2020 / 2021 ANNUAL
THE BEHAVIORAL HEALTH EDITION
MENTAL HEALTH FIRST AID
WORDS M AT T E R MASKING THE PAIN
QUIZ: HOW MENTALLY HEALTHY ARE YOU?
THE ROAD TO HE ALING HOW BEHAVIOR AL HEALTH INITIATIVES ARE CHANGING THE VALLEY
SPIRIT YOUR PARTNER IN WELLNESS
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Shaw Cancer Center combines advanced technology and a multidisciplinary team of specialists with a comprehensive wellness program to treat each patientâ&#x20AC;&#x2122;s body, mind and spirit. With an innovative, wholistic approach, cancer patients are empowered to become survivors.
F R OM T HE P R E S IDE N T & C E O
YOU R PA RTNER IN W ELLNESS
fte r 55 ye ar s o f c ar i ng fo r th e e ag le r ive r valle y ’s s ick an d i n j u r e d
residents and visitors, Vail Health is expanding its focus from “sick care” to “total healthcare,” including an emphasis on preventive care and wellness. With a new hospital in Vail and urgent cares throughout the valley, we are here for all your immediate healthcare needs. Additionally, Vail Health — in partnership with Colorado Mountain Medical and Eagle Valley Behavioral Health (EVBH) — also specializes in preventive medicine to keep people healthy, getting
upstream and ahead of chronic health conditions, including mental health and substance abuse. This approach allows us to address health issues before they become more serious and, ultimately, more costly for everyone. We are taking a wholistic approach to the healthcare of our patients, considering the physical, behavioral, cultural and financial circumstances of each individual while also developing population health strategies for the communities we serve. By addressing the overall health of our residents, we hope to improve quality of life while reducing the higher cost of more expensive care. To lead us in this effort, we created the role of chief population health officer to help us serve everyone in our diverse community — all ages, cultures and financial backgrounds. This community-first focus has never been more important than now. As evidenced in this issue of Vail Health Magazine, Eagle Valley Behavioral Health and our partners have changed the behavioral health landscape dramatically in a short time with ambitious plans for the future, which you can learn more about in “Transforming Behavioral Health” on page 30. In addition to Vail Health’s $60 million commitment to Eagle Valley Behavioral Health, Vail Health Foundation’s It Takes a Valley: Transforming Behavioral Health campaign will raise $100 million for EVBH and its community partners. In addition, we have helped bring 30+ new behavioral health providers to the Eagle River Valley through our partnerships in the community and with Colorado Mountain Medical. We urge our residents to use the behavioral health resources available at EagleValleyBH.org. If cost is a concern, financial assistance is available through Olivia’s Fund, which provides up to six free therapy sessions per person per year for anyone who lives or works in the Eagle River Valley. As a community, and throughout the country, we are finally awakening to the need for addressing behavioral health as proactively and diligently as we treat our physical health. This issue of Vail Health Magazine is a helpful resource in understanding why we must tend to our mental and spiritual selves, as well as how. I hope that as life’s challenges continue to present themselves, you take the time and effort to care for your body, mind and spirit. Wellness is a journey, and Vail Health is on your path. w i ll co o k p r e s i d e n t & c e o , va i l h e a lt h
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F E AT URE S
We Are the Eagle River Valley
The Eagle River Valley is comprised of people of different genders, races, ages and stages of life. Yet, we all have something in common: we need to be attentive to our behavioral health.
Journey to Happiness â&#x20AC;&#x201D; Stories to Inspire
Though we all strive to be happy, it is not always possible in the face of adversity, illness or other challenges. Several individuals in our valley have met those challenges head-on and share their stories to inspire others.
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T HE T E A M
Letter from the President and CEO of Vail Health
Emily Tamberino EDITOR
W E L L NE S S
Wren Bova ART DIRECTION & DESIGN
Carly Arnold Creative
Rocky Mountains’ Dirty Little Secret
Alcohol abuse pervasive and deadly in the Eagle River Valley
Understanding the 'why' behind behavioral health
CO N T R I B U T O R S
The power of the spoken — and unspoken — word
How mentally healthy are you?
The Power of Connection
Battling the happy valley’s loneliness epidemic
Medicating Behavioral Health
The stigma — and need — behind using pharmaceuticals as part of a behavioral health treatment plan
Katie Coakley Kim Fuller Katie Harmon Shane Macomber Karen Mason Kimberly Nicoletti Caramie Petrowsky David O. Williams
A Mind-Body Approach to Staying Well
Colorado Mountain Medical’s new behavioral health specialists help the community navigate everything from anxiety and depression to infertility and chronic pain
The past, present and future of behavioral health in the Eagle River Valley
Transforming Behavioral Health
Fight or Flight
The effects of stress are cumulative and risky
INS IDE R
Mental Health First Aid How to recognize a mental health crisis and get people the help they need
How To Feel Happier
The pursuit of happiness is ongoing and the options are endless
And Now a Pandemic?
Nobody is unaffected by COVID-19
Wait, Technology Can Connect Us?
It turns out technology isn't 'all bad'
Amanda Precourt has struggled with behavioral health challenges since she was young, and shares her story on page 43 to let others know they are not alone. P H O T O BY
O N T H E COV E R
A Quiet Terror
Dr. Jack Eck's struggle with PTSD after the Vietnam War
71 Directory 78 Maps for Local Care 80 Parting Shot 2 02 0 -2 021
DOCTORS YOU KNOW AND TRUST
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Colorado Mountain Medical provides comprehensive wellness to treat patients of all ages. Primary and
specialty care providers work closely with behavioral health specialists to support mind and body health. The following services are available in convenient locations throughout the Eagle River Valley. • Behavioral Health • Dermatology • Endocrinology • Family Medicine/Primary Care • Gastroenterology & Hepatology • Internal Medicine
• Obstetrics/Gynecology • Ophthalmology
• Otolaryngology/Ear, Nose & Throat • Pediatrics
• Predictive Health • Urgent Care • Urology
ROCKY MOUNTAINS’ DIRTY LITTLE SECRET Alcohol abuse pervasive and deadly in the Eagle River Valley by david o. williams photos by dominique taylor
has been described by many as the Eagle River Valley’s dirty little secret. A place that’s home to Vail and Beaver Creek ski areas, two national forest wilderness areas and hundreds of miles of mountainous rivers, streams and trails is also a playground for binge drinking and drug use that sends visitors to the Emergency Department and has killed locals within our very community. Mountain towns are idyllic and picturesque, but with events like Oktoberfest, which takes place not once in Eagle County, but on three different occasions; a special time of day called “après,” which is synonymous to “cocktail hour;” and more marijuana dispensaries than grocery stores, it’s no wonder the Eagle River Valley is fighting a battle with substance abuse. u bstance abuse , e specially alco h o l ,
WELLNESS Local restaurateur John Shipp, who owns the Dusty Boot Roadhouse in Beaver Creek, is all too familiar with this struggle. He and his brother, Dave, are two of a seven-sibling family from the Denver area, all born within seven years of each other. That kind of age proximity promotes closeness in a family. But Shipp says he had a particular bond with Dave, who was also unlucky enough to have inherited the family’s addiction gene that led both men to become dangerously acute alcoholics. “Dave got the gene, and he died from it,” Shipp says. “I got it, and I’m in remission permanently … hopefully.” When Dave was 29 years old and a new father, he realized he was drinking too much, gambling, succumbing to what John refers to as “the Shipp family history.” So, Dave stopped cold turkey and was sober for 23 years until he became an emptynester dealing with life transitions and the death of the family’s matriarch. On medication to deal with depression, Dave started drinking again and died within three years. “I wouldn’t be here if it wasn’t for the fact that I was more honest than my brother was,” Shipp says of his own battle with alcoholism starting when he was in his late 30s – a 12-year odyssey that he says burned through mountains of money, therapists around the country and countless relationships. “Dave never would accept the fact that it’s OK and there’s nothing to be ashamed of if you know you’re born with the gene,” Shipp says. “This is not a weakness; this is not a moral failing. Anybody who knows me, knows I have the willpower as big as anybody else. It’s just not about moral failing or willpower. This is about life. And this is about chemicals in your brain.” Coming to that realization, however — destigmatizing the disease in your own mind and in how you talk about it with others — is still a long way from finding the help you need to recover while trying to make the necessary life changes to ensure your recovery is permanent, Shipp says. That truly monumental task, he adds, takes friends and family who never leave you alone, a sincere desire for a better life and compassionate counselors and therapists who have hopefully lived what you’re living and can walk a mile in your shoes. Shipp praises group therapy and the role Alcoholics Anonymous (AA) played in his journey, although he admits he’s not sold on its anonymity. While Shipp understands staying anonymous is often the only way some people will seek the help they need, openness, for him, is the key to breaking down the stigma of addiction and getting more people to step forward to face their problems — especially in a small, tight-knit community where everyone seems to know each other. “If I help a few people by telling my story, then I don’t care what anybody knows about me,” Shipp says. “The more vocal I get about it, the more people come up to me — people that are pretty well thought-of in this community and running some pretty big organizations — who have said, ‘That happened to me. This is what I’m going through.’” Shipp acknowledges the challenges of seeking sobriety in a ski town.
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“Everything’s against you in this society,” he says. “So part of my process with this whole thing is just to be honest and open and upfront, because the biggest challenge our society, or any society, really faces is the stigma associated with mental health and/or substance misuse and addiction.” That’s why Eagle Valley Behavioral Health (EVBH), which is working to remove that stigma, isn’t called Eagle Valley Mental Health. Behavioral health is an all-encompassing term that includes substance abuse and the underlying mental health issues the substance is being used to treat. “Medicine can help me just like the drugs or alcohol can help me feel better temporarily,” Shipp says. “The questions are, how do I feel better consistently all the time? What’s causing me to be depressed? What’s causing me to be anxious? What’s causing me to be manic?” Shipp says the hardest things to change were the stressors causing the behavior. “I had to first change the things that hit my trigger points. It was a process that took years of trial and error. The goal was to live a balanced, healthy, happy life — a lofty goal, but one worth fighting for.” Divorced now with an adult daughter, Shipp says his ex-wife is still a good friend and that she and their daughter have stood with him through everything. They can recognize his teetering into mania, but more importantly, so can Shipp. He’s learned, through an estimated six+ months of inpatient therapy in treatment centers from Minnesota to Utah, to meditate, calm his mind and focus on what really matters in his life. Shipp is gratified to see the transformation of behavioral health in Eagle County — from a treatment desert when he first began his journey in the early 2000s to a burgeoning environment for therapy and recovery. But, he acknowledges, there is more work to be done. Shipp wants to see more group alternatives to AA, more licensed therapists who have been through addiction wars and more affordability and insurance flexibility.
John Shipp and his daughter, Lyle. John Shipp is one of seven siblings. An alcoholic "in permanent remission, hopefully," both he and his brother, Dave, were born with the family's addiction gene. While John was able to be open about his struggles and get the help and therapy he needed, unfortunately Dave was not.
EAGLE COUNTY'S SCARY TRUTHS 23% of adults report binge or heavy
25% of high school students report
binge or heavy drinking.
of driving deaths involve alcohol impairment.
37% of high school students had at
least one drink of alcohol in the last 30 days. Excessive alcohol use, including binge drinking, is a risk factor for chronic health conditions and a number of outcomes related to injury and violence, including suicide. Sources: The Colorado Behavioral Risk Factor Surveillance System (BRFSS) and Healthy Kids Colorado Survey (HKCS).
When COVID-19 shut down most businesses in March 2020, Shipp sought treatment for two friends. He’s worried more will need help as the economic crisis builds. “How do you get out of your basement, right?” Shipp asks. “For anybody who’s been depressed and lonely, or is drinking too much or doing drugs, isolation is where your brain wants to go. You want to go there, and isolation is not your friend. Isolation will kill you.” In recent years, Eagle County has garnered a statewide reputation for excessive alcohol consumption and dangerous behavior as a result. A 2018 Colorado Division of Criminal Justice study entitled “Driving Under the Influence of Drugs and Alcohol” listed Eagle County as one of 15 Colorado counties (there are 64 in total) where more than 1% of the population had been arrested for driving under the influence (DUI). And there has been a significant spike in the number of people suffering from alcohol intoxication and having to be admitted to Vail Health’s Emergency Department. “If we look at alcohol intoxication over the last four years, it has increased 332%,” says Chris Lindley, chief population health officer for Vail Health and executive director of EVBH. “So that’s an exponential curve increase of substance abuse, but specifically alcohol intoxication.” The valley’s behavioral health is further deteriorating during the ongoing pandemic, Lindley says. But things were pretty rough, especially on the alcohol-abuse front, even before March 2020.
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Alcohol is ubiquitous at most local events, from fundraisers to après ski. But it's not just a social activity done in moderation. Locally, 23% of adults and 25% of high school students report binge or heavy drinking.
DO YOU OR SOMEONE YOU LOVE HAVE A SUBSTANCE ABUSE ISSUE?
“Every day, we are battling significant alcohol abuse,” Lindley says. “When was the last time you went to a local function where alcohol wasn’t served? You can’t think of any, right? There’s always alcohol.” That omnipresence seems to take a deadly toll every winter, with the predictable but nonetheless tragic passing of people who overindulge and die of exposure in the shocking cold of the Colorado Rockies. Most recently, 24-year-old Cole Greenfield, a Montana native working as a ski instructor at Beaver Creek, died trying to walk back to his apartment in Avon after drinking too much and being refused entry to a local bar. He was fit, driven and dreamed of becoming an outdoor adventure guide, but he fell victim to too much alcohol and the unforgiving elements — and to some extent the hard-partying culture of the Eagle River Valley. Once the pandemic subsides and larger gatherings are allowed, Lindley would like to see more dry functions where people can engage, interact and participate in activities without a cocktail in hand. “Because in this community, it’s very hard for someone to stay sober when everywhere we go there’s alcohol involved,” Lindley says. “It’s not comfortable when you’re always around it. Besides the outdoors, where do we go to have a good time and socialize in a sober environment? It’s hard to find.” Beyond more sober social options, Lindley says the valley’s collective mindset must change. “We can’t look at alcoholism as a person’s mistake or failure. How they got there doesn't really matter,” he says. “What matters is they are addicted, and they need help. They have a medical condition now that we need to support them and help them with.” For more resources on addiction, recovery and support, visit: EagleValleyBH.org/SubstanceAbuse
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Here’s a quiz from StartYourRecovery.org, compiled using information from the Centers for Disease Control and Prevention (CDC), National Institute on Alcohol Abuse and Alcoholism (NIAAA) and Substance Abuse and Mental Health Services Administration (SAMHSA). 1. Do you drink alcohol when you’re feeling down or worried?
2. Do you drink to forget something in your life or past?
3. Can you go to sleep and wake up without a drink?
4. Do you cope with emotions by drinking?
5. Do you have a hard time managing stress without alcohol?
6. Do you engage in “binge drinking,” having five or more drinks on a single occasion?
7. Do you have trouble maintaining relationships, hobbies or activities because of your drinking habits?
8. Do you consistently go over limits on drinking that you set for yourself?
9. Do you find yourself in dangerous situations or experiencing thoughts of suicide because of drinking?
If you answered yes to three or more questions, you might have a substance abuse issue. Find a therapist who specializes in the treatment of substance abuse by visiting: EagleValleyBH.org/SubstanceAbuse
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ROOT CAUSE Understanding the 'why' behind behavioral health by k atie coakley
Is it the numbers measured in blood pressure, heart rate, cholesterol and body weight? Or is it the wellbeing of the body, mind and spirit? Increasingly, patients are seeking treatment for conditions related to behavioral health — issues that can include depression or anxiety, weight loss or diabetes management and quitting smoking, drinking or drugs. As a result, healthcare is moving beyond the numbers, and integrated behavioral healthcare is becoming the gold standard. Mental health is a key component in this puzzle. Though we all have “down days” or “feel blue” now and then, some people experience persistent, debilitating and devastating depression, anxiety or mental illness. While there isn’t one reason why people experience metal health challenges, most can be traced back to a combination of factors, both biological and environmental, including genetics and biology, life experiences and external factors. However, by understanding the causes, behavioral healthcare providers can work to unlock the right treatment, or combination of treatments, for each person. h at m a k e s s o m e o n e h e a lt h y ?
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HOW GENES CAN IMPACT MENTAL HEALTH Does mental illness run in families? Is there a gene that determines whether or not an individual will suffer from mental health problems? Yes and no. “Even though we have lots of research on the root causes of mental illness, whether it’s depression or anxiety, for instance, it’s almost impossible to link it to one thing,” explains Dr. Casey Wolfington, licensed psychologist and community behavioral health director for Eagle Valley Behavioral Health (EVBH). “We’re such complex creatures and so much of who we are is a combination of both our genetics and what we experience as humans.” Genes may play some part in mental health disorders, but it’s not as straightforward a correlation. Instead, mental health disorders like depression and anxiety are what Dr. Marshall Thomas, director of the Johnson Depression Center at the University of Colorado and the medical advisor to EVBH, calls a polygenic disorder: There are multiple effects based on multiple genes. To add to the mix, there’s also a gene environment interaction that doctors believe starts even before you’re born — a mother’s stress hormones can actually trigger certain things in a baby’s genes prenatally. “Your genes aren’t static. They’re turned on and turned off by the environment, especially by trauma and stress,” Dr. Thomas explains. “So there’s a huge role that the environment plays on who ends up depressed, who ends up with certain chronic diseases.” In other words, there may be genes that indicate mental health issues like depression, bipolar disorder or schizophrenia, but just because those genes exist doesn’t mean that those illnesses will manifest. There is also some indication that families can have a predisposition for certain mental illnesses, like depression or bipolar disorder. “For example, with depression, if you have a first-degree relative (like a mother or sibling) with major depression, you’ve got a 10% chance of having major depression yourself,” Dr. Thomas says. “It’s not 100%, it’s 10%. If you look at the general population, that's probably 5%. So that genetic predisposition puts you at increased risk.” As a result, the ability to reduce or alleviate stressors in the environment can play a major factor in preventing 12
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Research shows that living with anxiety actually changes the brain.
depression, or mitigating the effects of depression, if you’re genetically predisposed to the condition. “If you take appropriate care and practices to help mitigate environmental stressors like early loss and trauma, you’re less likely to actually manifest depression,” Dr. Thomas says. This is positive news. Just because there are genetic indicators or family history, experiencing a mental health challenge is not a foregone conclusion. Instead, our environment and our connections to other people can not only make a difference in our own lives, but we can make a difference in other people’s lives. “That should be where a lot of our attention is: How do you get upstream with this and create nurturing environments either in the family or in the community that mitigate stress in kids and help them not walk into adolescence or adulthood with a body that's already had all the stress genes turned on to set them up for anxiety and depression and substance abuse?” Dr. Thomas questions.
NURTURE VERSUS NATURE These environmental stressors — everything from loss to trauma and abuse — can play a huge role in behavioral health. “There are studies where they count how many adverse childhood events someone has,” Dr. Thomas says. “And the research shows there’s a direct correlation between the high number of adverse events that happened in childhood and the instances of medical illness and psychiatric instances.” As a result, creating nurturing and supportive environments, both in the home and in the community, is crucial for creating positive behavioral health. This is where the importance of relationships comes in. Research has linked the number of connections that one person has to his/her resilience and ability to overcome difficult times or obstacles in life. This goes beyond the early years. In addition to having strong relationships at home, it’s important to have other connections — at school, in the workplace and in your social life. Your support group
doesn’t only help when uncontrollable situations occur, but it can also create positive influences throughout life. “Even if genetics show a predisposition for anxiety or depression or learning disabilities, for instance, our social connections and strong relationships with other people are our biggest predictors of health,” Dr. Wolfington says. THE BIOLOGICAL, PSYCHOLOGICAL AND SOCIAL When it comes to treating behavioral health issues, it’s important to look at all aspects that could be contributing to the problem. “When we’re talking about mental health, oftentimes we’re thinking about specific diagnoses rather than all of the different systems that contribute,” Dr. Wolfington says. For example, someone with diabetes may also be experiencing anxiety or depression. Instead of treating the depression as a separate, individual illness, the patient may see a better outcome if the mental aspect of dealing with the diabetes is addressed. Having tools and strategies to deal with the mental burden can ease the depression, leading to improved mental health and, hopefully, better management of blood sugar. In short, everything is connected and dealing with just one aspect of a person’s condition limits overall wellness. “In order for us to enhance behavioral health or physical health, we have to look at all dynamics of health,” Dr. Wolfington explains. TAPPING INTO GENES FOR TREATMENT Pharmaceuticals are often part of a treatment plan for mental illnesses. But what if there was a way to use your genes to create a more effective treatment? This is a question many pharmaceutical companies are trying to answer. Genes may determine some of our responses to treatment, but again, it's not a question of addressing a single gene. And though several companies tout genetic testing as a means to guide choices for antidepressants, “experts with no financial interest in genetic testing have repeatedly recommended that genetic tests should not be used in choosing treatments for depression,” wrote Dr. Bruce Cohen and Dr. George Zubenko on the Harvard Health Blog. In fact, the FDA advised that the tests had no proven value and should not be used. The organization also stated that the use of the tests could lead to inappropriate treatment choices that might harm patients.
Even if genetics show a predisposition for anxiety or depression or learning disabilities, for instance, our social connections and strong relationships with other people are our biggest predictors of health.
