Q&A: Dr. Morgan Medlock, Commissioner for the Colorado Behavioral Health Administration – State of Reform

Dr. Morgan Medlock, BHA Commissioner

Courtesy: The Commonwealth Fund Fellowship in Minority Health Policy at Harvard University

Appointed in January of 2022, Dr. Morgan Medlock is an emergency psychiatrist and addiction specialist with a passion for people and health equity. She previously served as the Chief Medical Officer and Director of Crisis and Emergency Services for the Washington, D.C., Department of Behavioral Health. She also serves on the faculty of the Massachusetts General Hospital Center for Law, Brain, and Behavior and Howard University College of Medicine and has held a previous appointment as a Clinical Fellow in Psychiatry at Harvard Medical School. 

Among her many leadership positions, Dr. Medlock served on the American Psychiatric Association’s Council on Minority Mental Health and Health Disparities, including a term as Vice Chair from 2019-2020. She also participated in the District of Columbia Hospital Association’s Opioid Taskforce, serving as Co-Chair from 2019-2020.

 

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State of Reform: House Bill 1278 concerning the creation of the Behavioral Health Administration is under consideration in the current session. Can you speak to the opposition facing the bill and the challenges looking forward?

Dr. Morgan Medlock: Through our stakeholder process and our commitment to engaging all voices and especially the voices of individuals with lived experience, the bill is actually in a good place and moving forward. We expect it to be heard in the Senate committee as early as next week, and we’re looking forward to really hitting the ground running once the bill is passed. Our first action will be to establish our Advisory Council and we plan to open the application portal for that council the following week after the bill passes, so we actually feel that the process at this point is intact and moving forward.

SOR: What are some of the strategic objectives and partnerships at the start of your administration?

MM: The number one objective is to let our communities across the state know that we hear them and we see them. So our first commitment is to establish our Advisory Council. The bill establishes that there are up to 20 seats on that council and representatives from across the state, from every community and background and ethnicity, are to be considered by me as Commissioner in those appointments and we’re committed to that. So that’s our first action. 

We have several goals for July, one of which is to launch a brand new website where individuals who are experiencing challenges in accessing care can submit concerns and feedback. In the background, we’re working on a process with our ombudsman liaison in our teams that can respond to those issues …  The bill establishes that over the next two years, we’re to develop a complete grievance resolution system. And so in July, we at least want to be able to do intakes and understand the concerns that are happening across the system. 

The other thing we’re focusing on is launching a public facing treatment directory where individuals can go on our website and click a transparent link essentially focusing on getting access to care irrespective of whether it’s mental health or substance use need. We want to pilot that new directory in July as well. So it’s an exciting time and we’re focusing on launching all of the tools that can directly help families and individuals seeking help as early as possible in our administration. 

Now, some broader goals are that by the end of this year, December 2022, we want to have the larger BHA strategic vision published, but we didn’t want to just do that in a silo by ourselves. We want to engage the Advisory Council and leads across state agencies who are also directing behavioral health services in writing that strategic vision, but we look forward to releasing that later this year. I want to also say something about workforce, which is another priority. Our workforce development officer position is currently in the interview stage. And we want to bring that person on because obviously if we design a whole new system, but we don’t have people to deliver those services, then we’ll still be in crisis. Our workforce development strategy will actually be released as early as September 1st, and then integrated into our larger strategic vision.

SOR: There’s another bill, House Bill 1256, regarding reforms to civil involuntary commitment and M1 mental health holds. Can you speak to the importance of this bill and your vision for its equitable delivery?

MM: What I am excited about in this bill is that we do have responsibility for training individuals on the proper assessment before an M1 hold is placed and I think this is really critical. We, through our training, will be able to clarify that individuals experiencing intellectual disability, autism spectrum disorder, etc. [so that the assessment] does not preclude them from also having a mental health challenge that may need a crisis intervention. I’m looking forward to us being able to train first responders and intervening professionals on the proper application of M1 holds.

SOR: How important will having the BHA address the social determinants of health be to achieving the outcomes that benefit underserved communities?

MM: Let me first just clarify, because [the term] social determinants of health is mentioned a lot and I think the definition has been somewhat eroded. I use the CDC definition of social determinants of health, meaning that when we talk about those determinants, we’re not necessarily talking about the risk factors that people have such as needing transportation or needing housing but we’re talking about the economic policies in the larger structure of our society that create those risks and needs. From that perspective, what we’re really talking about is justice in our structural environment and in how policies are shaped, and absolutely that determines health. 

We want to be a BHA that speaks to both the determinants and the influencers of health, those higher policy needs that have to be addressed, those gaps that have to be closed. Also, we want to address those influencers and drivers such as just needing housing, transportation, and food. So we, as part of our administration, are standing up a Division of Statewide Programs and Technical Assistance. Within that division, there will be an office for care coordination, which will help individuals navigate what is a fairly complex system of behavioral health in our state. But in addition, that care coordination team will be supported by a social determinants of health policy adviser. I’m really excited about that position in particular, as we think about our future.

SOR: What role do community groups play in supporting the system in a way that breaks the cycle of hopelessness many are suffering from today?

MM: I espouse to the view of community empowerment. We shouldn’t be creating anything for our communities without our community. Nothing for us without us. That is really what we believe in as an administration. Again, the question has been asked, ‘What am I most excited about?’ It’s partnership with communities that have historically been marginalized and oppressed, and bringing those individuals and communities to the table to help us shape policy. What an exciting way not only to right some of the historical decisions that have been made, but also to show our commitment to equity. So our community, our council, will really be the engine that drives this transformation.

 This Q&A was edited for clarity and length.


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