Editor’s note: I had the pleasure of speaking with Paul Reich, the Community Relations Liaison for the Center for Mental Health, on June 15. Our conversation, presented below, has been edited for length and clarity.
Trigger Warning: This interview contains discussion around suicide. A list of local and national mental health resources is available at the bottom of this story.
Brian Wagenaar: How did you get into the mental health realm? What brought you to the role you have today?
Paul Reich, BA: I live down outside of Telluride, and my wife and I raised five kids here. I was involved with the school board and spent a lot of time working around youth substance prevention. Like Crested Butte, Telluride’s not a stranger to substances and youth substance consumption.
About six years ago, a parent who runs a nonprofit here said “hey, I’m looking for somebody to help with our mental health services, would you be interested in a job?” I then took a Mental Health First Aid class in 2016, and left the class going “when am I ever going to use this?”
I thought of it like CPR, how often am I going to come across somebody who needs me? Within a week, I got a phone call from somebody, and over the course of the conversation I came to realize that this person was really struggling.
It took me about forty minutes to ask her if she was thinking about killing herself. Had I not taken that class, I never would have asked the question—because I would have been afraid of planting the idea. I also would not have wanted to ask the question for fear that she would say yes, which she did.
As a result of that training, I realized that I could help somebody, and that was a really neat feeling. I became a Mental Health First Aid instructor, and since then have continued to add training. I’m now a Question, Persuade, Refer instructor and a safeTALK instructor.
I do a lot of classes for community members as a non-clinician—we just did one for the Gunnison Sheriff’s Office, for example. I always ask: “How many of you have taken CPR?” Everybody raises their hands. Then I ask: “How many of you have actually done CPR?” Very few people actually have. Then I ask, “well how many of you have ever known a friend or a family member that has dealt with mental health challenges?”
I don’t ask them to show their hands, but when they do it’s everybody in the room. You really realize that most people don’t have much background in mental health. Unless we have some knowledge and training, we’re really flailing around in the dark.
BW: Can you tell me more about your specific role now with the Center for Mental Health?
PR: I spent five years with Tri-County Health Network, and I ran their behavioral health program. We had clinicians who did teletherapy, we did psychosocial education, we sponsored walks in the community, things like that.
I moved over to the Center for Mental Health about 14 months ago. My current job title is Community Relations Liaison. I do two things that I think are the most important. I do a lot of education, and I’m part of our disaster behavioral team—we respond whenever there’s a disaster in the region. Most typically in our region, that’s a suicide. When Eli died at Western this spring, I responded with one of our clinicians and talked to the basketball team, and talked to the athletes, and to the coaches. That’s a big part of what we do.
And it’s not always just suicide—in Telluride that same week, we had an avalanche death of a young person. We went to his place of work, where he’d worked for eight or ten years, and we just helped people grieve—to regain a sense of normality. When someone dies in a community, whether it’s by suicide or some other sudden means, it creates a rip in the fabric. People are looking for ways to help restore some normality and safety in the community.
Even this kind of response—what they call “postvention” work, that is prevention in a way. You’re allowing people to open up about their feelings, and their feelings can be really conflicted. They can feel guilt, they can feel tremendous sadness, obviously, and have their own struggles with thoughts of suicide. It really helps the community to be able to talk about that stuff openly, because typically we don’t talk about it very openly.
BW: Can you talk to me a bit about some of the mental health trends you’ve seen in your six years doing this work, and with the ongoing pandemic?
PR: A couple things—one is that I do think we’ve made some progress in being able to talk about mental health. It’s hard to pick up a newspaper or look at a social media feed and not see something around mental health, and I think that’s good.
When you see the Simone Biles of the world, and Michael Phelps before her—people talking openly about their struggles, Olympic level athletes who are walking away from a gold medal because their mental health isn’t good—I think that’s really positive for society.
A bad development is that we’re more isolated, particularly senior populations. During the period from March 2020 to the end of 2020—we were all pretty isolated. Mental illness, substance use, and thoughts of suicide—the common nexus there is social isolation. Social connection is often the antidote to those things, to help us all survive.
I think our youth have really struggled, and as a parent of young adults I see that there’s a lot thrown at them these last couple years. Whether it’s the pandemic, the Roe v. Wade developments, the war in Ukraine, global warming—there’s a lot on our young people’s plates, and we’ve seen mental health challenges rise.
For many people, particularly around thoughts of suicide, sometimes the stressors in life build up—we lost our job during the pandemic, we just got evicted from our house because we can’t pay rent, our kids are not in school, I’m drinking more, or my spouse is drinking more.
At a certain point, it’s not surprising that people start thinking about suicide because of the level of the stressors in their life have reached a point where they can’t cope—they don’t have the needed coping and support systems in place to help them and suicide seems like the only option to what they feel are insurmountable problems. (Disclaimer: if you or anyone you know is struggling, please know that you can find help—there is always someone to talk to).