“So instead of getting overly focused on genetic testing, I think the focus should be on comprehensive care that is guideline-based. Comprehensive care is care that deals with and understands the biology, the psychology and the social aspects of the mood disorder the person has,” Dr. Thomas says. “At this point I would reserve genetic testing for people where a comprehensive stepped-care approach and multiple medication trials have not been successful.” EXPANDING AND IMPROVING THE QUALITY OF CARE Regardless of whether or not behavioral health is linked to biology or environment, having access to care can directly improve mental health. “Not having access to appropriate medical care or health insurance has been consistently linked to poor behavioral health and physical health outcomes,” says Dr. Wolfington. “That is one of the reasons that Vail Health felt it was so important to create an integrated behavioral health environment within our Colorado Mountain Medical clinics.” One challenge that both rural and mountain communities face is creating better access to ongoing care. This manifests not only in affordability and access for patients, but also having the behavioral health professionals available to help. Until recently, there were no training opportunities for prospective psychologists or clinicians in the mountains. However, in 2014, Bright Future Foundation, a community fundraising partner of EVBH, created the Colorado Psychology Internship Consortium, also known as CO-PIC, which prepares interns to meet the needs of rural and underserved populations. “It’s a really big deal because the vast majority of people who are in
practice as psychologists, doctors or physicians typically practice in close proximity to where they finished their residency,” says Dr. Wolfington, who helped establish CO-PIC. “The lack of pre- and post-degree training opportunities is one of the reasons that Eagle County struggled to effectively recruit providers.” Eagle Valley Behavioral Health has now been established as part of CO-PIC, creating partnerships with prospective psychologists and clinicians from schools like the University of Denver to try and create a pathway for the behavioral health workforce in our community. “Without a formal pathway, we’re just relying on clinicians with high student loan debt to take the risk of moving to our high cost of living, low housing availability community, and it’s not going to happen,” Dr. Wolfington says. “We have to be really intentional in making these partnerships. Otherwise, we’re always going to have a behavioral health provider workforce shortage.” By increasing access to care, which includes both mental and physical care, the community as a whole will be healthier. Mood and anxiety disorders are not like a virus — treating them is not a “one and done” situation, Dr. Thomas says. Instead, they require ongoing interventions, including lifestyle interventions, psychological interventions and sometimes biological interventions. The earlier you intervene, the better the outcome. Approaching behavioral health with a wholistic approach early on helps mitigate the unavoidable life stressors and trauma that can lead to mental health issues. So don’t ignore your behavioral health — it’s just as important as those other numbers on the doctor’s chart.
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YOU'RE TOO UPTIGHT
A R E YO U R E A LLY TH AT S TU PI D
U N P O PU L AR
R E TA R D E D
OVERLY EMOTIONAL YOU'RE CONFUSED
I HATE YOU
The power of the spoken — and unspoken — word by kimberly nicoletti
ticks and stones may break my bones , but words can cut me deeply: It’s not the childhood retort you may know by heart. This one tells the truth. “Words can hurt, and a lot of the words we use unintentionally, we’ve grown up with,” says Michelle Dibos, Eagle Valley Behavioral Health’s community engagement director. “But how would those words sit with somebody who has a mental illness?”
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IT WAS JUST A JOKE
YOU DON'T GET IT
UGLY WHAT'S THE POINT
GO KI LL YOU R S E LF
YOU'RE IN THE WAY
I M P O R TA N T
I DON'T CARE
YOU CAN DO IT
I NEED HELP
Phrases like “you’re crazy,” “he’s a psychopath” or “that’s insane” can trigger shame in people suffering from depression, anxiety and other mental health issues, especially when they already feel something’s wrong with their thoughts, emotions and behaviors. Passing something off flippantly with the catch-all “that’s so depressing” can further isolate someone who is genuinely hurting. Labeling people can make them feel even more alienated and out of control. But does that mean we should tiptoe around behavioral health problems and every word we utter? Eagle Valley Behavioral Health (EVBH) experts think not. In fact, their “Long Live” campaign purposely uses controversial headlines to get people’s attention. EVBH’s Executive Director and Vail Health’s Chief Population Officer Chris Lindley admits the bold words found everywhere from town busses to the Vail Daily have turned some people off. But by stating “Long Live the Bipolar,” “Long Live the Alcoholic” and “Long Live the Abused,” for instance, EVBH aims to shift the culture and break down stigmas, and it seems to be working. Since the campaign launched in the fall of 2019, “We started seeing a big uptick of people talking about behavioral health. People are opening up about it, and they’re feeling way more comfortable,” Lindley says. “Appointments with local therapists have skyrocketed, and it’s not that the problem is getting worse — people are finally seeking help and feeling comfortable with it. People will come into the doctor’s office and say ‘I’m depressed.’ We have never seen that before.” EVBH conceived of the Long Live campaign because “what we’ve been doing nationally doesn’t work. It’s getting worse, using the politically correct approach,” Lindley says. “I think we need to become frank and direct. We talk in circles, we talk around the edges, but we don’t ask the uncomfortable, direct questions.” WHAT DO I SAY? Straightforward questions can “save a life or can be the starting point to get someone the help they need,” Dibos says. Especially when it comes to suicide and selfharming, she says it’s important to reach out to people who seem to be struggling and directly ask: “Are you thinking about suicide?” Even “killing yourself” is OK to say, though she prefers people don’t use the phrase “committing suicide” because we need to decriminalize the idea. Dibos is not worried about insulting someone who appears depressed; she says if the person isn’t considering suicide, he or she will say so and usually feel more connected because someone cares. “Directly asking is very uncomfortable; it’s very challenging, but research has shown that being willing to ask is key,” Lindley says. “It’s easier to just not ask the question and walk away. We have to get away from this mentality.” Opening up the conversation with questions like: “How (or what) are you feeling?” and “What has been happening — or has happened — to you?” can help people see other ways “out.” “They usually don't want to take their life, but they don’t want to live with the pain,” Dibos says. “It’s a choice of two awful options.” Listening to someone’s pain and offering hope and understanding is like giving a drowning person a life boat and helping him or her row to the safety of shore.
“It comes down to proactive conversations,” Dibos says. “You start seeing the value of the questions because you see you’ve really helped someone in a difficult place.” The same direct, empathetic and nonjudgmental conversations apply to any behavioral health challenge, from alcoholism, drug dependence and eating disorders to domestic violence. If you suspect substance overuse, asking things like: “How many drinks do you have a day?”, “Are you using alcohol or drugs to numb or escape?” or “Is it interfering with your daily responsibilities?” may cause someone to consider if substances are impairing his or her life. Asking adults and children if someone is hurting them can help them find shelter. Even talking about how they define abuse can make them recognize that, in situations where they’re not actually being hit or physically harmed, their abuser is overly controlling or attempting to isolate them from friends. “Abuse can be really subtle, but over time, it puts you in a position where you’re disconnected from your support network,” Dibos says. Even bullying can look, sound and feel different from one incident to another. While physical bullying causes harm to the body, verbal, social and cyber bullying can be especially detrimental to someone's mental health.
The “Long Live the Depressed” ad draws attention to the 7% of adults who have had at least one major depressive episode.
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WELLNESS SHATTERING STIGMAS Beyond the bold headlines, the Long Live campaign busts through the shame of labels. Each ad assures people that they are not defined by a disease, mistake or life situation; they are not a burden; they are loved and have a purpose; and there’s hope. “It’s not you,” Dibos says. “You’re not the problem, but the situation around you may have you feeling a certain way.” Stigmas don’t just further hurt people struggling with behavioral health issues. They can often prevent them from getting the help they need. That’s why the Long Live ads encourage people to find a therapist or support group, or get connected to the local effort. “We want you to have a long, enjoyable life, but we need you to recognize when you need help,” Lindley says. Friends, family members and even professionals like doctors and therapists can ask the right questions, but it’s ultimately up to the person who’s struggling to open up. “Because it isn’t yet a stigma-free society, we’re asking something that’s really hard … but you need to find somebody that you feel safe talking to. That may be a friend or a family member or a professional,” Dibos says. “We now have an immense amount of resources in the valley, and we will get you help,” Lindley says. “We want to make sure no one is trying to do this alone. One of the challenges a lot of people have is they think they’re alone in their problems, whether it’s alcohol or domestic abuse, or they’re unhappy with their physical looks. We’re all battling different demons every day.” Finding the words to describe our emotions can help us tackle our problems and get the help we need from others. We teach our children to put names to their emotions — sadness, frustration, fear — but, as adults, we sometimes forget to differentiate negative feelings, which makes us more easily agitated. We’re often just “in a bad mood.” If we can identify our emotions specifically, we can better manage our feelings and explain them to others. Therapists can help their patients identify and articulate their feelings.
HOW DO I SAY IT? SpeakUp ReachOut, a community fundraising partner of EVBH, is dedicated to offering trainings on how to recognize the early warning signs of mental illness and how to help. Youth Mental Health First Aid teaches participants how to identify warning signs of mental illness in our youth and how to respond in ways that are helpful. Adult Mental Health First Aid teaches how to identify, understand and respond to signs of mental illness, including anxiety, depression, addictions and psychosis. Signs of Suicide (SOS) is designed for middle and high school students; they learn to identify symptoms of depression in themselves or others and to ACT — Acknowledge, Care and Tell — if they see signs of suicide ideation. Caregivers and counselors can take a two-day workshop on suicide intervention. The short two-hour Working Minds Training gives workplace administrators and employees tools to talk about mental health challenges. And, any community member can take the Question, Persuade, Refer (QPR) trainings, which empower participants to recognize and effectively respond to suicidal warning signs. It takes some vulnerability and empathy, but with a little practice, discussing behavioral health can become as commonplace as talking about physical illnesses. Rather than suffer in isolation, the one in four people who will deal with behavioral health issues sometime in their lives don’t have to feel the shame, confusion and hopelessness they once did. Open communication is essential. “Society has become more and more distanced. We share messages with each other, but we’re not really communicating,” Lindley says. “We have to re-engage and talk with each other again.” Your words, however difficult to utter, can make a big difference in not just one person’s life, but an entire community’s health.
Recent data shows suicide is the second leading cause of death for youth ages 15-24. 90% of those who attempt suicide do not go on to die by suicide.
The 2019 Healthy Kids Colorado survey found 29% of middle school and 16% of high school students reported being bullied on school property.
It Takes A Valley: Transforming Behavioral Health
It Takes A Valley: Transforming Behavioral Health aims to raise $100 million for Eagle Valley Behavioral Health and its community partners: Bright Future Foundation
Vail Health has committed $60 million to behavioral health, which brings the organization's total investment to $160 million over 10 years.
There are many opportunities for you to make a meaningful impact. Contributions provide critical funding for:
Mountain Family Health Centers
• Olivia’s Fund • Crisis Services
• Latinx Programs
• Prevention & Education
Early Childhood Partners
My Future Pathways SpeakUp ReachOut The Hope Center of the Eagle River Valley
• School-Based Services • Area of Greatest Need
We need everyone’s support because it really does take a valley. Together, we can make a difference.
Join the campaign today or learn more at ItTakesAValley.org
THE POWER OF CONNECTION
Battling the happy valley’s loneliness epidemic by david o. williams photos by dominique taylor
o n e li n e ss an d d e pr e ssi o n
come in many forms in our mountain communities and affect people of all demographics in very different ways. But people at the greatest risk for experiencing loneliness — the elderly, youth and those living alone — say the best weapon in their arsenals is simple human connection. “There is a substantial loneliness epidemic in our communities that occurred way before COVID-19 hit and we were forced to self-isolate,” says licensed psychologist and Community Behavioral Health Director for Eagle Valley Behavioral Health Dr. Casey Wolfington. “We are innately social creatures and we’re wired for social connection.” Social engagement is especially fundamental to the development process in children and teens,” says Dr. Wolfington, whose work over 14 years of practice has focused on children and adolescents who have experienced trauma. “When we were initially faced with the order for COVID-19 isolation, I saw many families downplay the impact on their teens, their kids and their own selves. I don't think many people really understand that connection and relationships are a fundamental milestone in child and teen development. That was taken away, and if we keep taking it away, we do not know the long-term consequences.” Judson Haims, owner and director of Visiting Angels Eagle County, asks many of the same questions about Eagle County’s steadily aging population, where he sees longtime residents losing friends and family members and becoming increasingly isolated. His company dispatches licensed caregivers to assist in homes, and says there are many things we can all do to keep older residents connected. “Keeping our eyes open for community members who have kind of faded away, being a neighbor,” Haims recommends, citing the paradox of the Eagle River Valley, where neighbors unflinchingly hold fundraisers for friends with cancer but don’t intervene for loneliness or depression.
He encourages, “Ask, ‘What can I do?’ And be aware of advocating for people; we should all be advocates.” Haims was touched when high school musicians started playing impromptu concerts for the residents of Castle Peak Senior Life and Rehabilitation Center in Eagle during the COVID-19 lockdown in March 2020 — an effort they undertook of their accord. “Now you bridge that youth age group with a senior age group, and you create something very special,” Haims says. “This younger age group is more receptive to helping out elders than any other generation in many generations. How we help the society at large is by looking around and seeing what we can do with an earnest desire to help out others.” Dr. Wolfington agrees that finding creative ways to bring people together, especially in this time of pandemic isolation, is critical to staying healthy as a community. “Social connection is the biggest predictor of strength of health, both physical and emotional, across a number of studies, and when we think about loneliness, that has actually been linked to substantial rates of early death,” Dr. Wolfington says, pointing to higher incidences of cardiac issues and cortisol levels, which is the body’s main stress hormone. Haims, who first moved to Eagle County in 1991 to work in restaurants, hospitality and marketing, started his Visiting Angels franchise because a growing number of friends had aging parents in need of care, including some of the founding members of Vail. They came for the highly active outdoor lifestyle and didn’t want to leave as they became less active. “It could just be a forfeiture of the things that you used to have that now make you feel isolated, and with the isolation comes loneliness,” Haims says, adding he’s had remarkable success hiring caregivers who have retired from or are working on certifications in the local healthcare industry. He also says empty-nesters looking for ways to give back have been a boon.
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But he acknowledges that all of the factors that make it difficult for other employers to find qualified workers — high cost of living, housing, health insurance — also impact his company, especially during the ongoing pandemic. And those factors also contribute to stress and loneliness. People move to the valley and are
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in awe their first year, he says, doing whatever it takes to make ends meet and live the dream of skiing, biking and boating in the Rocky Mountains. Then long-term reality sets in at about year three. “Now all they’re doing is working; they’re not mountain biking, they’re not hiking, they’re not going out,”
Haims says. “They say, ‘This sucks; I’m never going to have the money to buy a house,’ and they leave. That cyclical turnover creates issues of depression and anxiety for the people that are there, but also flows upstream to the employers.” All of those factors continue to compound for people who decide to stay, says Carol Johnson, director of programs and events for SpeakUp ReachOut, a suicide-prevention group that is working to address loneliness in a county with one of the highest rates of suicide in the nation. “If we can’t talk about [loneliness], we are putting ourselves on the road to serious mental health risks. Not unlike the name of our organization — SpeakUp ReachOut — I believe locals need to take these actions more,” Johnson says. “We need to talk about our feelings, problems and difficult situations without fear of shame and stigma from those we are opening up to. “We need to put our phones down in the presence of others, make eye contact, ask questions and actively listen. We need to have the confidence to say to a friend, a neighbor, a family member, a colleague, ‘Hey, you don't seem like yourself, do you want to talk about it? I’m asking because I care about you.’ These simple approaches could possibly save a life,” Johnson adds. Johnson says there is a difference between being alone and feeling lonely. Loneliness can occur in the presence of others, and reaching out during COVID-19 looks a little different than pre-pandemic life and possibly takes more effort. Connections may have to come via Zoom, FaceTime, small gatherings in homes, walks outside and meetings at safe spaces where masks are being worn. Haims and Dr. Wolfington agree that too often socially connecting in Eagle County involves drinking, and while technology is serving to connect us all in new and exciting ways, Dr. Wolfington adds that social media is feeding the loneliness epidemic. “Social media has absolutely contributed to it because … you can be connected without really being connected,” Dr. Wolfington says. “I’ve had kiddos that I’ve worked with that when they name their friends, they name people that they meet in different chat rooms or on different games they play that they've never physically met before. That feels really sad … really scary.”
Connecting over a shared interest can contribute to a sense of community, as concerts and other live music events demonstrate. For children and teens, socializing with peers is a developmental need that allows them to explore emerging ideas, views, values and feelings.
Vail Health fields a softball team called "The Scrubs" to promote connection amongst staff outside of work.
Social connection is the biggest predictor of strength of health, both physical and emotional, across a number of studies, and when we think about loneliness, that has actually been linked to substantial rates of early death. Thankfully, there are a growing number of tools in the valley for people who are feeling disconnected during the current crisis or who found themselves in need even before the pandemic. In the midst of COVID-19, Eagle Valley Behavioral Health launched Community Stream, a website dedicated to keeping the community informed, healthy, active and engaged. Podcasts, live stream and recorded events are hosted daily. Topics include fitness, music, education, wellness, spiritual and peer support. To find opportunities for connection, visit: CommunityStream.org Check the newspaper and social media for other local happenings, pick up the phone and call a friend, meet your neighbors or invite a co-worker on a walk after work. There are ways to safely connect with others, and in a time when social distancing is encouraged, connection has never been more critical.
MEDICATING BEHAVIORAL HEALTH The stigma — and need — behind using pharmaceuticals as part of a behavioral health treatment plan by k aren mason
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f yo u h av e d i a b e t e s , you take insulin, and no one thinks twice about it. But if you tell someone you’re on antidepressants or antipsychotics, there is sometimes judgment that is purely based on a misunderstanding of medications used to manage behavioral health imbalances. Prescription medications are used to address a host of chemical imbalances in the body, but the stigma surrounding medicating behavioral health disorders sometimes prevents people from getting the support they need. Dr. Marshall Thomas, executive director of the Johnson Depression Center at the University of Colorado and professor of psychiatric and family medicine at University of Colorado School of Medicine, is the medical advisor to Eagle Valley Behavioral Health. Historically, he says, admitting to a mental disorder has been seen as a sign of weakness. And though that notion is waning as education and awareness increase, it is still harder for people to admit they’re struggling with bipolar disorder than a knee
injury, for instance. Often, people who need the assistance of mental health medications don’t use them because they don’t think they need them. Some will try a medication and decide it doesn’t work when, in fact, finding the right medication and dosage requires some trial and error. “Frequently, they didn’t have an adequate treatment plan,” explains Dr. Thomas. “Either they didn’t have the right medication, an adequate dosage or the right dosage.” For example, Dr. Thomas says bipolar disorder doesn’t respond well to anti-depressants. “You need a different medication approach,” he explains. How providers work to find the right medication and dosage is an important part of the delivery system. There isn’t one medication that works for all. “It’s important to work with a psychiatrist to manage medication use and talk openly about the effects,” says Dr. Thomas. There is a 40% remission with the first trial of a drug, he says. “You have to continue to work to try different medications, add in lifestyle changes, as well as psychotherapy.”
