Mental health battles leave locals isolated by stigma, desperate for services | VailDaily.com

Mental health battles leave locals isolated by stigma, desperate for services

EAGLE — If John Harakal suffered from a disease of his heart or his lungs or his limbs, then chances are there would be collection jars set up at business cash registers around town.

Community fundraisers for the Harakal family would have been organized and people who only casually know the family would be participating in a meal delivery schedule. That's what happens when an Eagle kid gets sick.

But John' Harakal's health battle involves a chemical imbalance his brain. He has been diagnosed as bipolar Type 1 and he has been hospitalized six times for as long as six weeks as he battled with mania and even the call to take his own life. While the Harakals' close friends have been supportive, the nature of John's illness has often left the family feeling isolated.

"What my son has gone through I wouldn't wish on my worst enemy," said John's mother, Agnes Harakal. "Someone actually said to me one time, 'Why should I care? It affects you and not me.'"

“We have a call center but we have no beds. We are sending these people home, by themselves, and we are hearing that they are killing themselves.”Agnes HarakalMother of John Harakal

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But the Harakals' struggle isn't just about a single family. It is about a large population of people in Eagle County who battle mental health issues and who don't have access to the services they need.

"Do you know how painful it is to drive my kid to Grand Junction to get treatment when I pass by two new cancer centers?" Agnes Harakal said.

She isn't the only person who is feeling that pain.

Lagging support

"Mental health issues are increasing throughout our country and Colorado lags the rest of the country in dedicating money to mental health support," said Christopher Dick, deputy operations manager of Eagle County Paramedic Services. "Our ambulance and fire professionals are on the front lines of this increasing epidemic and are seeing more and more calls for service due to mental health illnesses."

Dick noted the ambulance district is seeing an increased number of 911 calls for mental health emergencies, an impact for district resources.

He noted the district is often spread thin because ambulance crews are involved in transporting mental health patients to psychiatric facilities in Denver, Colorado Springs, Boulder and Grand Junction. That's because there are no local in-patient beds for psychiatric patients. So even when a local reaches out for help by calling a crisis line or contacting a doctor or emergency services, he or she is likely many hours and many miles from getting help.

That failure in the local system is maddening for Agnes Harakal. She has been trained to respond to mental health crisis telephone calls, but her ability to truly help someone is thwarted.

"We have a call center but we have no beds," she said. "We are sending these people home, by themselves, and we are hearing that they are killing themselves."

No easy answers

Agnes Harakal's personal experiences have shown her the glaring problems with Colorado's mental health care system. The lack of resources, noted above, is just one of the huge difficulties her family has faced.

Costs associated with getting psychiatric assistance nearly crippled the Harakals. The family has medical insurance, but initially they were responsible for 50 percent of their hospital bills. Agnes Harakal noted that total topped $150,000.

"That bill is more than what most people here make in a year," she said.

Eventually the family was able to expand that coverage to 80 percent and address the financial challenge, but the lingering stigma of mental illness remains a daily challenge for the Harakals.

"I think if I said my son had cancer, people would have a fundraiser," Agnes Harakal said. "The stigma is a real issue."

Battling the stigma of mental illness is where Agnes Harakal is launching her effort to address this area's glaring needs.

Reaching out

Agnes Harakal didn't know where to start in her quest to advance mental health services locally, so she launched her efforts by reaching out to local officials. The Eagle County Paramedic Service was an early ally.

"This is not a simple problem and there are no simple answers," Dick said. "We do fully support raising awareness and supporting requesting more resources in our community. As a Health Services District, we are committed to being part of a solution for our community as well."

Mind Springs Mental Health is another advocate for increased resource as is the Total Heath Alliance. Agnes Harakal has also reached out to the Eagle County commissioners and the Eagle Town Board, the two governments she most closely identifies with from her home in Eagle.

Last month, Agnes Harakal made a direct appeal to the Eagle Town Board to launch a discussion about mental health in the community. County commissioner Kathy Chandler-Henry accompanied her to the meeting.

