CHEYENNE — On Monday, Gov. Mark Gordon announced the launch of his new mental health initiative, which identifies five key pillars that are “critical” to boost outcomes for those battling with mental health issues.

Gordon’s “Mental Health Roadmap” is the result of collaborative work among the executive, legislative and judiciary branches of state government that will advance “systemic behavioral health reform in Wyoming,” according to a news release.

The five key pillars identified in the road map include access to mental health care, affordability, quality of care, innovation, and suicide prevention and anti-stigma efforts.

During a town hall at the state Capitol on Monday, the governor said that mental health care services should not only be accessible, but affordable and of good quality — it’s not enough just to acknowledge a need for it.

“We want to ensure that cost of care is not a barrier for accessing services in Wyoming,” Gordon said.

The road map focuses not only on community mental health reform but also targets workforce development, criminal justice reform and suicide prevention. Gordon said state officials are “exploring funding” of $250,000 to train workforces in behavioral health reform, and he requested an additional $2 million for pediatric virtual services.

“Wyoming has a significant shortage of behavioral health professionals,” he said. “Especially so with pediatric specialization.”

The governor also asked lawmakers for another $2 million to contract with mobile crisis services in Wyoming to support first responders, including law enforcement and EMS.

Role of state agencies

Wyoming Supreme Court Chief Justice Kate Fox was one of many experts who joined the governor during the town hall discussion.

“People ask me, ‘Why is the judiciary involved in these behavioral health projects?’ And it’s an easy answer,” Fox said. “Behavioral health is in our courts.”

Fox explained that courts have become the “emergency rooms for society’s ills,” especially related to mental illnesses and substance abuse. Increased incarcerations of people with low-level, nonviolent charges have driven up costs for the state, she said.

“(This) is the most expensive and least-effective way of dealing with it,” Fox said.

Department of Corrections Director Dan Shannon echoed Fox in his statement regarding increasing costs of incarceration.

“You’d be shocked at the amount that are incarcerated that are severely mentally ill,” Shannon said. “When we fracture a leg, we call EMS ... when a mind is fractured, we call law enforcement.”

The governor was also joined by directors from the Wyoming Department of Family Services, Department of Health and Department of Corrections. Department of Health Director Stefan Johansson said the collaboration of so many state agencies to focus on the issue “is a huge deal.”

“We absolutely can have a larger role to do things differently … but also see what’s happening,” Johansson said.

State agencies, such as the Department of Health, are limited in their understanding of what is actually happening at the local level, he added. It helps to hold these town hall meetings across the state to hear firsthand from the public what gaps in mental health services still need to be addressed. “We don’t know what we don’t know,” he said.

What the public has to say

Among those who filled the seats of the Capitol’s auditorium were public servants, Cheyenne residents, judges and health care specialists. Several stories were tearful anecdotes of a person’s experience with suicide, whether personally or with a loved one.

The Cowboy State no longer ranks number one in the country for its per-capita suicide rate, but the governor said there’s still a lot of work to be done.

One spokesman from the Laramie County Sheriff’s Department said the number of suicide attempts in jails “has doubled” since 2019, although none of them have resulted in death.

“The risk is increasing, and it does impact over 50% of our (jail) population,” the spokesman said. “Talking to other jails, it is pretty systemic or consistent across the board.”

One part of the issue he highlighted was the wait time required to get “high risk” inmates into the Wyoming State Hospital in Evanston, which Johansson acknowledged as “unacceptable.”

Part of the reason for extended hospital wait lists, Johansson said, is the occupancy of beds by nursing-level hospital patients in need of long-term care. Once the Wyoming Life Resource Center in Lander is fully staffed, he said, “those populations are scheduled to be served in a more appropriate nursing facility setting.”

“It’s a lot of volume competing for a limited resource,” the WDH director said. “But we can’t sit here and say that for another five years without making improvements.”

With the governor’s behavioral health redesign plan set to take effect this summer, criminal justice populations will be “one of the three main priority focuses.”

Another public comment came from Allison Cunningham, a Cheyenne resident who is deaf. Through the translation of an American Sign Language interpreter, Cunningham told Gordon that 2% of deaf individuals do not receive the health care they need because a number of mental health agencies don’t provide interpreters.

“We’re humans, we have a mind, we have emotions,” she said through the interpreter. “The Americans with Disabilities Act is established, and it requires that access. I feel that the state needs to set aside money to the centers for these accommodations.”

Gordon acknowledged and thanked her for her comment.

“As we think about workforce development, it’s not only that we need to develop not only the talent to deal with mental health issues, but also people with skill sets like interpretation, to be able to communicate properly,” he said.

Amy Shaw, a care provider at Cheyenne Regional Medical Center, said she is the only comprehensive dementia care specialist in the state, to her knowledge. Shaw told Gordon and his fellow panelists that the state should focus on expanding dementia comprehensive care and telehealth services in Wyoming.

“Telehealth and dementia go hand in hand,” Shaw said. “People don’t really understand dementia. And so getting some expertise in how to help families understand that would be valuable.”

Rep. Dan Zwonitzer, R-Cheyenne, who also sat on the panel during the town hall, is co-chair of the Legislature’s Labor, Health and Social Services Committee. Zwonitzer remarked that Shaw’s comments “are very timely,” as he had just met with the Alzheimer’s Association of Wyoming’s newest policy advisor last week.

Lawmakers on the committee are currently working with the association to expand Project Lifesaver, a search and rescue program for individuals with Alzheimers or dementia. Furthermore, there are two bills that will be considered in the upcoming budget session designed to help and expand the definition of vulnerable adults.

“We are making strides … for the first time in the last decade, that I’m aware of … we can push through in 2024,” Zwonitzer said.