The failure of people with mental health disorders to take prescribed medications is one of the most concerning problems in psychiatric care. According to a study in the Journal of Clinical Psychiatry, nonadherence to medication can lead to a relapse of symptoms, rehospitalization, homelessness, incarceration, victimization or episodes of violence. BRIDGING THE MENTAL AND PHYSICAL HEALTH GAP Eagle County is on the forefront of breaking down the traditional silos of mental and physical healthcare, but the disconnect has been hard to overcome, according to Dr. Thomas. “Twenty years ago, our country took mental healthcare and carved it out of healthcare and disconnected the two. This is like disconnecting the mind and the body. We’re just emerging out of that, which is really exciting,” he says. Historically, there have been incredible challenges accessing psychiatric consultation in the Eagle River Valley due to an absence of these specialized providers, who tend to be concentrated in urban areas and don’t make it into rural communities. Dr. Thomas says the attempt to reconnect primary care with mental healthcare is already evident in the exam rooms at Colorado Mountain Medical, where patients can work with their primary care doctors to consult with psychiatric care providers, therapists and psychologists. Dr. Thomas says this effort to reintegrate mental and physical health to create a total healthcare approach is fairly new and cutting-edge. Colorado Mountain Medical has been recruiting additional licensed therapists, psychiatrists and nurse practitioners to support their growing behavioral health team, and has expanded its telehealth program to include psychiatry. “It’s a teambased approach,” says Dr. Thomas. “We are finding creative ways to bring psychiatric experts to Eagle County.” MENTAL HEALTH MEDICATION TYPES There are a variety of medications that are used to treat mental health issues. Perhaps the most common are antidepressants, which can help with depression, anxiety and insomnia. Though there are different families of antidepressants, they work in basically the same way. They either increase the brain’s concentration of the neurotransmitters norepinephrine and serotonin, or they work to stop the breakdown of norepinephrine and serotonin. Serotonin is known as the “feel good” brain chemical, while
Medications can help the body re-regulate and get back on track. For people with severe disorders such as PTSD, bipolar and OCD, using medications as an adjunct to help them re-regulate can help them regain control of their bodies.
norepinephrine is related to alertness and energy. By regulating the levels in the brain, a person can start to dig out of the black hole that depression might have put him or her in. And though there is no such thing as a “silver bullet” answer, antidepressants may be a smart place to begin a comprehensive treatment plan. It often takes a couple of weeks for people to experience positive results from taking antidepressants. Anti-anxiety medications often work faster than antidepressants, and can overlap with treatment of depression. As their name implies, they help relieve feelings of anxiety. Benzodiazepines and beta-blockers work on an as-needed basis, and can help manage the physical symptoms of anxiety, including the trembling and rapid heartbeat that people might experience in difficult situations. Taking these medications for a short period of time can help the person keep physical symptoms under control. Stimulants are used primarily in the treatment of ADHD in all age groups, though they can also help with other issues such as narcolepsy and depression. Like antidepressants, they promote the activity of the brain chemicals dopamine and norepinephrine. Stimulants provide a focusing, or calming, effect for people with ADHD. But there is a stigma surrounding stimulants, perhaps because when taken in excessive dosage, they cause a sense of euphoria. It bears noting that when taken at the prescribed dosage, there is no sense of euphoria. Antipsychotics and mood stabilizers are two different categories of mental health medication, but both are used to treat more serious and chronic mental health issues such as psychosis, bipolar disorder and eating disorders. HOW TO KNOW IF MEDICATION CAN HELP Dr. Thomas says one of the problems with the old system for treating
behavioral health was it became easier for people to get medication than a referral to psychotherapy for skills development. While some patients can get better with just medication or psychotherapy, Dr. Thomas says patients with moderate to more severe disorders typically need a combination of both over time. On an initial visit, the provider and patient will discuss the patient’s symptoms. If the patient is depressed because he just got a divorce or lost a job, the patient and doctor may decide to talk about it before trying an antidepressant. But if the patient is experiencing severe symptoms that are affecting biological functions such as sleep, energy, appetite and focus, then medication may help re-regulate the body’s systems and allow the patient to talk through the emotions surrounding the issue. “When you are in crisis, depression is a stress response that causes you to shut down,” explains Dr. Thomas. “Medications can help the body re-regulate and get back on track. For people with severe disorders such as posttraumatic stress disorder, bipolar and obsessive compulsive disorders, using medications as an adjunct to help them re-regulate can help them regain control of their bodies.” Behavioral health providers recommend complementary therapies like mindfulness, exercise, massage and improved daily habits, including dietary changes. “All of these things can help you feel stable and regulated,” he explains. “With a comprehensive approach, you look at what needs to be tweaked in each of these dimensions.” When it comes to treating a mental health disorder, it's important to have the support of a psychiatrist who can partner with the patient to find the right medication and complementary therapies that best treat the individual. 2 02 0 -2 021
HOW TO FEEL HAPPIER The pursuit of happiness is ongoing and the options are endless by kimberly nicoletti photos by dominique taylor
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etween sunny social
media posts and feelgood fads, you might be getting the idea that if you’re not happy all the time, something’s wrong. But what’s really wrong is the message. Human beings feel. It’s what we do. Life’s peaks and valleys elicit all kinds of emotions, from joy and bliss to anger, fear and devastation. “It’s impossible to feel great all the time,” says psychologist and Community Behavioral Health Director for Eagle Valley Behavioral Health Dr. Casey Wolfington. “A lot of our community struggles with that happiness ideal.”
huge piece, sometimes we don’t understand its impact.” Texts, social media and phone calls are fine, but relying solely on distant communication has left our society feeling exactly that: distant. In-person communication includes body cues, verbal tones and warm smiles that no emoji can transcend. Even when we’re six feet apart, it’s amazing how close we can feel. Fortunately, happiness seems to be more contagious than just about any virus; people who feel happy tend to elicit the same feelings in others. But, beware: anger and fear are just as catchy.
“We really don’t know what power we have,” Dr. Wolfington says about how our emotions influence others, and vice versa. Another simple, yet powerful, intervention includes nature and exercise — particularly when combined. “Nature is calming and helps build your immune system through vitamin D,” Lindley says. “Now more than ever, there are great reasons to get outside, and there’s never been a study that says exercise is not supportive. It’s not only the cheapest, but it’s also the least invasive, therapy because you can do it yourself.”
Being outside in nature can provide a sense of wonder and satisfaction, and sunshine's vitamin D is a bonus. Social interactions are important to a person's overall health. Coupled with a bit of exercise, it's doubly good for the mind and body.
GET HELP While perfect happiness is pretty darn hard to achieve in a lifetime, feeling down in the dumps for extended time periods isn’t any fun, nor is it healthy. So, how can we be happier? First of all, acknowledge your feelings, and know when to say when. If difficult emotions like anxiety, anger and hopelessness start to interfere with your daily functioning, it’s time to seek professional help. And, if problems begin creeping into more and more areas of your life, negatively impacting relationships, work and health, you’re probably overdue for a therapeutic tune-up. Granted, experts like Dr. Wolfington and Chris Lindley, chief population health officer for Vail Health and executive director of Eagle Valley Behavioral Health, would prefer that people seek help before a crisis hits. After all, athletes work with coaches who enable them to mentally prepare, and plenty of professionals in the business world turn to executive coaches. “It’s easier to seek help and form a connection when you’re not under distress,” Dr. Wolfington says. “The more we can do preventatively, the better.” NATURE & NUTURE The good news: There are many ways to find happiness. And you don’t have to pick just one. To begin with, focus on reestablishing strong social bonds. “Human connection is so important,” Dr. Wolfington says. “It’s been the key to survival throughout history. It’s such a
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MORE MODALITIES There are so many ways to feel more empowered, joyful and resilient, we can’t list them all. But here are several that can lead to a more fulfilling life. Cognitive Behavioral Therapy: CBT helps people identify inaccurate or negative thinking in order to view situations more realistically and respond in more effective ways. Psychotherapy: At its core, psychotherapy is talk therapy with a trained mental health professional. Psychotherapy has been studied in a variety of clinical and real-life settings, and can be as, or more, successful at treating mental health challenges as medication. Benefits include, but are not limited to, a reduction in stress, a new perspective on problems, tools for managing emotions, help with depression and ways to communicate with others. For tips on finding the right therapist, see sidebar on page 27.
Mindfulness & Meditation: What once was reserved for monks is now mainstream. Meditation apps and courses abound, and techniques include guided imagery, breathing and physical relaxation exercises and movement (like yoga) to help manage emotions. “Mindfulness encourages individuals to be present and fully attend to their experiences. This may include focusing on your thoughts and your emotions, but also letting go of the judgment that is associated with the experience,” Dr. Wolfington says. Light & Sunlight: Research indicates that practicing safe sunlight exposure can enhance serotonin levels, which are linked to mood. Some people’s depression and anxiety are seasonal: Less daylight results in more symptoms. They may benefit from full spectrum lights, or increased sunlight. Animal-Assisted Therapy: Animals have a naturally soothing, warm-fuzzy effect. They can even help people manage difficult emotions.
Human connection is so important. It’s been the key to survival throughout history.
“We are seeing research supporting positive outcomes for animalassisted therapy, from children struggling with reading disabilities to adult veterans struggling with post-traumatic stress disorder,” Dr. Wolfington says. Grief Work: Grief work comes in various forms, one being The Grief Recovery Method. Grief, and other therapeutic work, can be done individually or within groups. “There is not one person that is not touched by grief during this pandemic,” says Celynn
Animals help promote feelings of happiness and wellbeing, whether they are officially trained therapy animals or simply the family dog. Apps such as Headspace make meditation easy for those on the go — even a couple of minutes of mindfulness practice can help.
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FINDING THE RIGHT THERAPIST
McClarrinon, a local licensed social worker in Avon, naming losses like jobs, routine, travel plans, freedom and not seeing older parents, as well as loss of physical touch. “The Grief Recovery Method creates a safe environment in which to look at old beliefs about dealing with loss, to look at what losses have affected your life and to take new actions, which lead to completion of the pain attached to one of those losses.” Positive Psychology: This relatively new, scientific approach to thoughts, feelings and behavior focuses on strengths instead of weakness in an effort to build the good, rather than repairing the bad. Time is spent on building optimism, wellbeing, gratitude, self-confidence, hope and more. Forgiveness & Acceptance: The whole point of feeling your feelings is to move on and live more freely. But when somebody wrongs you, intentionally or not, it can be difficult to let go of the hurt. There are two sides to forgiveness: decisional and emotional. Decisional forgiveness is generally the “easier” of the two,
as it involves a conscious choice to replace ill will with good will. Emotional forgiveness is harder because you have to move away from the negative feelings and stop dwelling on them — despite sometimes still experiencing the consequences of the wrongdoing. “People often seek therapy to move forward without all of the anger or emotions that impact their happiness,” Dr. Wolfington says. “Working through forgiveness is really about processing your own emotions.” Medication: Sometimes, behavioral health issues related to chemical imbalances benefit from medications. Psychiatrists specialize in medications for mental health. YOUR TURN Lindley believes in the 1% Rule: Take one small step, every day, to lift your mood by just 1%, and within a year, you’ll reach 365% improvement. “As individuals, we all know which activities help calm us, so it’s knowing yourself and what things allow you to disconnect and let the mind rest,” Lindley says. “It may be different than the majority of your friends, but that’s OK.”
Sure, you want to find a type of therapy that resonates with you, but feeling connected with your therapist may be even more important than the modality. “It all comes back to the relationship with your therapist,” says psychologist Dr. Casey Wolfington. “The strongest predictor of success is how you feel about your therapist; it enhances change across the board.” Of course, feeling connected doesn’t always mean feeling completely comfortable, 100% of the time. “You also want to feel they can challenge you in the way you want to be challenged,” she says, adding that people should be able to clearly see that they’re heading in the right direction in therapy. Overall, you shouldn’t feel judged, and you should feel safe enough to tell your therapist when he or she may be missing the point. Therapy should be more like a conversation of discovery, Dr. Wolfington says. You may not feel bonded immediately, and that’s OK. Just listen to your inner knowing. “Go with your gut,” she says. “If, in the first session, you don’t feel connected, honor that, but also know that therapy is sometimes hard to get used to. Like a new job, it may take a warming-up period.”
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How Mentally Healthy Are You? by k atie coakley
hile the pursuit of happiness might be an inalienable right, attaining it can be easier said than done. From a general sense of malaise to near-debilitating fear and pain, emotions and feelings can run the gamut and can be affected by everything from the weather to chemical interactions in the brain. But when the down days start to occur more frequently than the good days, it may lead to the question of “how mentally healthy am I, really?” This short quiz will help you consider your own mental health — and offer a bit of advice, too. Think of it as a “check-up from the neck up.” Answer the following questions with sometimes/never or often/always.
In general, are you hopeful about your future? Are you interested and excited about things in your life?
O F TE N / A LWAYS
S O M E TI M E S / N E V E R
If you answered “often” or “always,” then congratulations: You are experiencing a strong sense of wellbeing.
If you answered “sometimes” or “never,” then you may be struggling with factors in your life causing you significant levels of distress. This could be tied to your physical health, your interpersonal relationships, your job or school responsibilities. Consider talking to a therapist, making a short list of achievable goals or planning something you can look forward to.
Over the past two weeks, how often have you felt like you have little interest or pleasure in doing everyday things, from going to work/ school to interacting with friends and family?
O F TE N / A LWAYS If you answered “often” or “always,” then you might be suffering from depression. In this case, speak to a therapist who can help guide you through additional questions to determine your current state of mental health and recommend treatment.
S O M E TI M E S / N E V E R If the answer is “never,” then your current mental state is healthy. If you answered “sometimes,” you might be experiencing minimal depression, which may or may not require treatment. Consider doing the activities you enjoy and surrounding yourself with people who motivate you or make you feel happy.
Over the past two weeks, how frequently have you been bothered by feeling nervous, anxious or on edge?
O F TE N / A LWAYS
S O M E TI M E S / N E V E R
If you answered “often” or “always,” then you might be experiencing anxiety. In this case, consider exploring ways to deal with your stress, like calming your mind through relaxation exercises. A licensed therapist can offer a variety of suggestions and help you find the ones that work best to manage stress and worry.
If the answer is “sometimes” or “never,” then your anxiety would be considered manageable. After all, there are plenty of dayto-day things that can cause minor anxiety, and lots of ways to deal with that emotion.
Over the past two weeks, have you felt that you ought to cut down on your drinking or drug use? Have you felt guilty about it?
O F TE N / A LWAYS
S O M E TI M E S / N E V E R
If you answered “often” or “always,” then substance use might be putting you at risk for health and other problems. Behavioral health conditions like this are treatable and most people find that they can make positive changes in their lives with professional help and the support of family and friends.
If the answer is “never,” then you have a handle on your vices. If you answered, “sometimes,” then more screening could help pinpoint areas where you could use support.
Over the past two weeks, have you thought about or tried to end your life? Have you imagined that you would be better off dead, or had thoughts of hurting yourself in some way?
S O M E TI M E S / O F TE N / A LWAYS If the answer is “always,” “often” or “sometimes,” please call the 24-hour, confidential Hopeline at (970) 306-4673.
TRANSFORMING BEHAVIORAL HEALTH
The past, present and future of behavioral health in the Eagle River Valley by kimberly nicoletti photo by dominique taylor
Left to right, Eagle Valley Behavioral Health's Executive Assistant Claire Wilson, Outreach Operations Manager Kala Bettis, Data Systems & Analytics Director Mike Richards, Youth Engagement Coordinator Gerry Lopez, Behavioral Health Clinical Services Director Dr. Casey Wolfington, Executive Director Chris Lindley, Operations Director Dana Erpelding and Community Engagement Director Michelle Dibos.
n sixth grade , olivia ortega began finding notes from classmates in her backpack and locker saying things like: “You should kill yourself.” As the bullying continued, Olivia’s personality began to change. When her parents reached out for professional help in 2017, it took them a month and a half for Olivia to actually see a therapist, due to a lack of local providers. Health insurance didn’t cover the sessions, and the family didn’t qualify for financial assistance. Each session cost $270 — an unsustainable amount, given the amount of support she needed. Olivia cried out for help in ways that should have been recognized by her peers and teachers, but at the time, they were either not equipped to recognize the warning signs, or they didn’t know how to handle the situation. Olivia couldn’t find hope in the future, and a few days after her 13th birthday, in February 2018, Olivia took her own life.
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Olivia’s death was the wake-up call the community needed to launch an initiative to transform the behavioral health system in the Eagle River Valley. Between 2013 and 2017, Emergency Department visits for anxiety and depression had jumped 360%. Western mountain towns were labeled the “suicide belt.” In 2017, the suicide toll jumped from six to 16 lives. In 2018, the number increased again, to 17. “All of the sudden, it became a raging wildfire,” says Michael Holton, chief marketing and experience officer at Vail Health. “Everybody was on the same page, whereas before, some people were talking about it, but not a lot.” By August 2017, Eagle County Commissioners decided to place Measure 1A on the ballot, which would tax recreational marijuana sales and growth operations by 2.5% to support mental health. People like Chris Lindley, Eagle Valley Behavioral Health’s executive director and Vail Health’s chief population health officer, helped educate the community about the mental health crisis, and it made a difference. That year, 73% of voters passed Measure 1A. In early 2019, Vail Health’s volunteer Board of Directors supported the founding of Eagle Valley Behavioral Health (EVBH) and committed $60 million to the organization over the next 10 years. The Vail Health Foundation initiated the $100 million It Takes a Valley: Transforming Behavioral Health campaign. In addition, Eagle County has contributed $1.3 million. EBVH launched in July 2019, with Lindley at the helm. Since then, the organization and its partners have accomplished nothing short of amazing results. They’ve increased the amount of therapists, resources and programs; launched a website to be a single source of information regarding behavioral health in the community; decreased stigmas around mental illness and created an outpatient program with Colorado Mountain Medical. COLLABORATION Early on, EVBH began amplifying local nonprofit efforts, such as SpeakUp ReachOut’s suicide prevention trainings, education and “You are not alone” messages. It encouraged open conversation by running stories about mental health in the Vail Daily and promoting events like Mountain Youth’s “Eat Chat Parent,” which, with the support of Vail Health and
EVBH, attracted over 500 parents and kids — 10 times the number of past participants. Since then, it has partnered with more than 25 local organizations, including Eagle County Schools, local government, businesses, therapists and first responders. “We have additional knowledgesharing, more funding available and an overall increase in what’s available to the community,” says Michelle Meuthing of the Hope Center. Bringing the Hope Center to Eagle County was life-changing for many. Eagle County Paramedic Services provided the funds to make it possible. Today, the Hope Center of the Eagle River Valley provides a crisis hotline, intervention and individual counseling; offers community education; and facilitates referrals, crisis services and prevention education in schools. Its clinicians accompany police and paramedics responding to crisis calls. They help calm and assess people, establish a safety plan, link them to therapeutic resources and follow up. Clinicians also arrive without police or paramedics, in unmarked cars (for anonymity) when people in crisis call the 24/7 Hopeline. They provide evaluations and connect people facing job losses, eviction, domestic violence, abuse and other crises to local resources like therapists, food pantries or Bright Future Foundation (for domestic violence and sexual abuse). Before the Hope Center came to Eagle County, paramedics usually took people to the Emergency Department for evaluation, or police officers took them into protective custody, which meant handcuffing and holding them at the station. Within seven months of the Hope Center’s interventions, ambulance transportations to the Emergency Department decreased by 76%. The Hope Center has also positively impacted schools by adding clinicians to the district to identify and provide therapy to high-risk kids. Its end-goal includes 17 clinicians total. If Olivia had that level of in-school support, she may still be alive today. Living with what-ifs is devastating, which is why prevention and intervention are so important. INTERVENTIONS “Imagine a system where my daughter, Olivia, could have asked for help and we could have afforded it,” Vickie Zacher, Olivia's mother, reflects. To address the cost of behavioral healthcare and make it available to all, Eagle Valley Behavioral Health es-
tablished Olivia’s Fund, a scholarship that provides up to six free therapy sessions to anyone living or working in the Eagle River Valley. “My hope for Olivia’s Fund is that it will help anyone who is struggling, so they can get the treatment that they, or a family member, desperately needs,” Zacher says. EVBH promoted Olivia’s Fund when COVID-19 hit the valley, since the pandemic quickly proved to exacerbate problems people face, including a loss of work, isolation, family pressures, domestic and substance abuse, bullying and more. EVBH’s partnership with Colorado Mountain Medical has placed mental health in the same arena as physical health, reinforcing the importance of both. They refer to this model of care as integrated health. Primary care providers now screen all their patients for behavioral health issues and can bring a therapist in from their team when needed during the physician visit. In addition to individual and family therapy, CMM’s behavioral health team offers support groups for anxiety, anger management and teen mood management. “People are talking about behavioral health issues more — it’s more in the forefront,” says Dana Erpelding, EVBH operations director. “The integrated health program at Colorado Mountain Medical is a game-changer.” In April 2020, EVBH partnered with Colorado Mountain Medical to create an intensive outpatient program, which offers eight-week sessions three days a week, for three hours each day. The program is designed for anyone at risk for, or having a history of, psychiatric hospitalization; anyone coming out of a crisis evaluation or psychiatric hospitalization; or anyone with needs that weekly therapy isn’t meeting. All of CMM’s behavioral health team, as well as nearly every provider in the valley, are searchable in EVBH’s “Find a Therapist” database at EagleValleyBH.org. The site features each therapist's photo, location, credentials, specialties, insurance policies and whether or not they’re currently accepting patients. People looking outside traditional therapy can discover local professionals who offer alternative therapies like art therapy, yogic therapy, physical therapy for neurological disabilities and more, all under the “Therapeutic Support” link. The site also lists local support groups, from Al-Anon and Alcoholics Anonymous to brain injury,
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sexual assault, caregiver, grief and trauma groups. Resources are also available in the directory at the end of this magazine, starting on page 71. EVBH’s Behavioral Health Navigators were introduced to the community in March 2020. These bilingual facilitators connect people with therapists, support groups and drug and alcohol treatment. In partnership with Eagle County Community Paramedics, the Katz Amsterdam Foundation and The Colorado Health Foundation, they help people understand their treatment options, insurance benefits, costs and financial alternatives. They can connect people to short-term support services revolving around making healthy choices, positive thinking, managing stress and controlling anger, and they can find people long-term care and resources like childcare and housing. “Anyone who is struggling to find a therapist, or who is not sure what services are available, can call the navigators for support,” says Erpelding. “The navigators can also provide support for people released
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Within seven months of the Hope Center’s interventions, ambulance transportations to the Emergency Department decreased by 76%.
from inpatient care. That’s a critical time when, historically, we’ve lost people in between hospitalization and ongoing therapy. There hasn’t been wrap-around support.” EBVH has also created funding agreements to strengthen community organizations like Bright Future Foundation, which addresses domestic violence and sexual abuse. They support Mountain Family Health Centers, which integrates medical, dental and behavioral healthcare; Mountain Youth to co-host “Eat Chat Parent” talks by nationally recognized speakers in
English and Spanish; and Hearts Reign, which provides education, training and support to the Latinx community. In addition, they are funding SpeakUp ReachOut to offer mental health first aid classes to more community members. COVID-19 SPECIFIC INTERVENTIONS To address the isolation caused by quarantine and social distancing, EVBH launched CommunityStream.org, a platform that encourages community members to stay informed, healthy, active and engaged through
Behavioral Health Navigators help local residents navigate the complex system of behavioral healthcare and connect people to available resources to meet their needs when they experience barriers to access. Eagle Valley Behavioral Health's Community Chat series provided easy access to answers about behavioral health, local resources and challenges residents face.