BW: What’s the intervention there? What does an organization like the Center for Mental Health do to provide support? What can community members do?
PR: I think one thing that CMH and other organizations like ours have learned is that we can actually treat suicidality—we can treat suicide. For a long time, clinicians didn’t want to go there. And I would argue that even today, some clinicians don’t want to go there. Previously, we would treat depression, or we would treat anxiety disorder, or bipolar disorder, but we wouldn’t necessarily focus on suicide.
Now, we are really investing in our clinicians—training them to actually be able to treat suicide in their clients—focusing on suicide in their sessions with their clients, and focusing on developing safety plans with their clients so that if their client is struggling, their client knows what they can do.
If someone is determined to kill themselves, they’re going to do it—we can’t prevent every suicide. Each individual has to be the one who wants to live, but we can certainly help them. That means working with them to craft a safety plan, so that when they’re struggling with thoughts of suicide, they know what to do, and they know who to call. There are really specific things that we’re doing around that topic that I don’t think we were doing five years ago.
Some clinicians, to this day, are reluctant. It’s hard to deal with a life and death situation. Laypeople and clinicians are not dissimilar—clinicians have got some initials after their name, but ultimately they are just people. I don’t care if you’re a doctor of psychology, these still aren’t easy conversations to have with someone—the thought of someone ending their life.
We work with clients to examine their access to means. I’m a big believer in breaking the cycle. We can interrupt the cycle. When they’ve had that thought of suicide, we can help them hit the speedbrake. One way to do that is to ensure that they don’t have access to lethal means.
Part of that client counseling is ensuring they don’t have access to lethal means—removing guns from the home, for instance, or not having prescription pills easily accessible. You can put in some barriers—some gutters— to keep people from having access. That’s low hanging fruit.
BW: Can you talk about some of the mental health risks that are particular to the Western Slope?
PR: I’ve started, in my thinking, to move away from the concept of risk factors, and started viewing them as stressors. For example, we’ve got economic insecurity—you live in a ski town. It’s feast or famine with jobs—you’re either working 80 hours a week, which takes its own toll, or it’s April and you’re out of work.
The cost of housing and the security of housing is also a factor. You could live in a great house, and if the house gets sold, and somebody new comes in, you’re out looking for a new place to live.
The party atmosphere in our communities is also of note. The nature of our environment, and the type of people who come here is also important. Say you go out on a March day to CBMR. You get up on the mountain and it’s a beautiful bluebird day, yet you feel like crap. Well, you think, “I’m not supposed to feel like crap, it’s a beautiful day.”
Everybody’s out partying and having a great time, and yet you feel like crap compared to your environment. I think that creates an expectation in people’s minds that I shouldn’t feel this way, so therefore I can’t go tell someone I feel that way, because I must be the only one feeling this way.
I think our social isolation is another factor—we already live in a place where not many people live. I live in San Miguel County— the east end of the county is fairly populated, but if you head out towards Norwood, there aren’t many people out there. I think that social isolation is kind of built into the geography. I think it also attracts a certain subset of people who think: “I can solve my own problems.” That’s another thing that’s unique to the Western Slope.
I would also go back to guns again. During my discussions I put up this map showing high suicide rates—they call it the Rocky Mountain suicide belt—pretty much from Alaska down through Montana, Wyoming, down into Colorado and Utah. If you were to overlay gun ownership rates in that area, there’s a pretty close correlation. Half, or slightly more, of all suicides involve a gun of some sort.
It’s not an anti-gun tirade, but there’s a direct connection. If you have a gun in the house, there’s a higher rate of hurting yourself—studies have shown that, and gun ownership rates tend to be pretty high in our rural communities.
BW: What sources of strength do you see in our communities to help fight these mental health struggles?
PR: That’s a hard one, but I do think it’s easier to reach more people with our messaging and outreach. The stuff, for example, that CB State of Mind is doing, and the stuff that Gunnison Valley Health, the Center for Mental Health, and that Western is doing—I think is really positive.
In some respects, it’s easier to get the messaging out in a smaller arena. We just trained 14 deputies at the Sheriff’s Office, and I know cops get a bad rap—some deservedly so. But I would tell you, there were a bunch of people in that room last Thursday who really cared about their community, and really cared about doing this work. They have to ask the question: “are you thinking about killing yourself?” to people they come across on the street.
Sheriff John Gallowich was in the training and he talked about how he really wants to make sure that our deputies know how to handle people on the street who may have a mental health crisis.
This sounds utopian, but I do feel like people watch out for each other in these smaller communities. As big as Gunnison feels to me compared to where I live, it’s still a small town—yet you do have a lot of resources in the Gunnison Valley aimed at mental health.
BW: What keeps you hopeful in this work?
