Boulder bipolar clinic to suspend ‘much-needed’ services as finances fall short
Originally published at Boulder Daily Camera on November 24, 2019.
Bipolar disorder affects roughly 2.6% of the population. In Boulder County alone, that’s likely about 8,300 people.
Yet on average, about eight years pass from when someone first experiences symptoms and when they get treatment, likely due to stigmatization and lack of access to care. When Boulder’s Sutherland Bipolar Clinic suspends services in May 2020, that access will decrease just a little more.
The clinic cited unsustainable funding as the reason for taking a break in providing care, though it’s not closing entirely. It’s the only clinic in the Front Range, and possibly throughout the state, that solely treats patients with bipolar disorder.
The Robert D. Sutherland Memorial Foundation raises approximately 80% of the clinic’s funds through donations. While the clinic isn’t free, it operates on a sliding scale to make care accessible for patients whose mental health often directly affects their financial situation. The rest of the funding comes through small grants and in-kind donations, including its office at the University of Colorado Boulder’s Raimy Clinic.
Rachel Cruz, the foundation’s executive director, said that though the clinic’s budget — about $230,000 — is not a lot in comparison with other nonprofits, consistent funding has dwindled during its 17 years of existence.
“In an effort to still try and meet their needs for treatment and care, we continued to try and keep our center going with donor funding,” Cruz said. “Over the years, it’s become more and more challenging to ask for gifts in that manner. Mental illness is not one of those more prominent causes that people are willing to support.”
Not only does the clinic provide affordable, specialty help for those living with bipolar disorder; it also trains doctoral students to be the next generation of therapists. Natasha Hansen, a sixth-year doctoral student who has worked at the clinic for three years, said this trifecta of opportunities benefits everyone involved and has increased her passion for accessible mental health care.
“I feel like I’ve gotten an in-depth training in treating bipolar disorder, which really benefits from specialized treatment, but also a high-quality training for co-occurring conditions,” Hansen said. “It’s been incredible to work with individuals and help break what can be a vicious cycle.”
A disorder that can be managed
Though bipolar disorder looks different for every individual, it often includes cycling between elevated and depressed episodes. In a manic episode, the high point of the cycle, someone can experience symptoms like racing thoughts, euphoria and irritability. This can also manifest in a muted form, called hypomania.
The low point of the cycle is often a major depressive episode. Someone may not sleep well, feel emotionally depressed and even experience suicidality. Sometimes individuals will go through cycles of mixed episodes, with both mania and depression, or go directly from one episode to the next without any time in a “normal” mood. Occasionally bipolar disorder also includes psychotic symptoms like hallucinations and delusions.
While patients are often prescribed medication, therapy can be more tricky than other mental illnesses. Hansen likens it to diabetes: both are chronic conditions, without a cure, that put people at higher risk for adverse health. They can also coincide with other conditions. Bipolar disorder often accompanies substance abuse, anxiety disorders or attention deficit hyperactive disorder.
Yet bipolar disorder, like diabetes, can be managed with a balance of psychological therapies and maintaining physical health. This degree of holistic care is often absent in clinics that are more generalized or when treating less severe mental illnesses.
“You can do everything right and someone can still flip into a severe episode, but at the same time these strategies make a big difference,” Hansen said.
Someone with bipolar disorder may experience signals — altered sleep schedule, for example — that could either trigger an episode or indicate that one is already on the way. The clinic’s patients learn how to recognize their own signals, consciously
intervene with behavioral strategies and manage their lifestyle to mitigate the frequency and intensity of episodes.
Hansen noted that patients also work on issues like interpersonal communication, navigating relationships and managing stress that any other person in therapy might address, too.
‘You’re not alone’
A large part of the clinic’s success comes through this all-encompassing approach. Often, this is through a community setting such as group therapy. Sam Shew, one of the foundation’s board members, said that the clinic has filled a much-needed niche.
“It’s nothing that anyone else is putting forth,” Shew said. “Being able to sit next to someone else who’s going through the same challenge that you are, you really feel that you’re not alone. It’s a much-needed service in the community, which is why it’s hard to see it closing.”
To be clear, the clinic isn’t closing outright. Right now, the clinic offers outpatient, individual, group and family therapy, as well as educational seminars for the general public. The foundation will continue to look for new ways toward financial sustainability, which may include narrowing the clinic’s operations to the most impactful services.
“I don’t know what it’s going to look like, but the interviews I’ve had over the past couple of weeks have pointed to the need for us to keep our services available,” Cruz said.
“We’re hopeful that we’ll be able to figure out a way to do this.”