EAGLE RIVER VALLEY’S BEHAVIORAL HEALTH RESOURCES
live streaming and pre-recorded events. Topics include fitness, meditation, music, cooking classes and games in English and Spanish. Specific podcasts include: Your Kid’s Brain on Tech, Break the Anxiety Cycle, How Health Insurance Policy Can Affect Behavioral Health and Finding Hope Through Happiness. Anyone in the community can register to share their talents and wisdom. “As a result of the pandemic, we’ve seen an increase in substance use and crisis line calls,” Erpelding says. “Resources like Community Stream are going to be needed more than ever. It’s an opportunity for people to connect and decrease isolation. We think that more people are going to have long-term behavioral health and financial impacts than are going to get sick with the virus.” FUTURE PLANS A crisis hospitalization facility, which will provide stabilization, detox, respite care and a walk-in clinic, was scheduled to break ground this year, but the pandemic caused EVBH to shift gears and address even more urgent community needs. The plans for this facility continue to be developed.
The organization has collected data and continues to survey community members about the impact of COVID-19 and how people want to move forward. Robust marketing campaigns help frame healthy perspectives on behavioral health and encourage the community to seek support when needed. EVBH is implementing a scholarship program to support local students in obtaining behavioral health degrees, as well as a loan repayment program to recruit licensed clinicians to practice behavioral health in the Eagle River Valley. And, EVBH is working to extend Mountain Strong, its employee assistance program, to employers throughout the valley. In its first year, EVBH made a big impact in turning the Titanic of paltry resources and stigmas around. In its second year of operation, it is literally transforming the entire mental health landscape, from significantly reducing social stigmas to providing strong and affordable support systems throughout the valley. See how EVBH can help you by visiting EagleValleyBH.org. To support EVBH and its community partners, visit: ItTakesAValley.org
Until recently, behavioral health services were difficult to access. Cost, a lack of therapists and a dearth of general resources to help navigate the system fueled a stigma around getting help. Today, EagleValleyBH.org is a one-stop resource for finding a therapist, support group or crisis intervention. Community Stream is a clearinghouse of online resources for locals, by locals, offering everything from workouts to cooking classes, to tips on parenting. Olivia’s Fund provides six free behavioral health support sessions per year to anyone who lives or works in the Eagle River Valley and demonstrates a financial need. Benefactors and foundations contribute to this scholarship, which was named in honor of Olivia Ortega, whose life was cut short by suicide when she was 13 years old. Mountain Strong is an employee assistance program for Vail Health staff, which provides up to six free therapy sessions “per incident” by licensed psychotherapists. An incident may involve dealing with the current pandemic, financial issues, relationship issues, mental health challenges and more. Services also include medication management. EVBH is working to extend Mountain Strong to other employers in the valley. 2 02 0 -2 021
WE ARE THE
Eagle River Valley The Eagle River Valley is comprised of people of different genders, races, ages and stages of life. Yet, we all have something in common: we need to be attentive to our behavioral health. BY DAV I D O. W I L L I A M S
uch has been written about the so-called â&#x20AC;&#x153;paradise paradoxâ&#x20AC;? of seemingly homogeneous and largely idyllic mountain-town communities hiding a veritable onslaught of depression, substance abuse, loneliness and despair. But the reality is most mountain towns are far more diverse than they appear to the outside world, with people of all ages, ethnicities and socioeconomic status suffering similar problems and often struggling with less help.
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Eagle County Gender Sexuality Alliance helps promote representation for the LGBTQ community.
Evan Weatherbie (pictured center in black t-shirt) founded the Eagle County Gender Sexuality Alliance to foster awareness and acceptance, and to build bridges for anyone in the community to receive support.
“People have a misperception of what our community truly looks like, and it’s this idea that, ‘Oh, it’s a resort community; everyone is on vacation all the time; everything is perfect,’” says Dr. Casey Wolfington, licensed psychologist and community behavioral health director for Eagle Valley Behavioral Health. “The fact is that we have a lot of struggle in our community. When I was working with Bright Future Foundation, I was shocked initially that we saw over 600 cases of domestic violence and sexual assault a year [in Eagle County]. And the cases that I was working on were
on par, if not more horrific, than the trauma I saw in the emergency room down at Children’s Hospital [in Denver].” Those are city issues, or so the misperception goes. Residents of ski towns are young, healthy, athletic, affluent and immune to the problems people face in urban areas. Right? The reality is behavioral health issues follow folks to the mountains and are exacerbated by being far from family back home, caught up in a rat race of partying and working to get by in one of the most expensive places on the planet, and notoriously devoid
of professional help until recently. Whether you’re a working-class immigrant living in the local trailer park, someone who’s financially secure in a high-end condo or a family man struggling to balance multiple jobs, loneliness, depression and anxiety can find you. “People think that individuals who have means and access to income or insurance have a lower level of behavioral health problems, but that's not the case. Behavioral health is something that really spans socioeconomic status,” Dr. Wolfington says of the wide range of needs locally.
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Youth are amongst the most vulnerable to mental health challenges.
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“Often what we find is people who are successful in inpatient services somewhere else come back to the community, and all the problems are still here,” explains Dr. Wolfington. Perhaps most importantly, experts agree, is the need for a collective realization and open discussion around the fact that Eagle County is a diverse community and that everyone here can suffer inside, no matter how they present on the outside. A mother who “should” be so happy about her new baby can be struggling with postpartum depression. A wealthy, highly active and attractive socialite might be suffering major behavioral health issues just beneath the surface. A tough first responder who
charges into every emergency may be embroiled in his own internal crisis. A hardworking immigrant who left behind devastating trauma in her homeland can feel alone and terrified in a seemingly safer land of economic opportunity. A member of the LGBTQ community may have moved here from a more conservative place but still feel alienated in a resort area that celebrates and markets family values and heterosexual norms. A septuagenarian with resources who still enjoys the mountain lifestyle can feel trapped by it as friends and family age and move on.
EVBH AND COMMUNITYBASED CARE
To that end, Eagle Valley Behavioral Health (EVBH) has been working hard to meet the diversity of need, from Eagle County’s rapidly aging population to its younger, more transient residents; lowerincome, working-class families to immigrants and disconnected youth. The goal is greater access, more teen and pediatric specialists, more Spanish-speaking clinicians and outreach…more of everything right here in the Eagle River Valley. “One of the reasons Eagle Valley Behavioral Health is promoting community-based care and building higher levels of care within our own community is because you cannot address behavioral health concerns in a vacuum and when you do, it is not sustainable.” Dr. Wolfington says. “We want to support our community right here where they live, work and play. We want them to get the help they need without removing them from their support system, without removing their access to family, without creating a situation where they may have to choose between treatment and their job.” That includes the often overlooked and arguably more marginalized lesbian, gay, bisexual, transgender and queer (LGBTQ) community, Dr. Wolfington says. “We are absolutely dedicated to providing as much education for our clinicians, but also really educating the community, because individuals feel like the LGBTQ community doesn't exist in our valley, but it very much does, and maybe people are not aware of it because it doesn’t feel like a supportive community,” Dr. Wolfington says. “So how do we educate our community on how to be more inclusive and supportive so that we really can support that population?”
In 2017, Evan Weatherbie helped start the Eagle County Gender and Sexuality Alliance (ECGSA), a group that kicked off as a collaboration with Mountain Youth and is based out of, and coordinated as, a student group through Colorado Mountain College (CMC) in Edwards, but is open to the public. Weatherbie, who is gay, has been a fulltime faculty member and professor at CMC since 2011, teaching history and English. He grew up in a conservative northeastern Colorado community, which he left because of a lack of acceptance of who he was. Now Weatherbie hopes to foster an awareness and acceptance in Eagle County, as well as to build bridges for anyone in the community who may need therapy, for any reason. ECGSA stands in solidarity with other marginalized communities, including the Latinx community and the Black Lives Matter movement. “All kids need positive role models; they need validation and acceptance, and they need visibility of people that they can relate to and that they can trust,” Weatherbie says. “So I think any visibility, any attention that Vail Health or any other organization in our valley can bring to queer youth would be helpful. The queer community is just essential for people to grow up trusting themselves and accepting themselves. “When I think about my own experience, I had absolutely zero gay role models growing up. The message that I got from that community was that my identity was a detriment and that who I was was not OK. That’s one of the reasons that I left, and I looked for those spaces of acceptance in other communities. “What I hope is that people have some awareness that I’m here and my students are here and this group exists,” Weatherbie says. “And so for the people who really do need it and want it and are seeking that community, I want people to know that we’re here for them.”
REACHING ALL DEMOGRAPHICS
According to the latest U.S. Census Bureau data (as of July 1, 2019), Eagle County is 47.2% female, 52.8% male, 26.9% under the age of 18, 12.4% over the age of 65, 29.7% Latinx and 67% White. Within those demographics, there are veterans, cancer survivors, retirees, first responders, school kids and people from virtually every walk of life — many dealing with behavioral health issues from a low simmer to a full boil.
Longtime local Ella Burnett was a nurse in Gilman before settling in Minturn. Now 93 years old, Ella still loves walking in the woods near her home.
The point of first contact in a crisis can make all the difference, and local police departments were the first to support Eagle Valley Behavioral Health through their “First to Respond, First to Give” campaign, which was organized by first responders back in 2018 to raise funds to combat the suicide epidemic of one attempt per day that year. Eagle County Paramedic Services also led the charge, bringing the Hope Center to the valley. To reach as many people as possible in the community, Vail Health, since its merger with Colorado Mountain Medical (CMM) in July of 2019, has embedded an
As seniors age, they sometimes experience a sense of isolation and shrinking social circles.
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integrated behavioral health model within CMM, which serves 90% of the Eagle River Valley population. “If we think about kiddos, by the time they’re even five years old, they know that building, the waiting room, the doctors. They trust that medical home,” Dr. Wolfington says about CMM. “We’re seeing that across all of our different, diverse backgrounds, that the commonality is a lot of people are open to services at Colorado Mountain Medical. That’s really been a game changer in stigma reduction.” At the other end of the age spectrum, Judson Haims, owner and director of Visiting Angels Eagle County, says the valley’s aging population struggles with life in the mountains. “That’s part of the problem that we have here in our mountain towns — there’s a lot of people that grew up here, raised their kids here, and they’re of moderate financial means,” Haims says. “They’ve learned to love our mountain lifestyle of getting out, the Vilar Center, Ford Amphitheater, ballet, kayaking, running, walking, all these things, and when they find that it's hard for them to keep doing that, they run into that question of, well, ‘Where do I go? And what options are there for me here?’” That gradual feeling of not belonging, Haims says, of being disconnected and lonely, has to be addressed, regardless of socioeconomics … and age. It’s being exacerbated by the COVID-19 crisis, experts agree, and can be dangerous for young people as well.
THE CHALLENGES OF YOUTH
Sometimes our youngest community members are the most vulnerable, and therefore, the most likely to
get lost in the shuffle. Kids, new to the world and still sorting out how everything fits together, carry heavy expectations, fears and uncertainties on their little shoulders. “We need to train kids to recognize what their behavioral health needs are,” says Dr. Wolfington. “If we’re not talking with them about what their behavioral health needs are from a young age, we’re actually teaching them that it’s not OK to talk about them. So even no action is an action.” Dr. Wolfington recommends starting the conversation early and keeping it going in order to make it a priority and create awareness. That way, when there’s a minefield of emotions and triggers during the teenage years, talking is a normal part of the process. Teens face big feelings with giant pitfalls, but if there’s an already established vocabulary for talking about them, communication can help bring the monster out of the dark and take away the power of dread. “It’s good to have those conversations early and often, so kids can recognize it’s ok to have a range of emotions,” says Dr. Wolfington. It’s a lot to navigate — kids have a slew of expectations surrounding school, home life and extracurriculars, and many of them are also stuck in a 24/7 social situation. “The social demands that kids are facing in school are usually greater than the academic demands,” she says. “It is very unusual that I have kids in my office, stressed with academics. Usually they’re stressed about the social stuff.” And that social pressure never shuts off. It’s 1 a.m., and someone is posting about her evening, or making a funny little joke at someone else’s expense.
“Technology: That part never leaves you alone,” admits Dr. Wolfington. “It’s always happening. It creates this situation that feels like there’s no way out.” Teens, and many younger kids too, are inundated with social pressures, and without the perspective that age offers, life can easily feel overwhelming. “Maybe it’s more helpful to just admit that it’s really hard being a teenager right now,” says Dr. Wolfington.
FIRST RESPONDERS’ RESPONSE
When a wildfire breaks out, or there’s violence, trauma, an accident, first responders run toward the danger, not away. While most people can count a handful (or less) of traumatic situations they’ve witnessed, police, firefighters, EMTs and other health professionals see it again and again in the course of their jobs. Car accidents along I-70, skier collisions on the hill, domestic violence, house fires, missing children — these events make up the workday for many first responders. And though they are professionally equipped to protect and serve the community, it certainly takes a toll on their mental health. Depression and post-traumatic stress disorder (PTSD) affect an estimated 30% of first responders nationally, compared to 20% of the general population. And while approximately 3.7% of Americans have contemplated suicide, that rate jumps to 37% for fire and EMS professionals. And so, these men and women who rush into danger to help others are at greater risk from the effects of their job than the actual danger of doing their job. Perhaps compounding the situation is the natural response to reach for a
What we’re realizing is someone not seeking the services doesn’t make the problem go away. It just really exacerbates the problem until it’s reached a level of crisis where we’re at risk of losing people’s lives in our community.”
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Chief Joey Staufer has been involved with the initiative to transform behavioral health for his community and his police staff.
First responders deal with traumatic events as part of their job, and it can take a severe toll on their mental health.
coping mechanism. Because alcohol can temporarily take the edge off, and it’s an accepted cultural ritual, especially for those who work the front lines together, it’s easy to fall into a pattern of substance abuse. And while it might provide temporary relief as well as a sense of camaraderie, it can also compound the underlying issues that are ultimately so dangerous. A 2018 study showed that 29% of firefighters engage in alcohol abuse. And while 0% of rookie cops reported an alcohol abuse pattern, that went up to 27% after two years on the force, and jumped again to 36% for four-year veterans. EMTs command the most urgent concern, with upwards of 40% reporting a substance abuse issue. The irregular hours required by the job — sometimes days, sometimes nights — disrupt whatever sleep habits are in place. Though culturally everyone is encouraged to push through the fatigue — and indeed, for first responders it’s often considered “just part of the job” — lack of sleep is now being recognized as the health hazard it is. It can be a major contributing factor to PTSD, and has been directly linked to heightened emotional reactivity in people.
Used to solving the world’s problems, first responders are likely to neglect their own health. They often hold themselves to a higher standard, and to reach out for help might make them feel weak. But all the research keeps revealing the same conclusion: even the mightiest among us has behavioral health needs. The more we can work to destigmatize the need for therapy and support, the better it is for everyone.
Gerardo (Gerry) Lopez thought he was invincible his first couple of years at Battle Mountain High School in Edwards — “tough as nails, top dog, nothing could tear me down” — but then he switched schools to Eagle Valley High School in Gypsum his junior year, and it nearly cost him his life. Immigrants from Mexico in the 1980s, Lopez’s family had finally realized the American dream of home ownership and moved “down valley” to Eagle, but that meant leaving behind his group of friends at Battle Mountain, and he was struggling on the soccer team, trying to find his place but feeling the heat from hazing and bullying.
“One of the biggest things that I let Eagle Valley Behavioral Health know, that I let the schools know, is that it doesn’t matter if the kid is Hispanic from Mexico, or they were born here, or they’re Anglo. Nobody's immune to this,” Lopez says of his desperation in high school. “But one of the things that we can pinpoint is loneliness. There are a lot of kids that just feel like they’re outcasts or that their friends have found a different group of friends.” Lopez now works with school counselors and youth groups like My Future Pathways to connect with kids. In addition, there are a variety of other resources in the Latinx community such as three new Spanish-speaking Community Behavioral Health Navigators; Hearts Reign, which seeks ways to improve behavioral health in the community; and the many resources offered by MIRA, the Mobile Intercultural Resource Alliance. “We have a diverse community,” Dr. Wolfington says. “The statistics show between 40-55% of the students in our school district identify as Latinx. A lot of people overlook that. And so we really need to do a lot of work on getting Spanish-speaking healthcare and behavioral health providers
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A sense of stoicism in the Latinx community often prevents people from seeking help.
Founder of Hearts Reign, Sonia Mejía, meets with a group of Latina women on a regular basis to find ways to improve the behavioral health of their communities.
across the board to meet the needs of the community. The goal is to ensure that all the programming we develop is designed in a way that is truly representative of our community.” Dr. Wolfington says there’s a mistrust of institutions among the local Latinx community, and it impacts everyone from domestic violence victims to people who have substance abuse issues but don’t want to seek help because of their fear of what the repercussions could be. Questions of immigration status can also be a huge barrier to people getting the help they need, even though healthcare providers and local law enforcement will not ask. “What we’re realizing is someone not seeking the services doesn’t make the problem go away,” Dr. Wolfington says. “It just really exacerbates the problem until it’s reached a level of crisis where we’re at risk of losing people’s lives in our community.”
TRAUMA AND MACHISMO
Lopez says many local Latinx kids have experienced some serious trauma in their lives at a very young age, from
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drug cartel and gang violence in Mexico to the hardline immigration policies instituted in 2018. When immigrants were being detained at the border, some of them had families living in Eagle County. And that took a toll on them mentally and emotionally. “I talked to a lot of those kids, and before they knew about the new border practices, they were super-happy, super-outspoken, and then, boom, their family gets locked up and they come to school and it’s like they’re completely different. They’re shut down. They don’t want to talk. They don’t want to open up. PTSD is one of the things that I feel like a lot of our kids have.” Lopez also says there’s a certain stoicism in the Latinx community, an inclination to keep one’s head down and soldier through any problems. “It took me a really, really long time to take action because I was telling myself, ‘Hey man, your dad and your uncles, they all taught you to be quiet, it’s just going to pass. Just go to sleep and you'll wake up better tomorrow, but I would do that for days and days. I would go to sleep, wake up the next
day and feel terrible,” Lopez says. Faced with two paths — going home after school and taking those pain killers or reaching out to someone at his school and talking about his problems — Lopez says he had to overcome his shame. “The only thing that was holding me back from actually talking about all these things was my machismo, my macho attitude,” Lopez says. “And to tell you the level of shame that I had going into that counselor and telling her what I was going through, it was on a high level. I had a lot of shame, but once I told her that I was feeling all of these things, that I had suicidal thoughts, that shame went away and I had a full sense of relief because I was being listened to.” For everyone in the Eagle River Valley — no matter the community they most closely identify with — the message is clear: seek support when you need therapy and make sure you get it. No matter who you are, it will help, because in one-on-one therapy you’ll find someone who can take into account your specific needs as an individual.
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STORIES — TO —
BY KIM FU LLE R P H OTOS BY S HAN E MACO M B E R
appiness is a goal. It’s not an end-result. We strive for happiness minute-tominute, day-to-day. We journey to feel that simple emotion that can make your lips curl upward, make everything else seem smaller, make the world around you seem clearer and — as the saying goes — can be so contagious, it makes others happy as well. What happiness looks and feels like changes over time. But we all strive for moments of it, and we define our lives by how much of it we have. Sometimes, the obstacles to happiness are immense: loss, trauma, injustice, hunger, despair. We might need more than a can-do spirit or attitude adjustment. Sometimes we need help — therapy, support groups, friends, family, our own personal discipline and perhaps a little bit of grace. The lessons we learn on our journey to happiness don’t usually come easily. Things out of our control affect us, and yet we continue to work for those feel-good moments that make it all worthwhile. People in our valley are suffering from a lack of happiness. Your co-workers, classmates, the guy riding the chairlift with you — everyone has layers, and some of those layers have been damaged or temporarily disturbed. There’s a stigma surrounding mental health that encourages silence. What might be an effort to respect someone’s privacy can actually contribute to shame and hopelessness. It’s something Eagle Valley Behavioral Health is working to combat every day. There are people in our community who have suffered and struggled in silence for so long, they are coming forward to tell their personal stories in hopes of breaking the stigma, shattering the silence and celebrating in the resilience of the human spirit. A chemical imbalance, unimaginable trauma or struggle with identity does not define a person. These are experiences, moments, chapters in people’s lives that help them become stronger, wiser and more compassionate. As the people in this story write the next chapters of their lives, they share what they’ve learned on their journeys to happiness. 2 02 0 -2 021
I am a
manda Precourt didn’t want to get out of bed. She didn’t want to ski or socialize. Even amidst heavy apathy, she wasn’t sleeping. She was becoming increasingly tired all the time, exhaustion paired with panic attacks, hot flashes and night sweats. Not yet 40 years old, Amanda knew this wasn’t menopause, and she says she started to lose touch with reality. “I didn’t want to live anymore because I was so miserable,” she shares. “I hadn’t slept in a year. I felt crazy. I felt completely crazy.” Years earlier, when Amanda was a sophomore at Stanford University, she had started to get really bad headaches and began feeling disassociated from her body. Intense and disorienting panic attacks began, episodes where her heart would race, she couldn’t speak and lost feeling of her hands, then felt like she would pass out. It took about six months for doctors to diagnose generalized
anxiety disorder and major depressive disorder. All the while, Amanda remained high-functioning and didn’t let her struggles be known to peers or family. “I didn’t really think much about it,” she shares. “I just took Prozac and didn't really want anyone to know because I didn't want it to be a handicap or considered abnormal that I dealt with depression and anxiety.” For over a decade following college, Amanda continued to hide her mental health issues from the outside world. “I blacked a lot of stuff out. I went through a divorce when I was 34 and 35,” she shares. “I started abusing drugs and alcohol to sort of mask my anxiety and depression. Again, I didn't want to go ask for help. I didn't want to deal with the fact that I was really depressed.” Amanda split time between Vail and Denver throughout the years, skimming on the surface of life while a dark undertow ensued. She was successful in her career of building homes and interior design, incredibly philanthropic and the life of every party. Yet her internal battle started to become too much to bear. She was pulled toward rock bottom, unable to function and crying all the time. She knew something was wrong, that her mental health was slipping, but Amanda was too embarrassed to let anyone know she was starting to drown. ROCK BOTTOM Amanda was 37 years old when she tried to end her life by throwing herself out of a car at high speed on the interstate. Her mother was driving, bringing Amanda back from a series of tests at the hospital in Vail. Something just switched in her brain, Amanda recalls, and she didn’t want to live another moment. Her mom grabbed Amanda, slammed on the brakes and pulled over. “I mean, it was a miracle,” says Amanda. “I can’t believe I wasn’t injured. “I was thinking how mortified I was that I could be such a high-performing individual and someone who had been so driven, and so ambitious, and so on top of the world, and that I was in a place that was so low,” she says. “I just said, ‘I don’t want to be this person. I don't want to be here. I just want to go away.’” Amanda was put on a 72-hour suicide hold before being transported to Highlands Behavioral Health in Denver and then to The Menninger Clinic, a leading specialty psychiatric hospital in Houston, Texas.
