Children’s Hospital Colorado Reflects on Work Accomplished Since Declaring Youth Mental Health State of Emergency Four Years Ago

In a recent poll, Children’s Hospital Colorado (Children’s Colorado) found that 70% of Colorado voters believe the state is facing a youth mental health crisis; yet, many families and communities remain unsure of how to approach the topic of mental health. This Mental Health Awareness Month, Children’s Colorado is recognizing the work that has been done since declaring a youth mental health state of emergency in May 2021. In addition, the hospital is sharing mental health resources with the goal of providing kids with care in the right place, at the right time, while asking Colorado leaders to keep youth mental health top of mind.

Acknowledging the national youth mental health call to action

“Children’s Colorado was the first pediatric hospital in the nation to broadcast the troubling trend in our emergency departments: that, during an ongoing global pandemic, one of the top reasons kids were coming to our hospital was for suicide attempts,” said Jena Hausmann, president and CEO of Children’s Colorado and board president for the Children’s Hospital Association. “Soon after our hospital’s announcement, we saw similar declarations from national medical institutions and the U.S. Surgeon General. This nationwide acknowledgement of what our youth were enduring was an important step toward creating systematic solutions to improve how children navigate the healthcare system, find help when they need to talk to someone (such as the I Matter Program) and get equitable insurance coverage for mental health treatment. As we look ahead, state and federal leaders must keep their foot on the gas pedal – we must continue improving the behavioral healthcare system to meet the needs of children, youth and their families seeking support, destigmatization and appropriate care for mental health.”  

Between 2020-2024, the Children’s Colorado Pediatric Mental Health Institute saw a 55.7% increase in inpatient admissions, outpatient growth and acuity of patients across its continuum of mental health services – the largest growth in demand compared to other populations served within the hospital’s system of care. In 2024, Children’s Colorado pediatric experts cared for more than 11,000 patients in need of pediatric mental health care across its entire system (inpatient, partial hospitalization, outpatient, etc.). There were just over 7,000 pediatric patient visits conducted across Children’s Hospital Colorado’s four emergency departments (EDs) for a variety of mental health concerns. The number of visits increased slightly since 2023, but overall, the number of patients has plateaued around pre-pandemic levels. Pre-pandemic levels of demand for pediatric mental health services were already concerning to medical experts.

Improving how kids receive care in the hospital setting 

This need for care, paired with grant funding from the newly created Behavioral Health Administration (BHA), drove Children’s Colorado to create an innovative mental health emergency unit on the Anschutz Medical Campus that offers different care pathways for patients experiencing intermittent or nonacute suicidality, so they do not have to spend more time in the emergency department than needed. Creating a more effective and supportive environment for patients and families when they need to be in the hospital is critical to improving mental health outcomes and reducing time spent in the hospital.

While many kids still experience “extended stays” in the hospital, averaging 15 days in 2024, as they wait for more appropriate, longer-term care options to become available outside the hospital, the state has expanded treatment options for youth with high acuity mental health needs in Colorado. Additionally, Children’s Colorado has driven a 23% reduction in psychiatric inpatient length of stay for patients since 2020 through quality improvement measures intended to reduce the amount of time spent in a hospital setting and improve patient outcomes while enabling increased access to scarce pediatric inpatient beds. To build off this, Children’s Colorado launched a new Pediatric Mental Health Care Transitions Team to provide wraparound support to families as they make the hospital-to-community transition for mental health care. The multidisciplinary team of placement specialists, health navigators, educational specialists, care coordinators, and peer and family support partners helps caregivers navigate next steps for mental health treatment to reduce preventable hospital readmission and repeat emergency visits.

