Bob Yates is a regular opinion columnist for Boulder Reporting Lab. He is a former member of the Boulder City Council. Every month since 2016, Bob has published The Boulder Bulletin, a newsletter about local government and the community.
Colorado ranks among the worst states in the nation for mental health care. According to Forbes, our state is the sixth-worst in treating adults with mental illness. And we are the third-worst at providing mental health insurance for youth. That’s pretty embarrassing.
While compelling arguments can be made for the federal and state governments to provide the mental health care that Coloradans need and deserve, don’t hold your breath. The federal government — with increasingly bizarre proclamations of ways to provide less physical and mental health care for Americans — is not the place to look for leadership these days. And a billion-dollar hole in the state’s budget means that counties and cities in Colorado are on their own for a while.
So, the Boulder County commissioners unanimously placed on this fall’s ballot a proposal that we tax ourselves to pay for mental health treatment for county residents. To be sure, the tax measure is only a stopgap, intended to last three years. But it will allow the county to fund the treatment that the state and feds can’t or won’t.
The proposal on the ballot is a pretty modest sales tax of 0.15%, which comes to a penny and a half on a $10 purchase. But that mental health tax will bring in $14 million a year for the next three years, allowing the county to fund mental health programs that are starved of state and federal support.
While we talk freely about heart disease or cancer, mental illness continues to be a taboo topic, something that other people have and which shouldn’t be discussed in polite conversation. Unlike nearly every other human ailment, where we are getting better at treatment, we seem to be moving backward on mental illness. The stats tell the story:
One in five Boulder County residents reports poor mental health. Imagine if one out of five people had cancer. It would be a health crisis worthy of immediate attention. Mental illness gets ignored.
Colorado’s suicide rate recently jumped from 10th highest in the nation to eighth highest. And Boulder County’s suicide rate is climbing faster than the state’s. On average, one person a day is brought to an emergency room in the county after having attempted suicide. Too many are successful.
Latinos in Boulder County are three times less likely to receive mental health care than non-Hispanic whites. People identifying as LGBTQ have twice the level of depression as the rest of Boulder County’s population, with nearly three out of four transgender youth reporting poor mental health, often untreated. We have people in our community with untreated schizophrenia and bipolar disorder. Lacking treatment options, some people self-medicate and then become addicted to those substances, worsening their problems.
I volunteer at the All Roads emergency homeless shelter, and I know that two-thirds of unhoused people have a mental health disorder. The sheriff reports nearly the same ratio among inmates at the Boulder County jail. We freely complain about people who behave inappropriately or commit crimes, but we can’t deny that many do so because their mental illness is untreated.
So, we can do one of two things: We can live with all this depression and suicide and homelessness and crime in Boulder County, hoping that someday the federal or state governments come to our rescue. Or we can take matters into our own hands and raise the community funds necessary to treat our fellow county residents. All it will take is for us to pass Ballot Measure 1B, which will raise the sales tax in the county by 0.15% starting on Jan. 1, and ending on Dec. 31, 2028.
Now, don’t get me wrong. The county’s plan for spending the money that this temporary sales tax will generate is not perfect. The absence of federal and state funding means we will need to build the airplane while we’re flying it. We will have to improvise over the next three years, applying the county tax funds to mental health interventions we think will be most helpful. Some will work and some won’t.
But during those three years, we will make observations and collect data so that, when the mental health sales tax is expiring in 2028, residents of Boulder County can decide whether to extend it for a longer period. Maybe we’ll even designate funding for a residential mental health facility, as our neighbors in Larimer County did in 2018.
Taxes are no fun. We already have too many, and a lot of them are dedicated to the wrong things. We’re not going to fix that overnight. But what we can fix now is the gap in mental health treatment created by our inattention to this growing problem, exacerbated by the collapse of federal and state budgets.
If we want to get Colorado and Boulder County out of the unenviable position of having inadequate mental health treatment, we’re going to have to step up and pay what is necessary to take care of our neighbors. We’ve had floods and we’ve had fires, and we’ve pulled together. We can do it again.
There’s a third way Bob, let the developer pay. Most of this comes as a result of their profiteering. Another regressive tax will make housing affordability and consequent mental health degradation worse. It’s not an economic driver.
I agree with Ashley Stolzmann, this didn’t poll. It’s a waste of funds to run it. Not ready for prime time. Use prevention and go to the root.
Thanks, Bob, for this clear and compelling essay on the importance of funding mental health in our community.
We made the decision many years ago not to treat the illnesses we erroneously call “mental” with the same ethic or morals we treat other illnesses. We have not significantly changed our minds.
Harold, regrettably, you may be correct. This ballot measure will be a good test of whether the community has shifted and is now willing to pay for treatment of mental illness. – Bob
What’s next, though? Do we have to impose more and more county taxes to fund healthcare for people who are losing Medicaid, and those who can no longer afford insurance on the ACA marketplace for any healthcare? Premiums for most are projected to increase by around 28% and more for older people. The state may provide funding that will mitigate that increase by around 8%, but that might not happen. The entire system needs to be reformed and is on the verge of collapse. We are nibbling around the edges and this won’t help much.
Actually, according to Polis, the average increase for ACA coverage for those on the Front Range would be 170% if Congress refuses to extend the federal tax credit subsidy that lowers the cost to consumers. Republicans remain opposed, of course.
Thanks for an excellent opinion piece. I support this measure which will fund early intervention, navigation, crisis response, treatment, and recovery programs.
I want to add that the measure on the ballot was supported by all three County Commissioners. They wisely agreed with the therapists and first responders on their staff that our community is hurting for these programs.