“ N O W T H AT I ' M H E A LT H Y A N D HAPPY AN D MANAG I N G M Y M E N TA L H E A LT H O N A D A I LY B A S I S , I A M S O G R AT E F U L T H AT I ' M A L I V E . I W A N T T O S AV E O T H E R P E O P L E . ”
Amanda says Menninger saved her life. She was there for 15 weeks, working with experts to balance her endocrine system and treat her depression, which she learned is linked directly to hormonal imbalances. “I knew I needed to stay because I couldn’t live in the world the way I was,” shares Amanda. “But it was tremendously, tremendously hard. I also just wanted to get better. I wanted there to be a quick fix. I kept saying, ‘It’s been four weeks, can I get out? It’s been eight weeks, can I get out?’ It took as long as it took. I couldn’t leave and reintegrate into the world until I really had my hormones balanced, and that takes time. It also takes time for the medications to work. It’s not a quick fix, but it is a fix. It is life-saving if you stick with it.” Amanda says she was embarrassed and heartbroken, but even more so, relieved. She finally realized she was going to get help. She explains, “I could finally give in to the fact that I needed to get help, and I needed to go somewhere. I could breathe, I could breathe.” MANAGING MENTAL HEALTH Emerging back into life after treatment was hard, Amanda shares, as she had to reintegrate into a world that didn’t understand where she had been. “I think there were a lot of questions and a lot of rumors circulating about what had happened to me and why I had disappeared,” she shares. “I didn’t talk about it for about five years because I didn't know how to describe how low I’d gotten. Now I’m really happy to be able to tell my story because I think it's really important that people understand that this happens and it's really common.” Amanda says she started to feel a sense of wonderment and excitement about facing the world with the understanding of what her brain really was dealing with. “I didn’t understand what generalized anxiety disorder and major depressive disorder meant from 17 to 37,” she shares. “Getting out of treatment, I had a better understanding of my brain. I had a better understanding
of the fact that it wasn’t my fault. It was my chemistry. It’s a disease, and I can live with it. “Now that I’m healthy and happy and managing my mental health on a daily basis, I am so grateful that I'm alive. I want to save other people.” As a generous Vail Health Foundation benefactor and Eagle Valley Behavioral Health Board member, Amanda has been instrumental in supporting the organization’s efforts to transform behavioral health in the valley. “This is my thing. This is my cause. I am 100% behind everything Eagle Valley Behavioral Health is doing and Vail Health is doing,” she shares. “I have to say that I am so incredibly impressed with what they have done in such a short period of time. In just a year, Eagle Valley Behavioral Health has done more for our community than I think we could have done in 10 years in a lot of other communities.” Managing mental health is a daily practice for Amanda. “It’s not something that just goes away, I can’t just take my medication and assume that I’m going to be okay. I really have to work at it,” she shares. Amanda uses physical fitness, time in nature, walks with her dog, moments to slow down, mindfulness, journaling and meditation as tools to maintain her mental wellness. And distinct from those years she spent alone in her darkness, Amanda sees a therapist regularly and asks for help and support from her husband, friends and family when she needs it. “I’m really happy to have my dark days because I wouldn’t enjoy life and the beauty in life without having struggled,” shares Amanda. “Now I really realize I am a survivor. I’ve had many chances to exit this world, and I haven’t taken them. Although I did try, I survived. Now when I have those down moments, and I get them — where I have a moment of thinking, sadly, I want to leave the world — I correct myself really quickly and I have to remind myself that I am a survivor. I’m meant to be here on earth because I have a lot to do. I have a lot to do. So I survive every day.” To see Amanda’s full story, visit: EagleValleyBH.org/Amanda 45
overcoming le a new bat t FINN MOTT
inn Mott was 13 when he started getting severe headaches. As the final months of his eighth grade year were consumed by pain and dizzy spells, Finn stopped going to school and had to sit out of soccer practice. After five inconclusive visits, a new doctor saw Finn and finally ordered an MRI. “I remember sitting in the tube of the MRI, worrying about how my hair was going to look afterwards,” shares Finn. “Because really the only thing that mattered to me at that time was being popular and having the perfect hair.” Not long after the scan, his common teenage concerns were exceeded by something much more critical. Finn had cancer in his brain and his spine, and from the moment he received this news, every priority changed. On the way to Children’s Hospital Colorado, where he would proceed to undergo a lower lumbar puncture, brain surgery, four rounds of chemotherapy and 30 days of radiation, Finn asked his mom if he was going to die. “At that point, we didn’t know,” he shares. Now 18 years old and in his first year of college, Finn is a true survivor. But cancer isn’t the only battle he has had to fight. “The hardest part was coming back home,” he says, “and only being known as ‘the kid with cancer.’ Nobody wanting to talk to me at school because they were afraid to say something. Or they just didn’t know how to confront me … I didn’t want to be the cancer kid. I didn’t want to be the person who was damaged or broken.” 46
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DEPRESSION AFTER CANCER Finn says he began struggling with his mental health the moment he was diagnosed. “I pretty much became depressed on the spot, and didn’t want to fight for my life anymore,” he says. “I didn’t want to go through this. I didn’t see the light at the end of the tunnel.
That was very hard to overcome.” In the hardest times, Finn describes his depression as a dense fog that clouded his mood. “I wanted to be happy … kind of like when a rain storm hits and you want the sun to come out, but it’s going to rain harder and harder until it becomes sunny again,” he explains.
“ I H AV E A C H O I C E T O E I T H E R L E T M Y PA I N R U I N E V E R Y M O M E N T, OR TO LET IT BUILD M Y C HAR AC TE R .”
Finn says cancer changed him profoundly — physically, emotionally and mentally. Physically, he lost more than 25 pounds and wasn’t able to return to soccer or cross-country running in the way he wished he could. His eyes were damaged, and his endocrine system was knocked completely out of whack. “I’m going to have to take pills lifelong, and injections. And you know, it can strain a person, especially when you have a big scar on your head and scars everywhere, and your veins are black and blue from being poked and prodded,” he shares. “That physical pain manifested itself a lot mentally and emotionally. Specifically, mentally.” There was a point during his sophomore year in high school when Finn says he felt the lowest he’d ever felt. He just wasn’t able to be as happy as he used to be. His parents noticed his lethargy and extreme apathy, and they took him back to Children’s Hospital where he was diagnosed with depression. He did not want to accept any of it, nor admit that he was “damaged and bruised.” “And it was also very emotional,” he shares, “especially when you’re in treatment or a hospital like that,
it doesn’t feel like you have a choice very often. And they’re just like, ‘Oh, you have to get this,’ or ‘You’re going to do this.’ “If I were to feel any pain, it would just make it worse. So instead I chose to just become numb, and as if I wasn’t even really there. I was kind of living out-of-body and because I did that, I had a really hard time processing what was happening and what I was feeling. And that’s a lot where writing came in, because even though I couldn’t feel that, I could write. My writing gives me permission to feel what I cannot always express.” A NEW CHAPTER Along with the daily practice of writing, Finn attributes much of his initial and continued psychological healing to attending Roundup River Ranch, a camp for kids battling or surviving serious illnesses. “When I went there, I wasn’t treated as somebody with a bald head,” he shares. “I was just treated as a boy who was trying to have fun. I was just treated as a person who was robbed a part of his childhood.” Finn also began seeing a counselor. He says this helped him see that his illness can only define him if he lets it. “I did not want it to define my life, and I made a promise in one of those therapy sessions to never let my pain take over my life, because I have a choice,” he says. “I have a choice to either let my pain ruin every moment,
or to let it build my character. I, from then on, let it build my character.” Finn also found a new passion: coffee. He says it was one of the first things that brought happiness back to his life. “You know, coffee is that thing that brings people together, or tea, or whatever it may be,” he says. “It’s the thing that brought me to other people to show myself as somebody that’s not defined by their illness … Coffee was the bridge between my old world and my new world. And my old self and my new self. And finding out my new self through the lens of coffee largely cured my depression in many ways.” Finn plans to either double major or independently design a major in poetry and business administration at Colorado College. While he misses his family and his three dogs, Finn is ready for a fresh start. “I’m very excited to go to college and have nobody know me as ‘the kid with cancer.’ I’m just Finn, I’m just a fresh slate, fresh identity and it's exciting, and it’s also nerve-racking, of course.” New challenges are inevitable, yet Finn says he’s not afraid to ask for help or support when he may need it. “If I ever become depressed again, or I’m having a rough time, I’m no longer afraid to reach out because I’m no longer afraid to be labeled as somebody who’s ‘broken’ or ‘damaged,’” he shares. “I had not accepted myself for a long time. And it has taken years for me to be able to say, ‘I had cancer and it does not define me. It empowers me.’” To see Finn’s full story, visit: EagleValleyBH.org/Finn
Picture oF Resilience
esilience is not the absence of struggle or adversity. Resilience is living with the deepest, darkest of challenges, then coming out on the other side of those experiences as a stronger version of who you know yourself to be. Vickie Zacher, formerly Ortega, is the picture of resilience. It’s hard to know the right thing to say when you’re looking into the eyes of a woman whose 13-year-old daughter took her own life just two years before. However, Vickie’s honesty and grace help those around her feel comfortable with talking about the uncomfortable, and it’s in those conversations that the truth carries even greater meaning. As she sits beneath portraits of her three beautiful children, Alyssa, Jonus and Olivia, Vickie courageously shares her story. “My daughter ended up taking her life. “That day was the hardest day of my life. It was a nightmare,” Vickie shares. “It’s hard to think about it because it causes me so much pain. There’s a lot of ‘what-ifs,’ ‘I should’ve,’ ‘I could’ve’ and ‘why,’ and that’s a day that will always stay in my mind. It will never go away.” The days, weeks and months that followed are still a blur. Vickie wouldn’t leave Olivia’s bedroom, staying and sleeping there to feel like she was with her daughter. Vickie sought out counselors and support groups, proving helpful, but never fully filling the void of Olivia. “It felt like a piece of me died that day and it won’t ever come back,” shares Vickie, “and I just feel like you learn how to live with it. Because it’s always there and I won’t ever forget her, and she’s part of me.” CATALYST FOR CHANGE Having lived in the close-knit community of the Eagle River Valley for nearly 30 years, Olivia’s death was painfully public. Vickie wanted to hide from the rumors. “I didn’t want to go to the grocery store,” she says. “I had people buy me groceries and bring them to me so I wouldn’t have to go, just because I didn’t want to see people there.”
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“ I DO F E E L LI K E I ' M A S U RV IVO R . I FEEL LIKE I HAD TO GO THROUGH TH E WO R S T TH I N G E V E R I M AG I N A B LE AN D I DI DN ' T K NOW I F I WOU LD M A K E I T O U T, B U T I D I D . H E R E I A M . ”
Not long after Olivia took her own life, Vickie considered suicide and came up with a plan. Pills, it would be, enough to erase the pain. Alyssa came home amidst the almost fatal spiral. Vickie’s friend was called and came over to stay the night. “I’m glad I didn’t succeed and that I’m still here,” Vickie says, reflecting on the darkest of days. “It would have devastated my family and my kids, and I feel like when someone ends their life, it just puts the pain onto other people. It might end your suffering, but it just passes it along.” Olivia’s death was a catalyst for change in the community. After working with Vickie and her impassioned purpose to help others who may be suffering from mental health issues, Eagle Valley Behavioral Health established Olivia’s Fund to provide financial assistance to anyone who lives or works in the Eagle River Valley to help pay for mental health and/or substance abuse services, for up to six sessions per person per year. Vickie is committed to help shift the stigma around mental health. “I think people are afraid of it,” she says, “and I think people don’t want to talk about it. I don't think it’s any different than somebody breaking their leg. It can be treated. You can get the help you need, but I think it’s hard for people to come forward because it’s always been frowned upon … it’s not anything to be ashamed about. It doesn’t mean that there’s something wrong with you.” ‘I'M A SURVIVOR’ Two years after her daughter’s suicide, Vickie is able to look back with perspective. She recalls the days when the only thing that got her out of bed was taking her dog, Jasper, out for a walk.
“The depression was hard because you are sad and you’re down in a deep, dark place and you don’t know how to get out of it,” she shares. “It’s more than being sad — it’s just like you’re stuck there. Sad — you could be sad for a day or two. But depression — you’re just there forever and there’s no way to get out and nothing makes you happy.” Vickie recognizes how it’s easier to pull herself out of depression nowadays. She enjoys walking Jasper, hiking with friends, visits from Alyssa and Jonus, and her work as an imaging specialist for Sonnenalp Breast Imaging at Shaw Cancer Center. She continues to see a counselor and reach out to friends for help and support. Vickie says she tells her story because she wants to help other people. “I want them to know that you can survive, that you can overcome the depression, the anxiety, and you can find joy through the journey,” she says. “Because once you’re gone, you’re just gone and you can't come back. “I do feel like I’m a survivor,” Vickie shares. “I feel like I had to go through the worst thing ever imaginable and I didn’t know if I would make it out, but I did. Here I am.” Sometimes Olivia visits, says Vickie, when she walks down the hallway in her home and smells the fragrant spray her daughter would wear. “Every day when I go for walks, I look for signs in the clouds,” says Vickie. “Maybe if there’s a heart or something to show me that she’s around, I can feel her around me.” Olivia always talked about taking a “hippie van” up the West Coast of the country after high school. Vickie has started collecting van memorabilia, and she thinks she’ll make that trip in a few years to honor her daughter’s dreams. To see Vickie's full story, visit: EagleValleyBH.org/Vickie. To support Olivia's Fund, visit: VailHealthFoundation.org/OliviasFund
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This is a story oF hope
ne of Sonia Mejía’s earliest memories as a child in Puerto Rico is watching her mother lying in bed and crying inconsolably. Sonia’s father had been gone for days, drinking himself away from the family. “And her cry felt like when you are mourning,” Sonia shares. “It was deep in her soul. And I have that memory really embedded in my head.” When Sonia’s father did come home, he was often in a rage, drunk and aggressive. Her mother was a valued nurse in the community, but frequently suffered from the disabling impacts of bipolar disorder. Sonia and her older sister were left to care for their younger brother and two younger sisters, witnessing their sick mother suffering all those days she just couldn’t get out of bed. “I don’t know why, but really early, I just felt so sorry for what she was living with. I loved them both, my mom and my dad, but I also felt sorry for them that they couldn’t manage,” shares Sonia. When Sonia was 11 years old, her father left the family for good, and Sonia’s mind spiraled to the conclusion that her family was completely out of control. “That was the first time that I really felt against the wall,” shares Sonia. As suicide ideation intensified for Sonia, she went to her mother’s medicine cabinet and took a heaping handful of pills. In this instance and another similar time when Sonia was 13 years old, she was taken to the
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hospital to have her stomach cleared with activated charcoal. “There was always an option to go to that medicine cabinet and grab as many pills as I wanted and just not be any more,” says Sonia. ‘ I WA N T E D T O BE INVISIBLE’ Sonia stopped being able to function at school. The minute she would walk past the door to her classroom, she would begin to get nauseous and dizzy. “It was like I was an alien in between everyone else — the kids in there,” she explains. “I couldn’t take it. So, I would just run out of the classroom and go to the backyard and sit on a bench … I wouldn’t eat, nothing.” Once the end-of-day school bell would ring, Sonia would leave her bench and go home. A social worker reached out to her mother and then did a full evaluation of the family. Sonia was put into treatment with weekly sessions for therapy. From the ages of 11 through 17, Sonia was hospitalized four times for her mental health. She was 19 when her mother became very ill and died from a massive heart attack. Sonia was completely devastated. When she tried to break the news to her younger brother, Sonia couldn’t talk through all the tears. “She was truly an amazing human being,” shares Sonia of her mother. “And even though she had her condition and everything, she helped so many people. Truly, it just hurts.” Sonia was diagnosed with bipolar
" I T E L L M Y S T O R Y B E C A U S E I D O N ' T WA N T A N Y B O DY O U T T H E R E T O F E E L L I K E T H E Y ' R E T H E O N LY O N E S T H AT A R E G O I N G T H R O U G H SOM ETHING LIKE THIS . I TE LL MY STORY B ECAUSE WE N E E D TO TA K E T H I S C O N V E R S AT I O N S E R I O U S LY I N T H E L AT I N X C O M M U N I T Y. . . I ’ M N O T H O L D I N G B A C K B E C A U S E T H I S I S A S T O R Y O F H O P E . "
disorder when she was 18 years old, yet she had to go off her medication once doctors discovered it was contributing to atrial fibrillation — an irregular and often rapid heart rate. After learning of her bipolar disorder, Sonia was often able to manage her mental health relatively well through prayer, meditation and natural supplements, but big emotional and mental challenges would set off internal struggles. In her early 20s, Sonia got married and had her first three children. She and her first husband worked hard for their new family, but life became overwhelming and Sonia slipped into a deep depression. She was put in the hospital for treatment and slowly began to emerge from the darkness. Now a mother of six, Sonia’s periods of depression have clouded her life every half decade or so. In that state, she calls herself a “social wreck.” She’ll stay completely isolated, won’t eat, shower or change clothes. She explains these episodes: “I didn’t want to be seen. I wanted to be invisible because I didn’t feel that there was a space for me in this world.” HELPING OTHERS FIND SUPPORT Sonia says it’s hard to seek help for mental health within the Latinx community. Support from her children has saved her life, along with consistent therapy and her faith. Before coming to the Eagle River Valley six years ago, Sonia had been living in Florida with her family. In
2013, she experienced a series of health complications related to her heart condition. Her children took care of her and encouraged her to move to Colorado for a fresh start. Sonia has been making her life here ever since. “I fell in love with the mountains and found new strength and purpose,” she explains. Sonia lives every day with bipolar disorder, and she is passionate about breaking the stigma by talking about it and getting help. She founded a nonprofit, Hearts Reign, that encourages peer support in the ways of self-discovery, learning new strategies to cope and removing the stigmas associated with mental illness. “I tell my story because I don't want anybody out there to feel like
they’re the only ones that are going through something like this,” says Sonia. “I tell my story because we need to take this conversation seriously in the Latinx community. I tell my story because I want my kids to be proud of what we have accomplished … I’m not holding back because this is a story of hope. We made it, I made it. We can make this happen if we take on the resources that we have available. We can absolutely be healthy. We can maintain a balance. We can actually strive for more and better. We can ... there’s no limits, really. If you take charge, if you surround yourself with good people, you can absolutely do it.” To see Sonia’s full story, visit: EagleValleyBH.org/Sonia
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You are not alone on your journey through life. Help is close by, even if itâ&#x20AC;&#x2122;s sometimes hard to ask for it. Call a friend, ask for a hug and if you need additional support, find a therapist or support group at EagleValleyBH.org. Financial assistance available through Oliviaâ&#x20AC;&#x2122;s Fund.
It Takes A Valley.
MENTAL HEALTH FIRST AID How to recognize a mental health crisis and get people the help they need by k aren mason photos by dominique taylor
ould you know how to help a family member or friend who is considering suicide? What would you do if you noticed cuts on someone’s arms that indicated self-harming? Would you react to a social media post that said something like, “I can’t do this anymore…”? It’s likely that someone needing your help is asking in his or her own way. Are you listening? Do you know what to say or do? Are you afraid to get involved? COVID-19 has created a historic mental health crisis and it’s hitting Coloradoans and people around the world. Even before the pandemic, the Eagle River Valley was labeled as part of a “suicide belt” along with other mountain towns in the western United States. But there is help — not only for those who are suffering, but for those who are not sure how to help. The most important thing to know? We can all saves lives.
