housing, the cost of living, finding a sense of belonging — can compound and cause mental health challenges like anxiety, depression and substance use.

The survey was completed in the fall of 2021 by 587 participants, about 55% of whom lived in Pitkin County and 73% of whom worked in the county. It was offered in English (535 respondents) and in Spanish (52 respondents), according to a broad-strokes summary provided by Chelsea Carnoali, a mental health analyst for Pitkin County Public Health. The participation was more than five times that of a 2019 mental health survey that got about 100 results, according to Carnoali.

Analyzing the responses took a few months; a comprehensive report is expected at the end of next week pending some final edits, Carnoali said in an interview.

Carnoali presented the summary at a Jan. 25 mental health summit in Aspen for nonprofit, community resource and government entities. The response there was one of “surprise and almost relief for how we’ve opened our conversation to things that we’ve known, and we’ve needed to have … the data to represent what we had all been talking about for so long,” she said in an interview.

Survey-takers identified both social determinants like housing, finances and physical health concerns as well as barriers like cost, insurance and resource availability as factors impacting their mental health and well-being. Both components impact community mental health from prevention to treatment to recovery, according to the presentation slides.

The most common mental health symptoms identified were anxiety and depression. About 21% of survey-takers said that they or a loved one were currently struggling with addiction, with alcohol identified as the leading substance.

Valley stressors like inclusion, finances and community often intertwine among mental health concerns, according to the presentation slides provided by Carnoali. On a scale of 1 to 10 — 1 being “very excluded” and 10 being “very included” in the community — the average response was a 3.

Anonymous responses quoted in the presentation cite displacement, short-lived relationships and a work-dominated life as among the factors that play into that exclusion and, in turn, mental health challenges. For the many people who move to this mountain community from somewhere else, the support systems that most people may turn to in times of need just aren’t there.

Housing insecurity was the top dog in an overall ranking of which factors impact stress and well-being the most, followed closely behind by financial insecurity. Physical health was the third-ranked stressor. In the Spanish survey, results differed slightly: Physical health was the top-ranked stressor, followed by child care insecurity and job/financial insecurity.

Faced with external factors and internal mental health challenges, most respondents still weren’t necessarily prone to seek out professional mental health care.

Factors directly related to mental health care likewise had an impact on community well-being. On a scale of 1 to 10, with 1 representing someone “very unlikely” and 10 representing someone “very likely” to seek mental health support, the average response was a 3.

A “major barrier” to mental health care was cost and financial resources, according to a slide listing takeaways from the data. “I can’t afford it” was the top reason for that slim chance of seeking help. The cost and complications of insurance was the second-ranked response.

Respondents also said they felt uncomfortable talking about mental health with a loved one out of a fear of judgment, general discomfort with the subject and fear of negative consequences.

It isn’t exactly a rosy portrait of mental health and well-being. But having the data at hand now better equips Pitkin County and other mental health stakeholders to take a targeted approach to addressing barriers to services and gaps in the care that’s available and to developing programming and messaging campaigns.

Pitkin County will use the data — plus context from ongoing conversations about mental health in the community — to assess its current contracts with mental health care providers. Further analysis of local gaps and needs is yet to come, as is review and development of the current and potential new requests for proposals from the county.

Other agencies like Aspen Strong and the city of Aspen also have initiatives in the works; Carnoali emphasized that the aim is collaboration among partners and “a unification for what the strategy can look like moving forward” now that the statistics are in the books. Having the data to inform that work is both “incredible” and a bit “daunting,” she said.

“It’s definitely exciting and super validating. … It’s something we know, we’ve heard, we’ve experienced, I’ve experienced, so having that data to be able to kind of give it some life and opportunity is really exciting,” Carnoali said “And I’ll be honest, it’s a little daunting, because that social determinant piece, those outside stressors — those are huge … issues to tackle.”

kwilliams@aspentimes.com