Mary Dengler-Frey knows something about building things.
As a Regional Health Connector (RHC) at the Southwestern Colorado Area Health Education Center, she’s assembled programs and recruited providers to tackle three challenging problems: opioid addiction and substance abuse, diabetes, and suicide.
In her public health work, she has drawn upon a previous career as an architect. “Though they seem disparate, there’s similarity in the complexity and the coordination of moving parts,” she said.
Mary’s region consists of Montezuma, Dolores, San Juan, La Plata, and Archuleta. Each of the rural Southwestern counties she serves is geographically and demographically diverse. They include two of the three nationally recognized native American tribes in Colorado, outdoor recreation towns like Durango, and some of the state’s least populated areas.
In her two years as an RHC, Mary has continuously built on successes and knowledge to address important health needs.
Working with Providers to Reduce Opioid Abuse
In southwest Colorado, deaths due to drug overdoses have become much more common in recent years.
Mary’s first task was making sure that doctors and health care providers in her region were registered with the Colorado Prescription Drug Monitoring Program, or PDMP, which helps those who are prescribing and dispensing controlled substances prevent prescription drug misuse.
Now, each of the practices is registered. But that doesn’t mean the work is done.
Mary is connecting providers with information on safe prescribing, alternates to opioids, safe storage and disposal, and other educational resources to stem drug abuse. She is also promoting the Lift the Label public awareness campaign, which is aimed at removing “damaging labels and stigmas that prevent those with opioid addiction from seeking effective treatment.”
Figuring Out the Real Roots of Diabetes
Mary’s approach to reducing diabetes and improving cardiovascular health has also evolved. Needs assessments in the region have identified obesity-related diabetes as a top priority, as have leaders of the Southern Ute and Ute Mountain Ute tribes.
At first, she thought offerings like nutrition education and healthy eating classes would address high diabetes rates. Such programs existed, but it soon became clear, they often didn’t reach people who need them the most, particularly some of the region’s Native Americans. And many families were struggling with more fundamental problems, like lacking access to or the ability to afford healthy foods.
So Mary and some of the providers she works with shifted tactics: They took a training in culturally sensitive motivational interviewing, a strategy providers can use to better understand the roots of and potential solutions for the health challenges patients are facing. And she helped design a program that allows medical providers to write a “food prescription” that allows a person to access food for free. While many food prescription programs focus on weight loss or other health goals, this program is focused on addressing food insecurity.
But there’s much more to do done, she said.
“We’re really just scratching the surface.”
Colorado’s southwest counties have some of the country’s highest suicide rates. The issue has rattled many community members and focused national attention on Southwestern Colorado.
Early in her time as an RHC, Mary helped start a multiagency coalition focused on this challenging issue. The group identified two priorities: Helping youth become more resilient and sharing training and resources on suicide prevention.
Mary also worked on a film, screened at a local theater, that features young people from Montezuma County who shared stories about difficulties they had overcome.
In the meantime, Montezuma and La Plata counties have become part of the Colorado National Collaborative, a suicide prevention effort. Mary is helping lead that work in southwest Colorado.
Mary also connected a local school board with the suicide prevention coalition. Members of the coalition helped inform a new policy on suicide prevention in schools.
To make lasting change and reduce suicide, she said, “the community’s got to steer this work.”