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Asking someone directly about suicide can decrease the likelihood of it happening by 80%. And what’s more — 90% of people who attempt, don’t go on to die by suicide at a later date. “It’s interesting — mostly to learn how to respond to someone everyone has experienced their who’s in mental distress. We encourown depression or anxiety. But we age everyone to take the equivalent are so fearful of intervening when of CPR for mental health.” The SpeakUp ReachOut website it comes to others,” says Dr. Casey offers virtual and in-person training Wolfington, a licensed psychologist opportunities throughout the year. and community behavioral health QPR (Question, Persuade and Refer) director for Eagle Valley Behavioral is a one-hour emergency mental Health. “For a long time, there was a health intervention training for misconception that asking someone anyone who wants to learn how to if they were thinking about suicide recognize and respond positively to would lead them to doing it. This is suicide warning signs and behaviors. completely contradicted by research.” According to Fiore, only about In fact, when someone intervenes, 20% of the community has been it motivates people to seek help. trained, which is not enough. Research backs this up. Asking “Taking a training course will give someone directly about suicide can people the tools they need to start decrease the likelihood of it hapthe conversation,” she says. “Share pening by 80%. And what’s more — your own mental wellness and give 90% of people who attempt, don’t go people permission to do the same. on to die by suicide at a later date. This is how we can reduce stigma. Many people who contemplate The conversation should be as easy suicide suffer from feelings of as talking about a broken leg.” not belonging or being a burden. Dr. Wolfington says even the smallest intervention can have the profoundest impact. “You are not alone. You are "You are not alone. loved. You matter. You belong.” You are loved. You These simple messages have matter. You belong." the power to save a life. These simple messages Yet if you’re wanting to help have the power someone in crisis, it’s important to recognize your limitato save a life. tions. “When people are intervening, they often feel like they have to fix the situation,” she says. “Helping and saving someone are two different things. You don’t have to provide the therapy. Just asking someone how they are or letting them know you are concerned can be enough to change the trajectory of the person’s life. Beyond that, passing him or her on to the right resources can be the next step.” MENTAL HEALTH SKILL SET As the former program director and a current trainer for SpeakUp ReachOut, an Eagle County nonprofit on the frontlines of Eagle County’s suicide prevention efforts, Molly Fiore says most people know how to respond to someone who’s in physical distress. “But we all need 54
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WHO IS AT RISK FOR SUICIDE? Suicide does not discriminate. People of all genders, ages and ethnicities can be at risk. The main risk factors for suicide are: • A prior suicide attempt • Depression and other mental health disorders • Substance abuse disorder • Family history of a mental health or substance abuse disorder • Family history of suicide • Family violence, including physical or sexual abuse • Being in prison or jail • Being exposed to others’ suicidal behavior, such as a family member, peer or media figure • Medical illness • Being between the ages of 15 and 24 years or over age 60
“If you suspect someone you love may be in danger of hurting themselves, watch for changes in behavior,” says Fiore. “The greatest tool is trusting your intuition. If someone is not themselves, check it out. Be direct. There are a whole host of warning signs, including trouble with sleep or appetite, a change in life situations such as the loss of a job or relationship, or the death of someone close.” Fiore herself suffered for 23 years and came frighteningly close to ending her own life. “As someone who has contemplated suicide, I can tell you interventions really work. “Suicide is the most preventable cause of death,” says Fiore. “The path can be changed.” WHAT TO DO WHEN SOMEONE IS AT RISK If you think someone is considering suicide, the American Foundation for Suicide Prevention recommends assuming you are the only one who will reach out. Here’s how to talk to someone who may be struggling with a mental health issue. Have an honest conversation • Talk to the person in private. • Listen to the person’s story. • Tell the person you care. • Ask directly if the person is considering suicide. • Encourage the person to seek treatment or contact a doctor or therapist. • Avoid debating the value of life, minimizing the person’s problems or giving advice. • To learn more about having honest conversations about suicide, visit: www.SpeakUpReachOut.org If a person says he or she is considering suicide • Take the person seriously. • Stay with the person. • Help the person remove lethal means. • Escort the person to mental health services or the Emergency Department. • Call the Hope Center at (970) 306-4673. EAGLE RIVER VALLEY’S BEACON OF HOPE “Everyone in our community has the shared experience of going through an unprecedented time and adjusting to a new normal. None of us are alone. Fortunately, the level of collaboration between providers is the highest I have seen and allows us to support our community, students and families when they need it the most,”
remarks Carrie Benway, program director for the Hope Center of the Eagle River Valley, which opened its doors in 2018, just two years before COVID-19 began wreaking havoc on the physical and mental health of communities around the world. The Hope Center offers an array of services designed to close the gaps found in the valley’s behavioral health system and decrease the stress on first responders and the Emergency Department. Services include a 24-hour crisis hotline, crisis intervention, individualized counseling, school and community programs, plus information and referral services. Living in a resort community is challenging, says Benway. There are numerous impacts on behavioral health, including the high cost of living, substance abuse and seasonality of employment. Many people who relocate to the mountains leave their support systems and find themselves feeling alone. “Because of that and the many challenges our locals face, we’ve really had to work to enhance services,” she says. Eagle Valley Behavioral Health has led a movement to improving behavioral health in the community, and the landscape is quickly changing. “We have more momentum dedicated to enhancing behavioral health in our community than other communities,” says Benway. She points out that even the valley’s newspaper, the Vail Daily, focuses on the topic more than it ever did. “It’s interwoven into all aspects of our community. This helps reduce stigma and barriers.” OUR MOST VULNERABLE Eagle County Schools took a strong approach to prevention and intervention by bringing the Hope Center of the Eagle River Valley into their schools. The Hope Center provides in-person clinicians at every middle and high school to provide outpatient behavioral health services. A social/emotional curriculum has been implemented across all grade levels, which focuses on emotional identification, emotional expression, coping skills, mindfulness, relaxation and communication skills. Anyone who has been through adolescence knows it’s one of the most challenging periods of life. The impact of COVID-19 on teens has made growing through this stage of life even more difficult. Socialization is part of a teenager’s developmental process and there is a true, biological need for teens to connect with one another. Behavioral health experts
Don't hesitate to reach out to someone you think might need your help. Make it a phone call instead of a text, or visit with the person if possible.
agree, teens are especially vulnerable at this time. The Hope Center and other organizations in the valley like Mountain Youth empower parents to educate themselves and take an active role in their children’s behavioral health. It’s important that the adults children trust connect with and talk openly about behavioral health. Educational opportunities like Eat Chat Parent and Eagle Valley Behavioral Health’s Community Chats provide open dialogue for sharing experiences and learning how to help one another navigate the challenges of growing up. It's important to be honest about how we’re feeling, and take note. “We need to empower the teens to let us know if something’s going on,” Benway says. Experts agree we need to stop treating behavioral health as an emergency. “We don’t seek preventative help when we start to see symptoms with our mental health, like we do with our physical bodies,” says Dr. Wolfington. “We need to start providing everyone with techniques for managing stress before it’s too late.”
WARNING SIGNS OF SUICIDE • Talking about wanting to die • Looking for a way to kill oneself • Talking about feeling hopeless or having no purpose • Talking about feeling trapped or in unbearable pain • Talking about being a burden to others • Increasing the use of alcohol or drugs • Acting anxious, agitated or reckless • Sleeping too little or too much • Withdrawing or feeling isolated • Showing rage or talking about seeking revenge • Displaying extreme mood swings The more of these signs a person shows, the greater the risk. Warning signs are associated with suicide, but may not be what causes a suicide. If you are worried about someone, call the Hope Center at (970) 306-4673. 2 02 0 -2 021
A MIND-BODY APPROACH
TO STAYING WELL
Dr. Diane Voytko, a family medicine physician, introduces her patient to Cathy Schneider, a licensed clinical social worker.
Colorado Mountain Medical’s new behavioral health specialists help the community navigate everything from anxiety and depression to infertility and chronic pain by caramie petrowsky photo by dominique taylor
e o ple w h o t r u s t t h e i r d o c to r s often find themselves sharing more than the details of their physical health. Obstetrician/gynecologists, for instance, are frequently consulted regarding the emotions women experience in life. Primary care providers are also confided in, and recently, all Colorado Mountain Medical providers began screening patients for signs of behavioral health concerns. CMM’s goal is to treat each patient’s body, mind and spirit. When an issue arises, help is around the corner — literally. Colorado Mountain Medical’s clinics are intimate and integrated. That means, if a provider determines a patient requires specialty care like endocrinology, for instance, he can call or, in most cases, walk down the hall and make an introduction
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to one of the endocrinologists. Likewise, if a patient with diabetes admits he’s having a hard time managing his blood sugar because he’s suffering from depression, his doctor can refer him directly and seamlessly to someone on the behavioral health team. The team likes to refer to this as “the warm handoff.” The overarching goal of this integrated health model is simple: “To meet people where they are and get them timely, accurate care,” says Cathy Schneider, LCSW, a member of CMM’s behavioral health team. TIMING IS EVERYTHING Timing is especially crucial when it comes to providing behavioral health resources. Whereas in some larger healthcare systems, it can take upwards of three weeks to schedule an initial visit with a mental health provider, someone who is in crisis can access a therapist the same day if needed, either with a CMM provider or someone from the Hope Center. “If you’re in the middle of experiencing the loss of a loved one or having marriage issues, three weeks is a really long time,” says Schneider, adding that the top three issues locals face are anxiety, depression and substance abuse. If a provider is concerned for a patient’s mental wellbeing, he or she will recommend therapy on the spot. “As a company, we’re focused significantly on both empowering our medical providers to recognize patients who have behavioral health issues and growing our team of behavioral health specialists to handle the needs of the community,” says CMM’s CEO Dr. Brooks Bock, who has hired eight behavioral health specialists in less than a year, with additional providers available via telehealth through a partnership with the Johnson Depression Center at the University of Colorado. WHY INTEGRATED HEALTH WORKS Patients appreciate the seamless transition and convenience of having an integrated healthcare system under one roof. “The doctor might say, ‘I understand you’re having a hard time, I want you to touch base with one of our therapists — I think they could help.’ And then the therapist can come right into the room and do an intro right then,” Schneider says. “It really helps to demystify and cut the stigma out of mental healthcare.”
It doesn’t matter what type of care you’re receiving — patients are here to manage their health, and that’s a positive step along the journey to wellness
Since all CMM providers are using the same electronic medical record system, there is no need for obtaining permission to transfer records, as can be the case when the care isn’t integrated. “Medical providers connect with us regularly and we can consult back and forth on cases to ensure the patients’ whole-body health,” explains Schneider. In addition, several of Schneider’s therapy patients have mentioned feeling more comfortable sitting in the waiting room because no one knows if they are there to see a medical doctor or a therapist. “It doesn’t matter what type of care you’re receiving — patients are here to manage their health, and that’s a positive step along the journey to wellness,” Schneider says. “People should applaud one another for taking care of themselves — whether it’s their physical body or their mental health. When our doctors recommend therapy, it normalizes it for people.” Along with experience treating depression and anxiety, CMM’s therapists offer a variety of specialty care, including trauma; substance abuse (some of the team members are licensed addiction counselors as well as licensed therapists); chronic long-term health issues like HIV/AIDS, infertility and diabetes; smoking cessation; couples therapy; eating disorders and pain management issues. Two therapists specialize in using eye movement desensitization (EMDR) to treat both adults and teenagers. “We really do focus on different things,” Schneider says. “I like to say we are a small team, but we have a deep bench.” WHEN THE COMMUNITY FACES A CRISIS Colorado Mountain Medical launched the behavioral health program in December 2019. COVID-19 hit Eagle County two months later. When the
symptoms of COVID-19 were initially released, they included cough, cold, fever and trouble breathing. As the world developed a better understanding of the virus, one side effect became a clear and significant concern: behavioral health. CMM established dedicated sick clinics to treat the physical effects of the virus. They also braced their behavioral health team to support Eagle County residents through the emotional effects that would take a toll on a greater number of people than those who actually tested positive for COVID-19. When the emotional stability of everyone in the community was at risk as fear, job loss, changes in routine and isolation wreaked havoc on people’s behavioral health, CMM increased its in-person and telehealth capabilities. “The timing couldn’t have been more perfect for CMM to begin offering behavioral health. It’s been a very important initiative for the county as a whole, and will continue to be as we move into the future,” says Dr. Bock. SOLUTIONS FOR THE COST OF BEHAVIORAL HEALTHCARE Because the cost of therapy can be prohibitive for some people, Eagle Valley Behavioral Health launched Olivia's Fund, which provides financial assistance to anyone who lives or works in the Eagle River Valley and demonstrates a need. Olivia's Fund offers mental health and/or substance abuse services for up to six free sessions per person, per year. Colorado Mountain Medical has made significant contributions to improving the behavioral health landscape in the Eagle River Valley. By referring patients at risk, growing the behavioral health team and offering solutions for the cost of care, CMM is truly caring for the body, mind and spirit.
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FIGHT OR FLIGHT
The effects of stress are cumulative and risky by kimberly nicoletti
e d a le r t ! r e d a le r t ! ”
The military originally coined this term, and when the alert went out, troops prepared for an imminent enemy attack. Since then, red flag alerts have applied to nuclear threats, hurricane forces, wildfire risks, terrorism threats and now, COVID-19. Our bodies are hardwired to react to peril; it’s called the stress response. When we think we’re in danger, our bodies release chemicals, including adrenaline and cortisol, which prepare us to fight or flee by increasing our heart rate, boosting energy supplies and curbing functions that aren’t necessary in a fight-or-flight situation, like digestion, reproduction and immune responses. The stress response can be life-saving.
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“Short bursts of stress are positive and can save you from injury,” says Dr. Brooks Bock, an emergency medicine physician at Vail Health and CEO of Colorado Mountain Medical. But when the perceived threat continues for days, weeks, months and years, it starts to interfere with our wellbeing. In our modern lives, stress shows up in a multitude of ways, from pressures to be an exceptional parent, employee or child to health, financial and societal concerns. “Stress is a feeling of emotional and physical tension on the body, mind, psyche or spirit,” Dr. Bock explains. “All can cause you to feel frustrated, angry or nervous and suffer a variety of different conditions, both medically and from a behavioral health perspective. Stress can impact multiple parts of your body.”
With COVID-19, fires, kids and school, finances, the economy, the political climate and social injustice, we are much more at risk to become ill, depressed or anxious and to have a decreased ability to manage our emotional responses. We may cry more easily or get angry at the drop of a hat, and we may not make good decisions.
EFFECTS The initial response to stress causes the heart rate and blood pressure to increase and coronary arteries to constrict, which decreases oxygen and blood flow to the heart muscle. Muscles tense as they prepare to fight or flee; pain and spasms may result from long-term muscle tightness in the back, neck and jaw, and also cause headaches. Digestion slows, which increases the inflammatory response in the gastrointestinal tract and can lead to gas, diarrhea, irritable bowel syndrome and symptoms that mimic Crohn’s disease. “The consistency and duration of stress are where things go awry,” Dr. Bock says. Slowed digestion can alter the balance of gut bacteria, which can weaken the immune system, making people more susceptible to flus, colds and chronic illnesses like diabetes or cardiac disease. “With COVID-19, fires, kids and school, finances, the economy, the political climate and social injustice, we are much more at risk to become ill, depressed or anxious,” Dr. Bock says, “and to have a decreased ability to manage our emotional responses. We may cry more easily or get angry at the drop of a hat, and we may not make good decisions.” Long-term stress can affect fertility, as stress hormones impact the body’s main reproductive hormone, GnRH, and dysregulate chemicals that trigger ovaries to release eggs monthly. Prolonged stress literally reduces the brain’s gray matter, which helps control motor function, sensory data, memory, emotional regulation, speech and self-control. “As a result, those things are not as sharp and aligned as they may have been,” Dr. Bock says. “It’s the reason that, when we’re under significant stress, we can lose selfcontrol, because there’s a reduction in gray matter that helps manage emotions. And there’s pretty good evidence it affects the magnitude of the highs and lows we have.” Stress can also affect your weight. Turning to junk food or alcohol for a little shot of pleasure or relief during times of stress is a knee-jerk reaction. That alone can pack on a few pounds. But studies show that people under stress don’t burn the same number of calories as someone who’s not stressed. Additionally, regular exercise regimens usually go out the window when people are stressed, which compounds the problem. In addition to not eating
well or exercising, Dr. Bock says many people don’t hydrate adequately — particularly under stress. “Not taking in enough fluids or eating a balanced diet — that has only negative consequences,” he says. SOLUTIONS So how do we mitigate the effects of stress? Part of it involves how we perceive situations. Talking to trustworthy friends, family members and professionals can provide a calmer perspective. Working through the problems that cause stress can help us stay in the present moment rather than jumping to “what-ifs” when it comes to the unknown future. Brainstorming solutions for work and home issues can remind us that we’re not alone in our struggles. “Everyone needs a social support system,” Dr. Bock says. “We need to find a place of peace, comfort and trust. It’s why we are seeing an increased need for professional services — to help us figure out how to deal with stressful events.” Figuring out how to lighten your load may require saying no to certain things, both from a habitual perspective (like using alcohol or drugs to excess) and a social perspective (like taking on too many unnecessary responsibilities). To figure out what to drop and what to keep, notice whether a certain activity tends to result in more anxiety, frustration, anger or confusion. “Drugs and alcohol or other behaviors, like gambling, that may look and feel, at the moment, to be stressreductive, can have enough negative consequences to be stress-additive,” Dr. Bock says. Practicing basic self-care, from eating better and drinking enough water to getting adequate sleep and exercise, goes a long way in relieving stress. Exercise releases endorphins, which results in a more positive outlook, Dr. Bock says. It also deepens breathing, shifting the breath from chest-centered fight-flight to deep-belly relaxation, and it improves gastric and intestinal motility. While life involves plenty of stressors, we have choices in how we deal with them. Small and simple steps, like reaching out for support, exercising, eating better, pausing to rest, breathing more fully, changing your perspective and even laughing can go a long way in making you feel stronger and more resilient to life’s challenges.
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While we learn to adapt to life with COVID-19, experts emphasize the importance of physical and mental health maintenance. Don't neglect your wellness at this time.
AND NOW A PANDEMIC? Nobody is unaffected by COVID-19 by david o. williams
in Eagle County as a story about someplace else: China, Italy, New York City, Seattle. We watched as it traveled from country to country, glued to the 24/7 news cycle. But things hit home, literally, when Vail Resorts shut down mountain operations for all its Colorado locations in the middle of the Spring Break crush. No vacationing visitors meant no hotel guests, restaurant diners, ski school students, gear buyers or boutique shoppers. It created a domino effect, as business after business shuttered and the streets emptied. Schools closed, offices closed. We hunkered down, and stayed there for months. ovid -19 made its first appearance
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This is a shared experience. How much does a shared experience become a protective factor? Every single person in the world is going through this. We have this common language for it, we have a common support.
“The vast majority of us have never been impacted by any sort of epidemic or quarantine,” says Dr. Casey Wolfington, a licensed psychologist and the community behavioral health director at Eagle Valley Behavioral Health (EVBH). “Certainly there are parts of the world that have, but we haven’t. And so our entire history is pulling us — almost like gravity — to this idea of normal.” But our definition of normal has been completely upended. There’s so much uncertainty on a daily basis that it’s hard to get a footing. There are wildly varying reports of scientific research, causation and best practices — and that’s just surrounding the virus. There’s just as much uncertainty in what tomorrow will look like, and the next day, and the next, as businesses struggle, people keep to themselves and our traditional social and familial circles shrink. The ripple effects have undoubtedly been felt acutely throughout the community. COVID-19'S EARLY MARK In the months following Eagle County’s initial shut-down, calls for counseling surged. Colorado Mountain Medical (CMM) and Vail Health integrated behavioral health services at CMM’s Avon and Eagle offices at the beginning of the year, right before the virus hit, and at the time had just two therapists. They added providers, but appointments were quickly filled, signaling a need for additional support. Three more providers were hired, and everyone had a steady case load. What was so alarming was that the growing demand was coming from a smaller population with no seasonal workers in town. The Hope Center of the Eagle River Valley’s Hopeline, which responds
to calls 24/7 and dispatches crisis interventionalists, has seen a similar year-over-year increase in calls despite a dramatic drop-off in seasonal population after Vail and Beaver Creek ski areas abruptly shut down in mid-March. Those younger seasonal workers, living away from home in dense housing with a lot of partying, used to comprise the bulk of the calls. “For a while we didn’t have those people in our community when the mountain closed down,” says Chris Lindley, chief population health officer for Vail Health and executive director of EVBH. “The 3040% surge is attributed to long-term community residents that are now using the Hope Center.” Despite the ski season ending more than a month early and a total lack of big summer events, the volume of visits to the Emergency Department didn’t change, and the percentage of those visits for substance abuse and behavioral health issues was much higher than it's ever been. In the summer months following the outbreak, there were almost as many suicide deaths as COVID-19related deaths. And The Community Foundation food bank served four times its normal volume — up from 1,000 to 4,000 families a week. Domestic violence reporting was down 42% compared to the same month in 2019, especially among adolescents. Experts attribute this decline to teachers and other adults in the community not seeing kids who are being abused as regularly and therefore were not able to do the mandatory reporting required by law. “So they spent more time with the abuser and cases were much more severe,” Lindley says. “The number one trigger for stress and anxiety is financial concerns,
and that was before COVID-19,” Lindley says. “But now we have a large percentage of our population that doesn’t know if they’re going to recover financially. And it’s not just the business owners that are struggling now; it’s the employees of those businesses.” As the issues around COVID-19 piled up, they created a snowball effect with long-reaching consequences that have taken a toll on everyone. People are just plain exhausted — tired of worrying; tired of wearing a mask; tired of missing trips, date nights, concerts and special occasions; tired of trying to figure out child care; tired of complicated problems that have no concrete solutions. “That struggle is really hard,” Dr. Wolfington says. “I think one thing that we haven’t let go of is comparing our current situation to what it used to be. In life, whenever there’s a discrepancy, or a lack of congruence, it causes us stress. And right now, what we’re going through is not as good a version of what we had before. And so everything seems tainted.” Despite the fact that our coping skills are being tested, Dr. Wolfington sees a potential for happiness and a sense of stability. “Try to find things that you feel positively about,” she says. “This is not just looking on the bright side. This is confirmation bias: if you’re looking for something, you can usually find it. How often have you walked through the grocery store and somebody says, ‘This year is the worst,’ and you agreed? But people have had babies and birthdays and marriages — there are still all of these amazing good things, but we’re not looking out for them.” You don’t have to be an eternal optimist. It’s okay to mourn what
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we’ve lost during this time. Dr. Wolfington simply recommends looking for a balance between the positive and the negative. PSYCHOLOGICAL EFFECTS The effects of quarantine have been studied in limited ways, such as in places where Ebola or SARS were present. Long-term effects include insomnia, depression, anxiety and elements of posttraumatic stress disorder. “You can usually distinguish people who’ve been through a quarantine from people who haven’t based on their symptom levels, so you can segment them into a group,” explains Dr. Wolfington. “But the interesting
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part of that is they were all little communities that experienced the quarantine.” But the COVID-19 quarantine group is not a small one. “This is a shared experience,” she says. “How much does a shared experience become a protective factor? Every single person in the world is going through this. We have this common language for it, we have a common support.” Dr. Wolfington draws parallels to other arenas of misfortune and healing. Take, for instance, getting into a traumatic accident or losing a loved one. “One of the things that can predict your ability to recover is social connection,” she says.