Bob, I agree that mental health is a critical issue in Boulder County, and your piece makes a strong case for why it deserves more attention and funding. However, you don’t address why mental health should take precedence over other pressing challenges facing our community—like housing affordability, wildfire resilience, climate impacts, and infrastructure—so much so that residents should be asked to pay a special tax for it. To strengthen your argument, it would be helpful to explain why this tax should be prioritized above these competing needs, or how mental health investments could uniquely address or alleviate them.
James, yes those are all priorities. Over the last few years, the voters have approved county sales taxes for each area you list: Housing (0.185%), wildfire (0.10%), climate (0.125%), and infrastructure (0.10%). The voters have also approved county sales taxes for criminal justice (0.05%), emergency services (0.10%), open space (0.475%), and nonprofit support (0.05%). Mental health care is missing and needs to be elevated. – Bob
I wonder if we rank so low because we are so proactive at providing for the homeless and transients, both of which, if lured here, likely influence the scales. I am not convinced that taxing will address the emotional state of affairs in our society. It’s not addressing the root, esp as we get more polluted and louder in Boulder, which countless studies show degrades mental health and emotional well-being. Send that tax over to our police where we can finally get a handle on the middle-of-the-night drag racing. Why are we fining “speeders” going 7 mph over the speed limit on Broadway with these new camera installs while 100’s of illegal mufflers run rampant for hours in the middle of the night? There’s too many forced fines and taxes on the wrong population to pay for the entities (people, companies and industries) creating the issues.
While this might be a justified need, instead of raising taxes yet again, let’s stop spending millions on idealistic and low impact projects like bike lanes on Baseline and perhaps now Iris. Our local government doesn’t know how to prioritize spending what it has and we can’t keep thinking the solution is more taxes.
We need local regime change to those that understand it isn’t an unlimited pot of gold and the taxpayers won’t keep bailing them out.
Thanks Boulder G, although this is a county tax and the things you mention are city projects. – Bob
This mental health tax isn’t going to solve anything, Bob, nor will it ameliorate the growing inequality Boulder is so desperate to ignore with piecemeal and performative politics/policies like this. But if we’re going to speculative as to the actual cause of 1 in 5 Boulder County residents reporting poor mental health; the spiraling cost of living and affordability crisis seems like it outta be #1. But of course, the City Council usurped our chance to vote on something meaningful like a Vacancy Tax. Meanwhile they continue to give Developers ever more concessions and now are considering rolling back hard won short-term housing regs to give these vampire investors more reasons to keep their properties empty the rest of the year. Want proof? Look no further than the 50% of commercial properties still sitting empty so these robber-barons can shelter their wealth here in real estate and claim “lost revenue” to reduce their tax burden all the while our economic vitality and prosperity suffers. So if my fair share here is half a penny…..what financial burden are they assuming exactly?
This is the crux of the problem. And, yet again, political leaders are intent on simply nibbling around the edges instead of confronting the main problems that cause poor mental health for most people in the first place. People who are financially stable and own their own home can’t quite wrap their mind around the fact that almost everyone else’s basic survival is precarious. When people can’t participate fully, or at all, in society because they can’t even afford food or shelter, that is a big problem. Those unrelenting factors pushing people down and out cause mental illness in large part. It’s a big factor in the increasing suicide rate, no doubt. Humans are not designed to withstand and persevere through unending and worsening conditions like these. More and more people are falling through the cracks. Losing healthcare, losing jobs, can’t afford transportation to get to jobs, can’t afford rent, the list goes on and on. Meanwhile, as you point out, our city council can’t even manage the low-hanging fruit of a vacancy tax on the vast number of commercial properties siting empty in our prime business areas. God forbid they interfere with the divine right of capital. It was far more critical for them to spend their time crafting a plan to increase their own wages.
But, sure, a tax would help somewhat. There are too many people who are severely mentally ill and there are no recovery beds for them long-term. For the rest of us, a meaningful life that is sustainable would be the first step.
I’m all for treatment but this behavioral health tax initiative is vague at best. With the upmost respect for Bob, even he cites we maybe end up with a facility similar to Fort Collins.
I sat in the group that helped contribute to the County Behavioral Roadmap about two years ago. In 2023, I wrote an opinion piece in the Camera called a four-point plan to reduce campers downtown. It centered around a continuum of mental health and addiction support and inpatient programs: increase mental health responders to three teams working 24/7, maximize the use of the detox where people can be released to a 30 to 90 day impatient stabilization program, and, ultimately, participate and live in a two-year sober transitional transitional housing program, infused with mental health and recovery support, plus JOB training. Mayor Brockett said, let’s make it happen. Commissioner Levy requested a meeting with me to discuss the plan further. Here we are two years later, after ARPA dollars have come and gone, Medicaid cuts, spikes in overdose, our limited mental health acute services leaving town, and oodles of money from the Opioid Settlement making no visible difference among low-income households, children, and individuals experiencing homelessness. I can’t leave out our own ciry council writing a letter to the Commisisoners requesting that the Opioid Settlement funds be allocated to more substantial projects. Were they heard?
What’s the actual plan? People need details, specific goals if they are expected to pay for things. Not maybes. And, it is sad that our elected leaders haven’t figured that part out, yet. Most of us know that dumping Narcan all over town isn’t treatment, nor a substitute for treatment.
Again, we need treatment like five years ago, but empowering the county to spend taxpayer dollars as they please with no visible direction is a crapshoot that voters will decide in November. Time will tell.
Personally, I am sick of people of dying from overdose on the street, in their apartments , and in their homes.