Mental health

Facilitator Margo Zagoras leads a community meeting as part of Pitkin County’s Mental Health Strategic Planning process in the library last week. Zagoras has also met with those experiencing homelessness, as well as health care providers and other stakeholders to compile a robust list of root causes and potential solutions to the valley’s mental health needs.

Pitkin County is continuing work on a large scale strategic plan to address mental health by hosting in-person interviews and community meetings. The Aspen School District, Aspen Valley Hospital, city of Aspen, Aspen Skiing Co. and the Aspen Community Foundation all have representatives on the planning committee that will eventually propose a priority list for spending and resources to help those struggling in the community. 

Pitkin County Public Health Director Karen Koenemann has been leading the project. Though she emphasises that she is not a doctor or a mental health professional, she often sees the need for more mental health support in the various public health programs she oversees.

“A majority of my week is spent on mental health work, and that's probably not traditional for a public health department,” Koenemann said.

Social determinants such as cost of living and the need for stable housing can lead to chronic stress for individuals, and when a small community experiences that stress on a large scale, it touches everyone. At times when the community loses someone through a death by suicide, it becomes painful for everyone. 

“There’s this community grief, community-level stress, community-level malaise,” Koenemann said. “And we think about the degrees of separation, it’s a small community. We can feel it. We can feel the sadness. We can sense that, we can feel it from other people. I think about that on a community level.”

As part of the strategic planning process, a facilitator has met with individuals with mental health disorders, those experiencing homelessness, and facilitated community meetings in Spanish and English. A large portion of respondents said they did not seek mental health assistance because they didn’t know what help looks like, or if what they were going through warranted seeking help. 

“There is nothing wrong with calling a therapist and saying, ‘I don’t know what’s going on with me but I’m really down right now and I just want to talk,” Koenemann said. “We don’t need to self diagnose. I don’t need to diagnose if i'm depressed or not, someone else can help with that.”

She said the county has heard loud and clear that access, in all its iterations, is also a large barrier to seeking assistance for those in the valley. She said that could mean the transportation it takes to get to a doctor’s office, the long wait times for the limited amount of providers in the valley, and the high cost of seeing a professional.

“We just hear that over and over again — it’s expensive,” she said.

Last week, the facilitator met with a group of local residents who were tasked with identifying some solutions to the root causes of mental health strain in the community, and prioritizing ways to help overcome some of the biggest barriers to mental wellness. Koenemann said in her mind, the outreach process is critical to the success of long range solutions. 

“My heart and my values are really around community engagement, and to make sure we are hearing from people who have lived experiences and that we are hearing from a variety of folks in the community, rather than saying ‘I’m the government and I’m here to help,’” she said.

Greg Poschman, chair of the Board of County Commissioners, attended the community meeting. He said he made it a priority in his first term on the board to lend support to the expansion of the West Springs Hospital in Grand Junction, the closest inpatient facility for behavioral health patients.

“I think we know in our community we do have a problem here, and we are dealing with it,” Poschman said.

He acknowledged the data that shows Pitkin County’s high level of deaths by suicide this year, and said the large scale community conversation coming to light threough the strategic planning proess is helping.

“We are all asking what do you think this can be, and there are a lot of theories floating around and hopefully it will lead to a community that is better able to help out the surprising number of people who have come to this conclusion,” Poschman said.

He said along with putting resources behind mental health practitioners and facilities, we can also invest within the community so the general public can all be a part of the solution. 

“The community itself needs to rise up to raise our level of resilience and our level of awareness so that we can help these people who are in our midst and in need,” he said.

Poschman cited courses like Colorado Mountain College’s Mental Health First Aid Training, offered for free in conjunction with Mind Springs Health. The course helps build a language that can start a community dialogue around depression and suicide. 

“If everybody from the lifties, to the bartenders, to the cab drivers, to the school teachers to the police, if we’ve all taken it, then maybe we can identify somebody who really is in a bad way sooner, and get help to them sooner,” he said.

Poschman said part of being able to openly discuss hard topics is putting them directly in the spotlight, and acknowledge how common the experience is. 

“It turns out that everyone on the planet knows someone with a mental health condition.

We’ve all been touched by suicide,” he said. “The idea is let’s get rid of the stigma around suicide so you can walk up to someone who is a friend or an aqualitence and ask them, ‘Hey are you OK? Are you thinking of hurting yourself? Have you contemplated suicide?’”

He said these are not questions he would have felt comfortable asking, or even considered asking, before he underwent the training. But if the community as a whole felt better openly discussing how they are doing with one another, it wouldn't feel like such an uncomfortable topic.

The more the community as a whole is educated on mental health struggles, it can also help remove stereotypes that lead to people thinking people are OK when they are not. 

City Councilmember Ann Mullins said we’ve learned through recent deaths by suicide that there isn’t a textbook person who is vulnerable to depression, or anyone who is immune.

“It isn't people that are all by themselves and have been somewhat abandoned by family or society,” she said. “Now we see people that are right in the midst of the community that are struggling.” 

Mullins also said it’s important to acknowledge all ages of our community who are struggling. 

“It’s no longer just adults that are dealing with these really serious mental health issues. We are seeing this come down to youth, and youth that appear to be in good stable situations,” Mullins said.

Last week’s community meeting identified a number of ways to increase support for children both within the schools and through other resources. 

“We know from a public health perspective that prevention pays,” Koenemann said. “Healthy kids grow up to be healthy adults.”

The planning group will work on preparing a list of priorities to present to the county commissioners early next year. 

“By having the strategic plan, it allows us to strategically allocate our resources. So hearing from the community and knowing what strategies the plan should bring forth will allow us to say here is what’s really important this is where the gaps were, as a community how do we allocate resources,” Koenemann said.

She said the plan can act as a jumping off point for going after state and federal grants as well. And beyond funding, the plan will identify ways to better coordinate the various groups who are working to support those with mental health struggles in the valley. 

Poschman said he was encouraged to see a lot of what was suggested in the community meeting are programs that already exist. 

“Next what we need to do is make sure all these various groups we have are coordinated and aware of what’s going on. And that could be one of the challenges, creating a consolidated single call number,” he suggested.

Koenemann also said there are resources at hand that the community might be able to better identify as opportunities for connection, and mindfulness. Many respondents to the outreach this fall sighted exercise and the area’s environment as tools they use to keep their mental health in balance.  

“We asked the question, ‘What keeps you healthy?’ Because we do have things within our own constructs and own world that we can enhance,” Koenemann said.

And Poschman said finding those resources through community conversation is the first step in the long-term path to community wellness

“Everybody came out of there feeling positive that we’d made some progress against a daunting situation,” he said.

If you are struggling with a mental health issue and need help, please contact

Aspen Hope Center (970) 925-5858

Mind Springs Health 1-844-493-8255 or text “TALK” to 38255

Alycin Bektesh is a reporter for the Aspen Daily News. She can be reached at or on Twitter @alycinwonder.