With parents working from home and kids doing at least part of their schooling at home as well, life can be pretty hectic.
Maybe a colleague has lost a loved one, and talks about her experience. There’s a connection. “Quarantining has brought everyone together in that social connection,” Dr. Wolfington affirms. And that might prove to be a very good thing. THE KIDS One of the biggest concerns for parents, educators and others is how our children are experiencing the effects of social distancing and lack of community activities. At the most basic level, they’ve stopped socializing the way they’re used to. And many have missed out on milestones and commemorations of rites of passage — birth-
In life, whenever there’s a discrepancy, or a lack of congruence, it causes us stress. And right now, what we’re going through, is not as a good a version of what we had before. And so everything seems tainted.
day parties, graduation ceremonies — and it’s felt acutely. “We don't know how detrimental it will be,” Lindley says. “We know it’s going to have negative effects, but none of us have gone through this. Kids at this stage have never experienced anything like this as it relates to education and after-school activities and sports.” “Kids don’t have the same coping skills,” explains Dr. Wolfington. “As adults, we’ve developed ours over years. It’s taken us a very long time to know what works to make us feel better, and kids don’t know yet. They don’t have the same repertoire of skills.” They get them, instead, through indirect sources, such as sports or other activities — places where they have connections with others. And one very real consequence of COVID-19 is limiting those natural coping skills. Dr. Wolfington recommends figuring out what feeds your children’s social connections, and nurturing that in whatever way you can, whether it’s playing soccer in the park or doing arts and crafts. Remote learning and play cannot be a substitute for human connection. Lindley likes to quote former U.S. Surgeon General Dr. Vivek H. Murthy, who thinks of loneliness as “an epidemic because it affects a great number of people in our country but also because one person’s loneliness can have an impact on another person.” Loneliness is also one of the biggest killers on the planet, leading to stress, anxiety and disease. People must actively combat loneliness and find ways to connect as we move through the different levels of precaution in our valley, Lindley says. Whether it’s online tools that create virtual networks or finding spaces to get together in a room,
socially distanced and in masks. We all must work hard at breaking out of our patterns of isolation. “We don’t like change, and we don’t like the lack of predictability,” explains Dr. Wolfington. “We don’t know what any of this means, and it’s hard to fortune-tell. That creates a lot of stress in anybody.” WHAT WE CAN DO As we continue to play the game of wait-and-see, Lindley offers some daily tips for making it through the long haul of the battle against COVID-19 — things that everyone needs to do to keep themselves and their family members healthy, mentally and physically. And it bears mentioning that the local expert tasked with keeping the community’s mental health in good shape recommends starting by taking care of our bodies. “Take care of your physical health,” Lindley says. “Go see your primary care provider for an annual physical.” He encourages people to get their cholesterol checked, find out what their Body Mass Index (BMI) is, check their blood pressure, do medication management as well as cancer screenings. If anything is out of whack, start working on it with a primary care provider. “What we know going into COVID-19 is those who are healthier have much better outcomes than those who aren’t.” Overall body weight and blood pressure should be a top priority because obesity and hypertension are the top two risk factors for COVID-19, followed by type 2 diabetes (caused by obesity) and heart disease (often caused by smoking). “It comes down to a healthy lifestyle of behavioral health,
physical health and nutrition. Pay attention to the way you feel — your body, the way you move your body and the way you regulate your body is what we want people to start to think about as they go forward.” Lindley recommends “moving your body” at least 45 minutes a day, eating healthier, drinking less alcohol or cutting it out altogether. Also stop smoking and vaping because any type of self-inflicted lung damage is a really bad idea during a respiratory pandemic. Prioritize sleep. Seven hours is the minimum, and most people actually need between 8 and 10 hours to get fully recharged. Stay fully hydrated. “A lot of people struggle with this,” says Lindley. “We’re a society of coffee and sports drink drinkers. If you really are hydrated, you drink about half of your body weight in ounces a day. I weigh 220 pounds, so that would be 110 ounces of water a day. That’s a lot of water.” And finally, take care of your behavioral health by talking to those around you and finding a therapist to talk things through. Have conversations with your kids throughout the day and around the dinner table at night. “Ask them how they're feeling and how COVID-19 and all the changes associated with the pandemic are impacting them,” Lindley encourages. It’s not an easy time for anyone, but there are things within our control. And focusing on what we can control instead of what we can’t is a good place to start. Choosing to fit in that hike (good for both the body and the spirit) or maybe leaving the dishes undone in order to spend time connecting with your kids, are ways to prioritize what really matters: people — ourselves included.
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WAIT, TECHNOLOGY CAN CONNECT US? EagleValleyBH.org is a single source for behavioral health resources in the Eagle River Valley.
The website CommunityStream.org is a clearinghouse of online resources for locals, by locals, offering everything from workouts to cooking classes to tips on parenting.
It turns out technology isn't 'all bad' by k aren mason
to just about everything we do. And while historically, studies have shown that technology can have a negative impact on our mental health, Eagle Valley Behavioral Health (EVBH) experts are harnessing the power of technology to connect people to the resources they need. “Yes, we’ve got solid data that the use of social media has led to an increase in behavioral health problems. It deteriorates the human-to-human connection,” says Dr. Casey Wolfington, licensed psychologist and community behavioral health director for EVBH. “But in the current COVID-19 environment, we’re actually helping create some type of normalcy, thanks to technology.” o v i d -19 h a s u n d e r s c o r e d h o w i m p o r ta n t t e c h n o l o g y i s
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EVBH's Facebook page offers a daily feed of information, events, tips and thoughtful posts.
Since COVID-19 hit, what we need is physical distancing, not social distancing. So, how can we capitalize on technology to make sure people are feeling socially connected? Currently, 96% of behavioral health providers in the community are practicing teletherapy, according to Dr. Wolfington. “It’s been remarkably effective, and people have really opened up. Plus, because of telehealth, we’ve been able to expand our specialties and offerings.” All of these resources and more are available at EagleValleyBH.org, where users can connect with a therapist by specialty, location and insurance accepted. The launch of the website was one EVBH’s first milestones in the effort to connect the community to behavioral health resources and reduce barriers to finding care. “The website showcases just how many providers we’ve been able to bring into the fold to ensure the community knows who’s out there,” explains Dana Erpelding, operations director for EVBH. “The website makes it easy for people to find a therapist to fit their needs, and it takes the heavy lifting away from providers, allowing them to focus more on patient care.” TECHNOLOGY MORE INTEGRAL THAN EVER BEFORE Broadly speaking, most of us probably recognize that we’re utilizing technology like never before. “Can you imagine if COVID-19 had happened 10 years ago?” asks Dr. Wolfington. “Online learning would have been non-existent. For the most part, schools were able to adapt. And the same thing happened with places of employment. Ten years ago, most people didn’t have laptops or the software that allows them to telecommute.” Technology has been a solution to life from home. People are using Zoom for reunions, get-togethers and to mark special occasions such as birthdays and even weddings. Some of us have used social media more than we did before to keep the mood light, stay connected with friends and loved ones and share information during COVID-19. Organizations such as EVBH are utilizing technology to promote and offer a plethora of virtual events. Mountain Youth’s “Eat Chat Parent” program,
Since COVID-19 hit, what we need is physical distancing, not social distancing. So, how can we capitalize on technology to make sure people are feeling socially connected?
which last year brought 500 community members together at a variety of in-person events, now offers a video series featuring community conversations that allow for open dialogue and tackle tough topics such as protecting your child from sexual abuse and addressing technology misuse. EVBH also offers events, speakers, film screenings, training and educational seminars via virtual Zoom meetings to help people connect in the COVID-19 world. Its Facebook page is a daily feed of information, events, tips and thoughtful posts to keep its followers informed, engaged and hopeful. Thoughtful information and conversations that are more critical than ever wouldn’t be possible without technology. COMMUNITY STREAM When the fear of loneliness as a result of isolation began to set in as COVID-19 kept people at home, Eagle Valley Behavioral Health envisioned a tool to help community members stay informed, healthy, active and engaged. The result was CommunityStream.org, where you can now connect with others in an online core strength and agility class, watch a cooking demo, find COVID-19-related couples support or take a Zumba class. Live-streaming and pre-recorded events and podcasts are constantly being added. All of the content is created for locals, by locals. The community has quickly adopted the website as a resource. Town leaders have used it to communicate relevant information, such as how COVID-19 has affected the economy. Most importantly, it’s helping keep people mentally and physically well, during an otherwise difficult time. “It’s a great example of how we’re using technology to get people to get up and exercise during this time,” Data Systems Analytics Director Mike Richards says. Richards says CommunityStream.org “came out of the concept of engaging the community and keeping people up-to-date on things in the behavioral health space, as well as things that are just having a positive impact on people’s lives. “The big takeaway is that we’re trying to leverage tech in a positive way to engage the community,” he adds. “We’re being creative and thinking outside the box. We’re seeing what works and trying consistently to move the ball forward.” 2 02 0 -2 021
A QUIET TERROR Dr. Jack Eck’s struggle with PTSD after the Vietnam War
t was 1971 when dr . jack eck
returned from serving as a flight surgeon for an aviation unit in the Vietnam War and escaped to the Colorado mountains. After four years of college, four years of medical school, a one-year internship and one year as a doctor in the throes of war trauma, Dr. Eck chose Vail as a soft landing. Only two other doctors were here at the time, and Dr. Eck joined in to help support the town’s small medical clinic, now Vail Health. But it wasn’t until he got to Vail that he realized something wasn’t quite right. “I just wasn’t happy,” he shares. “I wasn’t suicidal, but the feeling was unlike me. I found myself thinking ‘Oh, how can the world be this way?’” While Dr. Eck didn’t have any physical injuries from serving in Vietnam, like countless other veterans, he suffered from post-traumatic stress disorder (PTSD). During the war and when he returned
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by kim fuller
stateside, Dr. Eck says the “quiet terror” was always present. “[In Vietnam] you didn’t know if the guy walking down the street was going to blow you up as he walked by you, or if he was just a guy out there trying to harvest his rice,” Dr. Eck shares. “You didn’t know who your enemy was, so you were always on guard. You were always in terror, a quiet terror. After a while, you sort of got numb to it.” While he was over there, Dr. Eck says he was busy and always felt needed, so the trauma didn’t really start to build until the years following the war. “I said to myself, ‘If I survive this, I’m going to go to a ski area for a winter,’” recalls Dr. Eck. He did just that, and aside from an internal medicine residency in Denver, an additional year of study in cardiology and intensive care with the help of the GI Bill, and a six month hematology sabbatical in New Zealand, he's been here ever since.
Captain Jack Eck, MD served as a flight surgeon in the 101st Airborne Division during the Vietnam War.
Dr. Jack Eck's medical career in Vail began in 1971 and spanned decades. photo by brent bingham photography
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WORKING THROUGH IT As Vail continued to grow in its early days, Dr. Eck was the first physician to serve on the Vail Ski Patrol. “Ski Patrol asked for training and help from my experience gained in Vietnam,” he shares. “I was a willing teacher.” His experience as a doctor in Vietnam significantly helped to shape the advanced orthopaedic and medical first responder techniques used by the Ski Patrol today. His practices also influenced the U.S. Ski Team and were adopted by resorts nationwide. Dr. Eck says he would go up the mountain and train the Ski Patrol on his days off from the clinic. The men he worked with became his best friends, and he says sharing the medical skills from Vietnam was helpful in dealing with his PTSD. He was functioning, he shares, and would get in a zone with patients so he wasn’t making mistakes in his work, but he still didn’t feel fully well. “Here I was in a wonderful place and I’d done a lot of mountaineering and climbing and kayaking, and there was something still off,” he shares. “I started seeing a psychiatrist, and it actually ended up being one of the smartest things I did.” Dr. Eck says talking through his thoughts and feelings with a mental health professional helped him sort it all out. “I wasn’t severely depressed,” he shares, “but just the fact that you can work through and have someone to bounce things off, and then you can focus on what reality is for whichever direction you want to go.”
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FIGHTING STRENGTH Many people still make a move to paradise-like places like Vail to escape or hide, says Dr. Eck, as he did with those initial experiences of PTSD after the war. “A lot of people come here to look for a fix,” he explains, “and they’re changing locations, but their problems are still there. And they get depressed.” Before support programs were available in the area, Dr. Eck says he would have patients come through the Emergency Department who were struggling with depression, anxiety and suicidal thoughts. “We had no place to put these people, none, nada,” he shares. “You send them to Denver and they walk in your office two days later and say they saw a psychiatrist in Denver who screened them and said they were fine and sent them back. Then how do they work through it?”
As the first physician to serve on the Vail Ski Patrol, Dr. Eck helped shape the organization's on-mountain first responder protocol. His influence extended to Ski Patrols at resorts nationwide. Dr. Eck was an internist at the Vail hospital, and for years he would have to send patients to Denver for depression, anxiety and suicidal thoughts.
Here I was in a wonderful place and I’d done a lot of mountaineering and climbing and kayaking, and there was something still off. I started seeing a psychiatrist, and it actually ended up being one of the smartest things I did.
Dr. Eck has given his service to the Eagle River Valley for nearly 50 years. As he retires, he will be remembered for his countless contributions.
Dr. Eck says he’s been happy to see the tremendous growth of behavioral health resources in the valley and credits Eagle Valley Behavioral Health (EVBH). He supports EVBH and has served as a board member with the Johnson Depression Center at the University of Colorado for the past two decades. Since he began practicing here in 1971, Dr. Eck’s contributions throughout Colorado and the Eagle River Valley have been profound. He was integral in the creation of Shaw Cancer Center, securing a $17 million gift from the Shaw family to make the cancer center possible. In 2007, Jack's Place, a cancer caring house, was named in his honor. It was during this time that he was successfully
treated at Shaw for prostate cancer. Dr. Eck was named Vail Valley Foundation’s Citizen of the Year in 2008, and was inducted into the Colorado Snowsports Museum Hall of Fame in 2015. After his retirement, he will continue to serve on the Vail Health Foundation and Johnson Depression Center at University of Colorado boards. In Vietnam, Dr. Eck says his mission was to “maintain the fighting strength” of the troops. As he retires at the end of 2020 from the Vail Health Foundation, may we remember his resilience in overcoming his own battles with depression, and the immeasurable support he’s given every patient, peer and friend over the years to maintain their own fighting strength.
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WHERE TO GO $
PRIMARY CARE • Altitude sickness • Respiratory and urinary tract infections • Cough, cold, fever and flu symptoms
URGENT CARE • Altitude sickness • Respiratory and urinary tract infections • Cough, cold, fever and flu symptoms
• Minor cuts and burns • Minor fractures, strains and sprains • Stomach illness and dehydration
When you’re sick or injured, it’s sometimes hard to know where to go for medical care. Vail Health offers a variety of healthcare
services in convenient locations throughout Eagle County so you can find the right care, at the right time and at the right cost.
Primary care is typically the least expensive option for medical care. Call ahead for an appointment. COLORADO MOUNTAIN MEDICAL Vail
108 S. Frontage Rd. W., Suite 101 (970) 926-6340
Edwards 322 Beard Creek Rd., Suite 1300 (970) 446-1300
50 Buck Creek Rd., Suite 200 (970) 926-6340
377 Sylvan Lake Rd., Suite 210 (970) 926-6340
If your healthcare need is immediate, urgent care is a walk-in service and is more affordable than the Emergency Department. COLORADO MOUNTAIN MEDICAL Vail
108 S. Frontage Rd. W., Suite 101 (970) 926-6340
230 Chapel Place (970) 949-6100
50 Buck Creek Rd., Suite 200 (970) 926-6340
377 Sylvan Lake Rd., Suite 210 (970) 926-6340
If you are experiencing any symptoms of COVID-19, call Colorado Mountain Medical at (970) 926-6340 for screening.
The Emergency Department is open 24 hours a day, seven days a week.
• • • •
• Minor cuts and burns • Minor fractures, strains and sprains • Stomach illness and dehydration
FIND THE RIGHT CARE AT THE RIGHT TIME
Shortness of breath Fever Dry cough Headache, body aches or ear ache
• Sore throat, loss of the sense of smell or taste • Abdominal pain, such as nausea, vomiting and diarrhea
If you or a loved one are experiencing any of the following medical emergencies, call 9-1-1 or go to the nearest Emergency Department. • Chest pain, numbness in limbs or face • Difficulty breathing or speaking • Head trauma • Severe bleeding
• Severe injury • Loss of vision • Confusion or sudden unexplained loss of consciousness
If you are experiencing extreme difficulty breathing, call 9-1-1 or visit the Emergency Department immediately. If breathing is troublesome but manageable, call Colorado Mountain Medical at (970) 926-6340 to schedule an appointment at one of our respiratory clinics.
VAIL HEALTH 24/7 EMERGENCY DEPARTMENT 181 West Meadow Drive | (970) 479-7225 • A Level III Trauma Center, staffed by board-certified physicians • Cardiac Catheterization Lab
• State-of-the-art imaging, diagnostics and laboratory on-site • Emergency helicopter transport
BEAVER CREEK MEDICAL CENTER
1280 Village Road | (970) 949-0800 | Open during ski season only. • Board-certified emergency physicians
• Wound, orthopaedic and respiratory care
• On-site X-ray and lab services
BEHAVIOR AL HE ALTH DIREC TORY
ag le valle y b e havi o r al
health maintains a dynamic website of the Eagle River Valleyâ&#x20AC;&#x2122;s behavioral health resources. Visit EagleValleyBH.org to find a therapist, support group and other resources. While this print directory includes some of the same information, the website is continually updated and available anytime and anywhere.
CHILDREN & TEENS Bright Future Foundation Buddy Mentor Program mybrightfuture.org/buddymentors (970) 949-7097 The Buddy Mentors program strives to inspire and foster youth through building consistent and trusting relationships. Research suggests youth who are supported by a mentor are less likely to use drugs and alcohol, skip school and engage in physical violence. These youth also show increased success in relationships.
Colorado Mountain Medical cmmhealth.org/behavioralhealth (970) 445-2489 Colorado Mountain Medical's goal is to treat mental health needs the same as physical health needs. The behavioral health team includes therapists to help with shortand long-term emotional and behavioral concerns in teens and children. Services include groups, play therapy, walk-and-talk therapy, trauma therapy, family therapy, parent coaching, behavioral support and intensive group support.
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MIRA (Mobile Intercultural Resource Alliance) is a mobile, bilingual resource center that offers basic health education and screenings, application support for public assistance programs, food resources and more to communities throughout Eagle County.
B E H AV I O R A L H E A LT H D I R E C TO RY
Eagle Valley Behavioral Health Therapist Finder eaglevalleybh.org/findatherapist (970) 569-7765 Eagle Valley Behavioral Health's website is a clearinghouse for information and resources. The robust "Find a Therapist" feature allows users to search a database of therapists to find one who best meets their needs.
The Hope Center's School-Based Clinicians ourhopecenter.org/eagleteam (970) 306-4673 The Hope Center of the Eagle River Valley's school-based program provides therapeutic care to students in ten Eagle County Schools and at the Stone Creek Charter School. Clinicians address the rising social-emotional challenges children and teens face through access to walk-in, therapeutic services at their school. The Hope Center’s school clinicians also provide therapeutic services to students in need over the summer break.
Mind Springs Health mindspringshealth.org Eagle: (970) 328-6969 Vail: (970) 476-0930 Mind Springs Health provides expert, compassionate mental and behavioral health treatment for all ages and concerns. Individual and group therapy, child and adolescent services, and English and Spanish-speaking therapists are available.
youth thrive. Mountain Youth’s work ensures Eagle County youth remain a priority; striving to be a community where young people are equipped with skills that support healthy bodies, healthy minds and improved decision-making and leadership skills to guide their lives. They offer safe-driving education, a youth advocacy board, life skills for student and parent education, and they facilitate the Healthy Kids Colorado survey for the Eagle River Valley.
have a voice, be involved and make meaningful change. Led by a Youth Executive Board, Valley's Voice is comprised of young people, ages 10 to 25.
Colorado Mountain Medical Support Group for Caregivers
My Future Pathways Community Center
This group focuses on the needs of the family caregiver
cmmhealth.org/supportgroups (970) 445-2489
My Future Pathways provides a helping hand to enhance and enrich the lives of Eagle County youth, leading to positive pathways. The organization teaches strong values, selfdiscipline, grit and integrity, with an emphasis on developing social and emotional skills. My Future Pathways fosters community collaboration and parental involvement, as well as positive behavioral health, to inspire youth to discover their own pathways.
