COLORADO SPRINGS, Colo. — Only two state-run psychiatric hospitals in Colorado provide inpatient care to individuals with acute mental illnesses and those who may be facing pending criminal charges. Once it's time for a patient to be discharged, a question often arises: where will they go?
One solution comes in the form of a new program: mental health transitional living (MHTL) homes. The homes are in locations throughout the state, including Lakewood, Littleton, Westminster, Pueblo West, and Colorado Springs.
The Cascade Home in Colorado Springs officially opened as a MHTL home in March 2024.
"It is exactly what it sounds like. It's a transitional home," said Bonnie Wright, the division director of the MHTL Homes program within the Colorado Department of Human Services. "Our mental health transitional living homes tend to be really great options for those individuals to help them reintegrate back into community, learn how to sort of get their feet back under them and move on to whatever the next stage of their lives is going to be."
The Office of Civil and Forensic Mental Health oversees the homes, which can either be operated by the state or contracted to a provider. In a state-run MHTL, all of the individuals working at the home are employed by the state. Contracted homes must meet certain requirements to partner with the state.
"Through that contract, we provide them with a degree of administrative support, some funding options beyond traditional funding options, which is Medicaid, Social Security benefits, and then we work very collaboratively with them," Wright said.
Nathan Duran-Martinez, 44, lived at the Cascade Home for roughly a year. His mental health journey began when he was in college.
"I was playing college football, and I was doing really well, and I hurt my knee. My football career is basically over, so my mental health just kind of went down the drain," Duran-Martinez said. "Started experiencing depression and anxiety, and at the time, I really didn't know what was going on. I didn't know about psychiatrists and therapy and psych meds. I didn't understand any of that stuff. So I left it alone, you know?"
Duran-Martinez began drinking before turning to hard drugs. He lived on the streets for more than a decade. In 2020, he moved from New Mexico to Colorado for work.
"I had a mental breakdown at the job site. I was hearing voices heavily, and I ended up relapsing and lost my car," Duran-Martinez explained.
He bounced between living on the streets and serving time in correctional facilities. In December 2022, he was unhoused when a snowstorm struck.
"I was warm, but I didn't wear any — I wore ankle socks, and I ended up getting catching frostbite," Duran-Martinez said.
Duran-Martinez said he could not feel the pain in both legs, which had turned black. He went to the hospital, and both of his legs were amputated.
After the surgery, Duran-Martinez turned himself in to authorities and said served a few months in the El Paso County Jail while recovering in a wheelchair. Then, he found his way to the Cascade Home.
"I started working the steps, and I started learning how to communicate and express myself. And a huge thing — being honest with myself and being honest with others," said Duran-Martinez. "Having a bed, having responsibilities, learning how to sit down and eat dinner at a table. You know, being able to sit down on a couch and watch TV, you know, learning how to be normal again, learning how to act to help me acclimate myself back to society."
The MHTL homes were made possible by House Bill 22-1303, which found there was an "urgent need for community-based mental health residential beds."
Leora Joseph is the director of the Office of Civil and Forensic Mental Health. She said the MHTL homes created a place for patients who are being discharged from the state mental health hospitals who no longer need such intensive psychiatric care. Simultaneously, it opens up beds at the hospitals for incoming patients who are stuck on the waitlist.
"There's not a lot of places that are willing to take people from the hospital. We call that a discharge barrier, and we have multiple patients who we don't know where to put them. A nursing home might say we don't want them, and their family might say we don't want them," Joseph explained. "This gives us that valve to allow us to transition people out, and it makes more room in the hospital for us to admit those people who are truly acute and are able to then go from the jail into the hospital. So, we're increasing our ability to discharge."
In 2011, the Colorado Department of Human Services was sued for failure to provide timely competency evaluations and restoration treatment, which had created a significant waitlist of pretrial detainees. As a result, the state was put under a consent decree in 2019, which runs through 2027. As part of that consent decree, the department is fined up to $12 million annually for non-compliance, and those fines must be distributed to programs that strive to eliminate the waitlist, including MHTL homes.
"Right now, because we're still under this consent decree, we're really looking at this as a step down from the hospitals, but that's not the only purpose," Joseph said. "We will be able to take it as a step up from community."
- Denver7 has reported extensively on the impact of delays within the criminal competency process. View our in-depth coverage through this link or in the video player below
Joseph said the MHTL homes give patients a taste of what life can be like.
"We're actually seeing lives get changed. That's what it's about. This is where healing really happens," said Joseph. "I can't imagine a bigger motivator to continue to stay on track with your health and your medication than having a taste of what independent living can be."
Duran-Martinez agrees, saying the community is something that inspired him to change.
"Gives me a sense of hope," he said.
Level 1 MHTL homes, like the Cascade Home in Colorado Springs, accept clients from anywhere while prioritizing hospital referrals. The services within these spaces are typically conducted through a comprehensive service provider. Level 1 homes are intended for people who are considered more independent, which is why the services take place in the community.
Level 2 MHTL homes only accept clients from the two state mental health hospitals. The goal is to reduce the number of people who are waiting to receive care, including competency evaluations and restoration treatment, at the state hospitals. A Level 2 home provides clinical services, like group or individual therapy, inside of the home.
Colorado will soon have 13 contracted MHTL homes and three state-run homes. All of the homes are expected to open by June.
When all of the MHTL homes are up and running, there will be five Level 1 homes and 10 Level 2 homes.
The final MHTL home will have a nursing home level of care, and the opening date is still being decided.
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