PR: What I struggle with, Brian, is the fact that over the last decade or twenty years, the arc of suicides in our country has gone one direction (motions upward). Now, the hopeful sign is that in 2020 the number dropped by about five percent nationwide. But it’s a really challenging problem to solve.
What I often say to people is that there were just shy of 1,100 suicide deaths in the state of Colorado in the last year—and there were 1,100 different reasons. As a parent, I worry a lot about my kids and their mental health. But I do think we’re getting the message out that it’s okay to talk to people about suicide—that it’s okay to have these conversations. So that gives me some hope.
Telluride lost its first high school student last August—he was going to be a junior. His parents were very open about sharing the fact that he died by suicide, and I thanked his parents after the fact. We walked into the room with his classmates—the 11th graders, on the first day of school. This was about three days after he died.
All those kids knew he had died by suicide. And we were able to talk openly about it with those young men and women, and I think it really helped them heal. It helped them acknowledge their own pain, their own struggles, their own guilt, but it also allowed us to have an open conversation about suicide. And we didn’t see another attempt following his death, which often you do see.
We still have a ways to go, but I feel hopeful about it. When I was in college, we didn’t talk about this stuff, yet people died by suicide and it was buried about as deep as you can put it. Over the arc of my life I’ve seen a lot of changes. But the heightened awareness of mental health, behavioral health, and the concept of taking care of yourself recently is a really hopeful sign.
BW: What does the Western community need to know about mental health? Are there particular training or resources you would point people to?
PR: You’re lucky to have a counseling service, you’re lucky to have telehealth options 24/7. We’re also going to be up at Western in August teaching Question, Persuade, Refer to the RAs—we did that last August, and we will do it again this summer.
If you’re uncomfortable with the topic, or just don’t know what to do, taking one of what they call the “gatekeeper” trainings (like QPR, Mental Health First Aid, and safeTALK) is a really good way to learn. I’ve always told Dean Gary Pierson and the staff at Western: “we’ll come do any training you want at any time you want.” If we can get students in a room talking, I’ll come up there anytime.
My son lives in Boulder and he joined a fraternity, and his friend is in a different fraternity. It was interesting because I went to Boulder, and I had just come from the Western campus where I was talking to students after Eli’s death. Both of the boys said that their fraternity made a really big issue of designating someone to talk about mental health. I was really surprised by that, because I know fraternities don’t always have the best reputations.
I thought that was a really hopeful sign. I know Western doesn’t have fraternities, but are there other student groups where you could be intentional about creating space to talk about mental health?
You can also just be there and watch out for one another. If you know a friend is struggling, reach out and say “how are you? I’m worried about you.” You don’t have to take a class to be a human, to be a decent person. Just saying: “hey, I’ve noticed that you haven’t been coming to class, are you okay?”
Things like that—just being open to being a good, compassionate and empathetic human being. At the end of the day, it’s about that human connection.
Mental health resources for the Western community:
- You or someone you know In Crisis? (FREE)
- Call 970-252-6220, the 24/7 Crisis Talk line
- Or Text TALK to 38255 or 741741
- LGBTQ+ 24/7 National Hotline
- Peer Support Specialists (FREE, people with lived experience in mental health or substance use):
- Contact 970-596-0127 or 970-596-8182
- Timely Care (FREE): Free mental health resources for western students, health coaching, 24/7 crisis text line, psychiatry (medication prescription for mental stability) and counseling:
- Go to timelycare.com/western
- Click sign in or make an account
- Use your western email and a password
- Fill in the required medical info
- Utilize the resources!
- Western Counseling Center (FREE): Unlimited therapy for Western students:
- Go to Crystal 104 and tell them you would like to make an appointment or call 970-642-4615 to make an appointment
- Fill out the required paperwork
- Make several appointments in a row if you prefer to secure your schedule!
- Crested Butte State of Mind Therapy Scholarships (FREE)
- Go to https://cbstateofmind.org/learn-more/therapy-scholarships/Therapy Scholarships – Crested Butte State of Mind
- CB State of Mind is committed to making sure that our residents have access to mental health care and that means eliminating the barriers of cost, navigating the system, and connecting to the right service.cbstateofmind.org
- Click on Application Form
- Fill out an application
- Let Meghan Dougherty (firstname.lastname@example.org) know if you have any issues or need help applying
- Get paired with a good fit for a therapist
- Enjoy your therapy scholarship!
- Center for Mental Health (Not always free, can cost $):
- Call 970-252-3200 to set up an appointment
- Let them know you live in Gunnison
- Ask about insurance coverage and pricing
- Gunnison Valley Health Behavioral Health (Not always free, can cost $):
- Call 970-648-7128 to make an appointment or find options
- Project Hope: Domestic Violence and Sexual Assault Resources, including therapy, support and connections:
- Call 970-641-2712 to set up an appointment or simply find out more
- Email email@example.com
- Additional resources can be found here under the mental health section: