Obstacles to delivering and accessing behavioral health care in resort communities: A rural case study

Purpose: Residents of affluent resort communities are often assumed to have low levels of stress and abundant resources to provide for their mental health and well-being. But in Aspen Colorado, high rates of alcohol and drug abuse and a suicide rate often three times the national rate indicate a much different reality. Many factors in Aspen place significant stress on those who live and work there, and create barriers to accessing quality behavioral health services. An in-depth behavioral health needs assessment was conducted to better understand these factors and make recommendations for improving access to quality behavioral health services. Methods: Demographic, economic and health status data was reviewed and compared to state and national data as well as data from similar affluent communities for comparison. Qualitative data was collected from a series of public focus groups and extensive individual interviews a broad range of constituents in the community. Results: While the community has many assets for promoting mental health and wellness, many significant challenges exist. Extreme economic disparity and a lack of affordable housing force many residents to work multiple jobs and commute fifty or more miles to work, resulting in significant social isolation. Substance abuse rates are high, but detoxification and treatment programs are scarce. Behavioral health services are often expensive, difficult to access and insufficiently coordinated. Many residents simply seek care elsewhere. Conclusion: The unique characteristics of Aspen require new approaches to increase access to affordable high-quality care and address the high rates of substance abuse and suicide.