Behavioral Health Framework
Historically, behavioral health has been overlooked nationally and locally, in part due to significant stigma associated with this area of health. After decades of underinvestment in behavioral health, and more identified need across the nation, people are turning to all levels of government for help.
The approach to the framework is to align city strategic work with the Roadmap vision and strategies; and continue to connect the community to Roadmap implementation engagement opportunities to avoid duplication of effort and repetitive community input requests.
The goal of the framework is to define the city’s role in behavioral health, under the broader umbrella of the Roadmap.
Key roles for the city within the Roadmap include:
- Augmentations to services that are within scope for the city – extensions of services already provided by city staff as part of traditional municipal responsibilities.
- Policy advocacy to improve local behavioral health access – joining regional partners to advocate for changes at the state and federal levels.
- Continued support to supplement funding for local behavioral healthcare providers, nonprofit organizations and community initiatives, particularly for costs not covered by public or private insurance – typically done through city competitive fund rounds or one-time funding opportunities.
- Partnership, research and idea incubation – ongoing, proactive collaboration with Boulder County and other partners to research and analyze local behavioral health needs, brainstorm potential solutions, and test concepts to fulfill Roadmap goals.
- Continuing to model behavioral health support and leadership in the city’s role as an employer.
Current Investments
The City of Boulder has made investments in affordable housing and human services that include significant support for behavioral health, as well as social determinants of health – the non-medical factors that can influence health (e.g. education, social economic status, neighborhood and built environment, health care access and quality and social connections). Examples of city investments in direct behavioral health supports or the social determinants of health include:
- The Crisis Intervention Response Team (CIRT) and Community Assistance Response and Engagement (CARE) programs, which provide an alternative response to 911 or police non-emergency line calls with behavioral health and/or medical issues;
- City grants to community nonprofit and healthcare organizations providing behavioral health programs (approximately $2 million in 2025);
- An annual average of $14.6 million in affordable housing funding; and
- American Rescue Plan Act (ARPA) start-up funds of:
- $400,000 for The Hope Institute Boulder, an innovative suicide prevention clinic model demonstrating impressive results in other parts of the country;
- $200,000 to support Wellness Centers in Boulder Valley School District (BVSD) high schools in Boulder; and
- $315,077 to support behavioral health case management and medication-assisted treatment in the Day Services Center for people experiencing homelessness.
Looking Forward
The city’s role in behavioral health, as well as its priorities and partnerships across the county, will become increasingly important as challenges mount for healthcare locally and nationally.
Resources in this area are not increasing – and with reductions in programs including Medicaid, difficult choices may be ahead. While it is hoped that the community will have the opportunity to expand access to behavioral health services under the umbrella of the Roadmap, the city and its partners should also be prepared for an environment of reductions and related tradeoffs.
Given the high demand for behavioral health services and the reality of resource constraints, city staff and partner agencies are focused on preserving existing services; and envisioning what service tradeoffs may be necessary. The city has established priorities to consider in this environment:
- Preserving safety net services and integrating them across systems
- Service navigation and connection
- Capacity to serve people with dual diagnosis and high acuity needs, with particular emphasis on youth and older adults
- Suicide prevention and substance use treatment
More information about these priorities and city roles in behavioral health can be found in the Behavioral Health Framework PDF.