"This is a huge problem in our community that is not well known and completely under resourced," Chandler-Henry said. "We don't have any solutions, but we know we work better when we work with the towns to solve problems."

Judging by the numbers, Eagle County faces a big challenge to meet the mental health needs of its residents. Agnes Harakal said the national average is 20 mental health hospital beds per 100,000 residents. Currently there are zero for the county's population of approximately 52,000 people.

Expanding that problem out further, Mind Springs in Grand Junction is the nearest resource for residents from throughout Western Colorado, and the hospital only has 30 beds. Agnes Harakal noted the Saint Mary's Hospital in conjunction with Mind Springs, spurred by the need for those services, recently announced it would be increasing its number of mental health beds to 64.

She seeing other encouraging signs. Over at Valley View Hospital in Glenwood Springs, a seven-person psychiatric unit under the direction of Dr. Peter Wiley, has been created as a crisis team. Team members assess mental health patients when they arrive. Those patients can then be transferred to acute care beds while they await transfer to a psychiatric facility.

Agnes Harakal plans to approach officials at local facilities to look at the community's mental health needs in an effort to get more local services. She also plans to talk about the problem and she urges others to talk about it as well.

"If you have a disease that no one talks about, how are we going to prevent it?" she noted."The stigma is dangerous. The stigma is a bigotry and it is killing people."

Call for compassion

Agnes Harakal noted an estimated 5.6 million Americans suffer from bipolar disease. "But no one wants to come out as bipolar," she said.

"We need to stamp out the stigma associated with mental health diseases. Families need to talk openly, around the dinner table, about how mental health issues should be treated the same as any other disease."

Agnes Harakal noted that a brain disorder is a physical disease involving the most complex human organ. In the case of a bipolar disorder, the manic stage manifests itself based on a person's personality. If he or she has a violent nature, then the patient may become more violent.

"In John's case, he remains a gentle person through his manic stage," she said. "Many people would be surprised to learn that John has a very high IQ — genius level in fact. That is a common characteristic among bipolar patients."

Agnes Harakal said her son's brain doesn't function the same way that others do, and as a result he follows a regime of medication coupled with work with a psychiatrist. "There is no quick fix, as his doctor tries to find the correct balance of medicines that work to stabilize him," she said. "Treatments that are successful for a few months start to fail and new medications are prescribed The side effects from the medicines can often be as debilitating as the disease itself."

There is currently no cure for bipolar Type 1.

As for John Harakal's daily life, he has taken Colorado Mountain College courses and participated in private tutoring sessions. He works when he is able. Fortunately, he has learned to recognize his illnesses' effects and an impending downward spiral so he can reach out for help. Like people who face physical life-threatening diseases, John Harakal is learning to live with his bipolar disease. His mother describes him as caring and brave.

"I just want to say how proud I am of my son. Despite all his challenges, he picks himself up every day and goes on," she said.

In John’s Words …

I have lived with bipolar for about a decade and needless to say, it’s been quite the roller coaster ride.

The ups and downs that come with it can at times be very difficult to deal with. One day I can be feeling incredibly great and ready to take on the world, and the next, feeling so sad and hopeless, in the worst cases, suicidal. For me, it often comes down to taking it day by day.

For so long, I simply couldn’t find any balance. I would ride on my high for a long time, and then crash and feel very depressed. The hopelessness would sink in, and I couldn’t seem to fix myself at all. Years of switching meds to try and find some stability wouldn’t seem to work, as trying to keep up with all of the highs and lows was very difficult. Not to mention, when I would feel manic, I was convinced I had conquered the disease and stopped taking meds, only to crash again a few weeks later and having to start the process all over again.

Luckily for me, after years of working with my psychiatrist and experimenting with so many different meds, I have finally found a combination that works quite well, one reason being that I am sticking to it and not shifting them around. There is no cure, and I know this is something that I’m going to have live with, but I feel optimistic as I have found medicine that works well for me and great family and group of friends there to support me.

— John Harakal