Vail Mind Center vailmindcenter.com (970) 446-6481
Mountain Recreation provides world-class recreational opportunities so everyone in our community lives a healthy and happy life.
www.mountainyouth.org (970) 949-9250
mountainyouth.org/valleysvoice (970) 343-0007
Mountain Youth is a non-profit founded in 2001 with a vision of creating a community where all
Valley’s Voice is a catalyst for change in Eagle County. It is a one-stop shop for youth to
mountainrec.org Gypsum: (970) 777-8888 Edwards: (970) 766-5555
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CAREGIVER SUPPORT SERVICES Caregiver/Memory Loss Support Group
myfuturepathways.org (970) 306-3123
The Vail Mind Center provides a wide range of speech therapy, occupational therapy and art therapy services for children with a variety of needs, including: autism spectrum disorders, dyspraxia, ADHD, dyslexia, cerebral palsy, Down syndrome, sensory processing issues and other developmental disorders/ deficits. Also available is psychological and education testing for children, including ADHD, autism spectrum disorder, learning delays and mood disorders.
for someone living with Alzheimer’s disease or another dementia. Caregivers take on tremendous responsibilities that can easily overwhelm them, so this group offers resources to address the caregivers' specific needs. The group meets the 2nd Tuesday of every month, 4:30-6:00 PM at 455 Nottingham Ranch Road in Avon.
CRISIS INTERVENTION: GET HELP NOW Are you or someone you love in immediate need of help? If so, call one of the following services for support. The Hope Center of the Eagle River Valley Hopeline
National Suicide Prevention Lifeline
ourhopecenter.org/eagleteam (970) 306-4673 (HOPE)
suicidepreventionlifeline.org (800) 273-8255
The Hope Center of the Eagle River Valley's crisis line is available for any community member to call 24/7/365. Calls to this crisis line connect the caller with a licensed therapist on the Hope Center’s mobile crisis co-response team. The clinician will evaluate the caller's need and respond in person to give a behavioral health evaluation and provide a referral for a continuum of care. When an emotional crisis happens at home, in school, anywhere, anytime of day or night, Hope Center clinicians respond to the scene of the crisis.
The National Suicide Prevention Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress, 24/7/365. The Lifeline is committed to improving crisis services and advancing suicide prevention by empowering individuals, advancing professional best practices and building awareness.
Colorado Crisis Services
Bright Future Foundation administers Eagle County’s only 24/7 crisis hotline for domestic violence and sexual abuse. Advocates, trained in the dynamics of domestic violence and sexual assault, safety planning and access to community resources, provide confidential support and referral services to individuals and families.
coloradocrisisservices.org (844) 493-8255 Colorado Crisis Services is available 24/7/365 for whatever you're going through. Call the number above, or text the word "TALK" to 38255 for confidential and immediate support.
Domestic Violence and Sexual Abuse mybrightfuture.org (970) 949-7086
B E H AV I O R A L H E A LT H D I R E C TO RY
Colorado Mountain Medical offers both in-person and virtual support groups for adults and teens. Please refer to the website for the most up-todate support group offerings.
Eagle Valley Behavioral Health Therapist Finder eaglevalleybh.org/findatherapist (970) 569-7765 Eagle Valley Behavioral Health's website is a clearinghouse for information and resources. The robust "Find a Therapist" feature allows users to search a database of therapists to find one who best meets their needs.
COUNSELING Colorado Mountain Medical cmmhealth.org/behavioralhealth (970) 445-2489 Colorado Mountain Medical aims to treat mental health needs the same as physical health needs. The behavioral health team includes therapists to help with short- and longterm emotional and behavioral concerns for adults, teens and children. Services include couples/marriage therapy, trauma therapy, walk-and-talk therapy, group support, family therapy, health management support, intensive group support and more.
Eagle Valley Behavioral Health Therapist Finder eaglevalleybh.org/findatherapist (970) 569-7765 Eagle Valley Behavioral Health's website is a clearinghouse for information and resources. The robust "Find a Therapist" feature allows users to search a database of therapists to find one who best meets their needs.
The Hope Center ourhopecenter.org/eagleteam/ (970) 306-4673 (HOPE) The Hope Center of the Eagle River Valley's crisis line is available for any community
member to call 24/7/365. Calls to this crisis line connect the caller with a licensed therapist on the Hope Center’s Mobile Crisis Co-Response Team. The clinician will evaluate the caller’s need and will respond in person to give a behavioral health evaluation and provide a referral for a continuum of care. When an emotional crisis happens at home, in school, anywhere, anytime of day or night, Hope Center clinicians respond to the scene of the crisis.
Mind Springs Health
Early Childhood Partners specializes in supporting young children, families and child care providers in a variety of ways, so that every child and family can thrive. Their multidisciplinary team of early childhood specialists helps families and child care providers navigate resources and identify programs that best meet their individual needs.
Vail Mind Center vailmindcenter.com (970) 446-6481
The Vail Mind Center provides a wide range of speech therapy, occupational therapy and art therapy services for children with a variety of needs, including: autism spectrum disorders, dyspraxia, ADHD, dyslexia, cerebral palsy, Down syndrome, sensory processing problems, and other developmental disorders/ deficits. Also available are psychological and education testing for children, including ADHD, autism spectrum disorder, learning delays and mood disorders.
mindspringshealth.org Eagle: (970) 328-6969 Vail: (970) 476-0930 Mind Springs Health provides expert, compassionate mental and substance abuse treatment for all ages and concerns. Individual and group therapy, child and adolescent services, and English and Spanish-speaking therapists are available.
eagleschools.net/childfind (970) 328-3750 The Child Find program evaluates children in a variety of areas, including cognitive functioning, physical functioning, hearing and vision, speech and language, and social/emotional development. Evaluations are free. Once the Child Find evaluation team (including the parents) has gathered sufficient information to determine a child's eligibility for early intervention or preschool special education services, then an Individual Family Service Plan (IFSP, birth to three years of age) or an Individual Education Plan (IEP, three to five years of age) is developed and services begin.
Early Childhood Partners earlychildhoodpartners colorado.org (970) 306-6767
Bright Future Foundation mybrightfuture.org (970) 949-7086 Bright Future administers Eagle County’s only 24/7 crisis hotline for domestic violence and sexual abuse. Advocates, trained in the dynamics of domestic violence and sexual assault, safety planning and access to community resources, provide confidential support and referral services to individuals and families.
Eagle County Sheriff's Office Victims Advocates eaglecounty.us/Sheriff/ Victim_Services/Overview (970) 328-8544 The Sheriff's Office realizes victims and their family members have special needs following a crime or crisis. The goal in these instances is to
provide an extensive, serviceoriented support system for anyone impacted by trauma. As a criminal justice-based program, the Sheriff's Office cannot provide confidentiality; however, the Victims Services Program works with the District Attorney's Office to provide information about benefits and resources available through the Crime Victim’s Compensation Act. Advocates are trained in crisis intervention to provide assistance while law enforcement is still on scene and shortly after. All staff and volunteers have extensive training on the neurobiology of trauma and its impact.
EDUCATION & PREVENTION SERVICES Behavioral Health Navigators eaglecountyparamedics.com/ behavioral-health-navigators The behavioral health navigators help Eagle River Valley residents navigate the complex system of behavioral healthcare and connect people to available resources that best meet their needs when they experience barriers to access.
Mountain Youth mountainyouth.org (970) 949-9250 Mountain Youth is a non-profit founded in 2001 with a vision of creating a community where all youth thrive. Mountain Youth’s work ensures Eagle County youth remain a priority; 2 02 0 -2 021
B E H AV I O R A L H E A LT H D I R E C TO RY
striving to be a community where young people are equipped with skills that support healthy bodies, healthy minds and improved decisionmaking and leadership skills to guide their lives. They offer safe-driving education, a youth advocacy board, life skills for students and parent education, and they facilitate the Healthy Kids Colorado survey for the Eagle River Valley.
Red Ribbon Project redribbonproject.org (970) 827-5900 Red Ribbon Project is a nonprofit that empowers the community to reduce teen pregnancy, HIV/AIDS and other sexually transmitted infections.
SpeakUp ReachOut speakupreachout.org (970) 632-3858 SpeakUp ReachOut is a nonprofit created to prevent suicide through training, awareness and hope. They provide suicide prevention education and loss support services.
UB.U ubunity.com UB.U challenges the community to explore the mind and educate the heart by building hope, authenticity and connection through brain health education.
Bright Future Foundation mybrightfuture.org 970-949-7097 Bright Future Foundation provides free counseling, housing and financial support to families and individuals affected by domestic violence and sexual assault.
Eagle County Health and Human Services eaglecounty.us/HumanServices (970) 328-8840
Human Services aims to FINANCIAL connect people and strengthen ASSISTANCE communities by providing essential services for those who are most in need.
A Way Out awayout.org
barriers and increase access for Vail Health for employees and their family members in need of behavioral health services.
Olivia's Fund eaglevalleybh.org/oliviasfund Olivia’s Fund provides financial assistance to anyone who lives or works in the Eagle River Valley to help pay for mental health and/or substance use services for up to six sessions per person per year. The scholarship funds are provided by generous private donors and foundations who wish to support behavioral health services, recognizing many individuals cannot get support because of financial barriers.
Mountain Strong EAP
A WAY OUT (AWO) is a non-profit serving residents in Eagle, Garfield and Pitkin counties. AWO provides financial scholarship support to people struggling with substance abuse. Its mission is to provide access to treatment and recovery for those in financial need and who have a keen desire to overcome a substance abuse disorder. Support is available in English and Spanish for individuals and families.
Many local resources are available in Spanish for the Latinx community.
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eaglevalleybh.org/ mountainstrong Mountain Strong provides coverage for individuals, family and couples therapy, as well as for medication management services. Appointments are available in-person, by telephone or virtually through telemedicine based on the needs and preference of the patient. The goal is to reduce
INTENSIVE OUTPATIENT PROGRAMS Colorado Mountain Medical Intensive Outpatient Program cmmhealth.org/iop (970) 445-248 Colorado Mountain Medical’s Intensive Outpatient
Program (IOP) provides a high level of support for individuals with a history of, or who may be at risk for, psychiatric hospitalization; people who have a higher level of need that is not met by weekly therapy; and/ or anyone coming out of a crisis evaluation or psychiatric hospitalization. The IOP is offered via telehealth in a group setting, which is complemented by individual therapy and medical management, if needed.
Mind Springs Health Community-Based Intensive Treatment mindspringshealth.org (970) 476-0930 This program is for people of all ages with a serious mental illness. Mind Springs Health uses Metricovery™, an awardwinning treatment program that decreases the wait time for treatment, allows time for recovery and provides ongoing, customized services to assist in maintaining recovery.
B E H AV I O R A L H E A LT H D I R E C TO RY
Behavioral Health Navigators
Hearts Reign is a Latinx community peer-run organization. They exist to enhance mental health awareness, prevention and wellbeing in the Eagle River Valley.
eaglecountyparamedics.com/ behavioral-health-navigators (970) 569-7765 The behavioral health navigators help Eagle River Valley residents navigate the complex system of behavioral healthcare and connect people to available resources that best meet their needs when they experience barriers to access.
Colorado Mountain Medical cmmhealth.org/behavioralhealth (970) 445-2489 Colorado Mountain Medical's goal is to treat mental health needs the same as physical health needs. The behavioral health team includes bilingual therapists to help with shortor long-term emotional and behavioral concerns for adults and teens. Services include walk-and-talk therapy, group support, health management support and more.
Eagle County Health and Human Services/Public Health eaglecounty.us/HumanServices (970) 328-8840 Human Services aims to connect people and strengthen communities by providing essential services for those who are most in need.
Eagle Valley Behavioral Health Therapist Finder eaglevalleybh.org/terapeuta (970) 569-7765 Eagle Valley Behavioral Health's website is a clearinghouse for information and resources. The robust "Find a Therapist" feature allows users to search a database of therapists to find one who best meets their needs.
heartsreign.com (970) 470-0707
myfuturepathways.org (970) 306-3123 My Future Pathways provides a helping hand to enhance and enrich the lives of firstgeneration Eagle County youth, leading to positive pathways. The organization teaches strong values, self-discipline, grit and integrity, with an emphasis on developing social and emotional skills. My Future Pathways fosters community collaboration and parental involvement as well.
Mind Springs Health offers psychiatric services in their Eagle and Vail offices.
cmmhealth.org/behavioralhealth (970) 445-2489 Colorado Mountain Medical's goal is to treat mental health needs the same as physical health needs. The behavioral health team includes medical prescribers to help treat the psychiatric medication needs of behavioral health. Colorado Mountain Medical also partners with the Johnson Depression Center at the University of Colorado.
facebook.com/MIRABus1 (970) 688-0001
My Future Pathways
Mind Springs Health
Colorado Mountain Medical
MIRA (Mobile Intercultural Resource Alliance) is a 40foot RV that brings bilingual resources directly to Eagle County neighborhoods and workplaces. It offers basic health education and screenings, application support for public assistance programs, food resources, workforce development, early childhood education coordination and physical activity programming.
Eagle Valley Behavioral Health Therapist Finder Colorado Mountain Medical's integrated health program brings primary and behavioral health providers together to treat each patient's body, mind and spirit.
eaglevalleybh.org/findatherapist (970) 569-7765 Eagle Valley Behavioral Health's website is a clearinghouse for information and resources. The robust "Find a Therapist" feature allows users to search for a psychiatrist who best meets their needs.
mindspringshealth.org (970) 328-6969
Hope Center SchoolBased Clinicians ourhopecenter.org/eagleteam (970) 306-4673 The Hope Center of the Eagle River Valley's school-based program provides therapeutic care to students in ten Eagle County Schools and at the Stone Creek Charter School. Clinicians address the rising social-emotional challenges children and teens face through access to walk-in, therapeutic services at their school. The Hope Centerâ&#x20AC;&#x2122;s school clinicians also provide therapeutic services to students in need over the summer break.
Neighborhood Navigators NeighborhoodNavigators.org NavegadorasdelaComunidad.org (970) 331-1070 or (970) 306-9466 The Neighborhood Navigators of Eagle County promote an inclusive community where people are empowered and feel a sense of belonging. The Neighborhood Navigators' goal is to improve the wellbeing of individuals and families based on communitydriven needs. 2 02 0 -2 021
B E H AV I O R A L H E A LT H D I R E C TO RY
SUBSTANCE USE SERVICES All Points North apnlodge.com (855) 904-1042 All Points North Lodge offers addiction treatment to clients struggling with substance use disorders and process addictions. Programs for treatment are available at outpatient, intensive outpatient, partial hospitalization and residential levels. Wherever you are in your journey to recovery, All Points North can help you take the next step toward health and healing.
Eagle Valley Behavioral Health Therapist Finder eaglevalleybh.org/find-a-therapist (970) 569-7765 Eagle Valley Behavioral Health's website is a clearinghouse for information and resources. The robust "Find a Therapist" feature allows users to search a database for substance abuse therapists that best meet their needs.
Mind Springs Health mindspringshealth.org (970) 476-0930 Whether an alcohol or drug addiction, help and treatment are available for anyone suffering from a substance abuse disorder. Peer recovery services and coaches also provide education and support.
Mind Springs Health Women's Recovery Center mindspringshealth.org Based out of Grand Junction, Mind Springs Health's Women's Recovery Center is an intensive drug and alcohol transitional living program specializing in wholistic recovery.
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SUICIDE PREVENTION SpeakUp ReachOut speakupreachout.org (970) 632-3858
Group therapy can be an important part of recovery and wellness.
SPIRITUAL SERVICES Eagle Valley Behavioral Health Website eaglevalleybh.org/spiritual
SpeakUp ReachOut is a nonprofit created to prevent suicide through training, awareness and hope. They provide suicide prevention education and loss support services.Â
Search EagleValleyBH.org for spiritual services to address and improve mental health. Spiritual services, support groups and religious clergy are available to everyone in the valley.
Eagle County Health and Human Services
These are services that are provided to families and friends of those who have lost someone to suicide. Surviving a suicide loss can be traumatic and difficult on multiple levels, and specialized support exists from the following organizations.
eaglecounty.us/HumanServices (970) 328-8840 Human Services aims to connect people and strengthen communities by providing essential services for those who are most in need.
Eagle Valley Behavioral Health Therapist Finder eaglevalleybh.org/find-a-therapist (970) 569-7765
Eagle Valley Behavioral Health's website is a clearinghouse for
information and resources. The robust "Find a Therapist" feature allows users to search for survivor support therapists that best meet their needs.
SpeakUp ReachOut speakupreachout.org (970) 632-3858 SpeakUp ReachOut is a non-profit created to prevent suicide through training, awareness and hope. They provide loss support services.
THERAPEUTIC SUPPORT Eagle Valley Behavioral Health Website eaglevalleybh.org/ therapeuticsupport Therapeutic support is offered to address and improve overall health. There are several services that can be therapeutic, but do not fall under the definition of traditional behavioral health therapy. These include, but are not limited to, art therapy, equine therapy, physical therapy and yoga.
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breast radiologist specialists, women in the mountains
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To Steamboat Springs
WOLCOTT EXIT #157
To Glenwood Springs
EDWARDS EXIT #163
EAGLE EXIT #147
GYPSUM EXIT #140
HOWARD HEAD SPORTS MEDICINE
Eagle County Airport
EAGLE HEALTHCARE CENTER
HOWARD HEAD SPORTS MEDICINE
Howard Head Performance SafeFit Employee Wellness
Cardiovascular Center Colorado Mountain Medical + Urgent Care Howard Head Sports Medicine
BEAVER CREEK MEDICAL CENTER (SKI SEASON ONLY)
Emergency Department Howard Head Sports Medicine
GYPSUM / EAGLE
EDWARDS MEDICAL CAMPUS
BEARD CREEK RD
HIGHWAY 6 / GRAND AVE
SANTA FE FURNITURE
EAGLE HEALTHCARE CENTER
K LA AN LV RD SY
EAGLE COUNTY AIRPORT
AT GYPSUM RECREATION CENTER
HOWARD HEAD SPORTS MEDICINE
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S ARD EDWESS RD ACC
MILLER RANCH RD COLORADO MOUNTAIN COLLEGE
HOWARD HEAD SPORTS MEDICINE AT EDWARDS FIELD HOUSE
EDWARDS MEDICAL CAMPUS Breast Care Center Edwards Pharmacy Howard Head Sports Medicine Colorado Mountain Medical Jack's Place, A Cancer Caring House
HOWARD HEAD SPORTS MEDICINE
Mountain Family Health Center: Edwards Shaw Cancer Center Sonnenalp Breast Imaging The Steadman Clinic Vail Valley Surgery Center
BRECKENRIDGE, SILVERTHORNE, FRISCO
FRISCO SPECIALTY CLINIC COLORADO MOUNTAIN MEDICAL
Cardiovascular Center Internal Medicine (Colorado Mountain Medical) Shaw Cancer Clinic
WEST VAIL EXIT #173
VAIL MEDICAL CAMPUS
HOWARD HEAD SPORTS MEDICINE
Cardiopulmonary Services Cardiovascular Center Colorado Mountain Medical + Urgent Care Emergency Department Family Birth Center Howard Head Performace Howard Head Sports Medicine Imaging Laboratory Plastic Surgery Steadman Philippon Research Institute Surgical Associates The Steadman Clinic Vail Pharmacy Vail-Summit Orthopaedics & Neurosurgery Vail Valley Surgery Center
AVON MEDICAL CAMPUS Occupational Health Traveler's Clinic Urgent Care
(Colorado Mountain Medical)
COLORADO MOUNTAIN MEDICAL
HOWARD HEAD SPORTS MEDICINE
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N FRONTA GE RD GU
S FRONTAGE RD
AT THE WESTIN
BEAVER CREEK MEDICAL CENTER
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BE N CH M AR K
BEAVER CREEK VILLAGE TO BEAVER CREEK
CITY MARKET SUN & SKI
VAIL MEDICAL CAMPUS
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Smile with Your Eyes
Meeting someone new or seeing someone you love can be difficult when a barrier that is meant to protect one another is preventing you from truly connecting. Luckily, as they say, the eyes are the windows into the soul. These photos capture the human spirit that can't always be seen, especially when masked. Photos by Dominique Taylor 80
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DR. JACK ECK Dr. Jack Eck has graciously served the
community in countless ways for nearly
50 years. As he retires, Vail Health extends our deepest gratitude for his dedication to improving the physical and mental
wellbeing of our community. We celebrate
his many contributions and will always hold a special place in our hearts for Dr. Eck. To honor Dr. Eck, donations can be
made to one of the areas he is most passionate about:
• Shaw Cancer Center • Jack’s Place
• Eagle Valley Behavioral Health
GIVE IN HONOR OF DR. ECK
• Dr. Jack Eck and his wife, Kathleen
D N U F s ’ a i Oliv FINANCIAL ASSISTANCE F O R B E H AV I O R A L H E A LT H
Olivia Ortega was adventurous, athletic, and loved animals and sports, including volleyball and gymnastics. Unfortunately, her life was cut short by suicide at 13-years-old. Olivia's Fund has been established to honor her life and ensure all residents of the Eagle River Valley have access to behavioral health resources. Olivia's Fund provides up to six free sessions per year for anyone who lives or works in the Eagle River Valley and demonstrates a financial need. Learn more at EagleValleyBH.org/OliviasFund
It Takes A Valley.