Progress takes a community approach  

“Through the implementation of trauma-informed clinical care models and launching reimagined crisis services just for mental health concerns, Children’s Colorado has transformed how we serve kids who are in crisis,” said Ron-Li Liaw, MD, Mental Health In Chief at Children’s Colorado, an inaugural position created in 2022, and the Cannon Y. and Lyndia K. Harvey Chair in Child and Adolescent Psychiatry. “However, the goal remains to create a comprehensive system of care that enables every child to receive the mental health support they need before they ever reach a crisis. Since joining the hospital in 2022 (when Children’s Colorado was still seeing historic numbers of patients), we’ve seen momentum for real change across our state and region for all children, regardless of whether they live in urban Denver, rural eastern Colorado, or on a reservation near the Four Corners. We are proud of the organizations, schools, primary care providers, youth councils, community groups, state and legislative leaders who not only responded to the emergency, but who continue to partner with us to prioritize building the mental health continuum of care (from prevention and community partnerships to outpatient specialty and inpatient care to wraparound supports for their families) for all Colorado kids.”  

Policy action driving positive change 

In the last four years, Children’s Colorado led and supported state and federal legislation that improves the youth mental health system of care for those who need specialized pediatric care for complex medical and mental health conditions. This includes creating better data monitoring across hospitals, supporting state-wide prevention programs and securing one-time American Rescue Plan Act (ARPA) funding to improve access to youth mental healthcare.  

Most recently, Colorado lawmakers passed House Bill 25-1002, which reduces unnecessary delays for behavioral, mental health and substance use disorder treatments by creating clear and fair standards for insurers to use when determining what they will cover. In addition to this bill, Governor Polis also recently signed House Bill 25-1135, which requires all Colorado public schools to create their own locally developed policy regarding screen time and cellphone use during school hours in K-12 settings. Recent research shows that adolescents who spend more than three hours per day on social media may face double the risk of experiencing poor mental health outcomes, such as symptoms of depression and anxiety. It is important for schools and their respective education community to consider the benefits of technology in education, with the need to minimize distractions in a classroom and risks to youth mental health.  

“We are honored to work alongside bipartisan state leaders who have invested in a state infrastructure, tools, policies and programs that contribute to building a comprehensive, sustainable youth mental health system of care in Colorado,” said Zach Zaslow, Vice President of Community Health and Advocacy at Children’s Colorado. “Revolutionary change to any system takes time. We are grateful to see a continued commitment from Colorado leaders to ensure that kids don’t just return to a “pre-pandemic norm,” but that we do everything we can to eliminate harm to kids and promote wellbeing across the spectrum of physical and mental healthcare.” 

Community change: What we can all do  

Discussing mental health should not begin and end in the month of May, especially when suicide remains a leading cause of death in children and teens across the country. Rather, there are ways the community can enact change all year long and begin providing support to kids preventively and when they need it most:  

• Destigmatization: 
  • Don’t be afraid to have the conversation:
    • Understand why you should talk to kids about suicide
    • Teach teens how to talk about suicide and mental health
    • Talk to your child about gun safety and difficult events in the news
  • Host a movie screening of an awareness film, such as My Sister Liv, focused on sparking conversations about mental health.  
• Invest in a Better Future for Kids
  • As a nonprofit hospital, philanthropic support from compassionate individuals, foundation partners and corporations fuels Children’s Colorado’s world-class pediatric care and research that can save lives. We urge our community’s help this Mental Health Awareness Month to get kids the help they need, when they need it. Thanks to a generous $25,000 match from Kristi and Marshall Burton and Family, donations will be doubled, dollar-for-dollar. Match my gift.  
• Advocacy:
  • Join the Child Health Champions advocacy network to be alerted to important public policy decisions that can dramatically shape the health of children.  
• Educators and communities:
  • Phone Free Toolkit: Toolkits | Phone-Free Schools Movement
  • Common Sense Media Info: A Community-First Approach to Cellphone Bans | Common Sense Education 
• Urgent safety community resources:
  • Contact your child's pediatrician or medical provider
  • Colorado Crisis Services
  • I Matter Colorado
  • Safe2Tell
  • National Suicide Prevention Lifeline
• Health resources for parents and caregivers:
  • If your child needs mental health care or you’d like to support your child while waiting for care, visit Children’s Colorado Mental Health Resources for Parents and Caregivers for resources on creating a mental health crisis kit, building resiliency and coping skills, and more.