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UNC Professor Contributes to State Crisis Plans for Healthcare

July 20, 2020

University of Northern Colorado Professor Thom Dunn helped lead the state of Colorado in developing its first set of healthcare plans addressing ethical standards of care in times of crisis, from natural disasters to pandemics, when healthcare systems are at risk of becoming overwhelmed.

Dunn served on Colorado Department of Public Health & Environment committees to create crisis standards, such as how to manage scarce medical resources during surges in demand, as a resource for hospitals and emergency medical services as the Covid-19 pandemic began.

“Our first task, and it was tense, was to help create crisis standards of care for hospitals and how they would triage, and how they would treat the most people possible,” Dunn said, noting the difficult compromises imposed by certain scenarios in which some patients would be unable to get access to life-saving devices, such as ventilators.

Dunn then approached the state to propose creating the standards for behavioral health and how to prepare for the effects of the pandemic on mental health.

“I saw another potential surge that could outstrip capacity for behavioral health as individuals may not be able to see their therapists or can’t get to their psychiatrists and they may not be able to get their medicine,” Dunn said. “And on top of that they have this extra burden imposed by the pandemic.”

He volunteered to convene a group of experts in the state who identified recommendations for treating patients when healthcare systems are strained for: outpatient and inpatient treatment; substance abuse disorders; correctional institutions; and involuntary treatment of mental illness.

“You pulled together leaders and experts from across Colorado to think through the potential pain points, defining our action triggers and the tactics for consideration,” Dr. Erik France, CDPHE chief medical officer, and Dr. Stephen Cantrill, of Denver Health Medical Center, wrote in a memo acknowledging Dunn. “It’s quite a piece of work. We look forward to sharing it with others across the state and nation and will update the Governor’s Expert Emergency Epidemic Response Committee next month on the recommendations.”

The next steps are to operationalize the plan and its set of recommendations. Examples of the committee's recommendations include:

  • Keeping mental health practitioners in personal protective equipment outside of hospital rooms of COVID-19 patients who are suicidal, as opposed to the requirement to have them bedside, to reduce exposure.
  • Easing restrictions for those living with opioid addiction to get access to the treatment they need through local providers.
  • Loosening requirements for therapists to treat patients who live in another state for online sessions.

“What we’re trying to do now is operationalize the recommendations that we think are the most important to be able to operate through a surge,” Dunn said.

Dunn, who pioneered research on the pathological obsession with healthy eating, teaches Psychological Sciences at UNC. He serves on the bioethics committee of Denver Health Medical Center, where he is a clinical psychologist and paramedic when his time permits.

“That gave me a perspective on emergencies and triage to then work on the crisis standards of care for EMS that the state invoked,” Dunn said. “And I’m hoping that we’re not going to need to invoke the crisis of care for behavioral health. We didn’t for scarce medical resources.”

— Written by Nate Haas

Colorado Crisis Standards of Care Website

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