FORT COLLINS • Terrell Keith’s journey into substance abuse and subsequent mental health issues is unique but not uncommon.

Then a sophomore in high school, Keith had up to that point what he describes as a “normal” childhood with support from his family, while also excelling academically at a Fort Collins high school

“I would say, I grew up pretty normal,” Keith said. “I was able to get almost all A’s until I was about 15 or midway through high school. That’s when I tried alcohol for the first time. And, I am one of the ones where as soon as I tried alcohol, it took over my entire life.”

“I turned into a totally different person.”

Alcohol soon wasn’t enough and Keith began using other substances, including intravenous drugs.

“I barely graduated high school, and in about 2017, I ended up going to a treatment facility for the first time,” Keith said. “I learned about what addiction is and isn’t and what was my fault and what wasn’t my fault. I’d love to say that I stayed clean and sober, but I didn’t. I ended up leaving that treatment center and, in about three days, I was back to using.”

Still, Keith’s initial visit was invaluable.

“The seed was planted,” he said.

Three years later Keith was arrested and faced with an ultimatum: Either go to jail or back to a detox center.

“I had no desire to go back up to detox,” Keith said, “because I had been so beaten down by my addiction after three hard years. But I was homeless and my mom was like, ‘You’re not staying here,’ so, I chose detox.”

Keith’s decision in the spring of 2020 was a life-changing one. His life is remarkably different today. He is confident, composed and in control. Most importantly, Keith has remained clean for almost five years and counting.

Even better, Keith now serves as a peer supervisor at Larimer County’s Acute Care Facility on the Longview Campus in southwest Fort Collins.

The facility, which is owned by Larimer County — the only county-owned such facility in the state — and operated by SummitStone Health Partners, provides withdrawal management and crisis stabilization. It turned a year old in December and had more than 7,000 acute care visits in 2024 — exceeding its projection of 5,000 for the year.

Thirty-two beds are available for those in need of help, and expansion is on the horizon to meet the demands of Larimer County. After admitting 2,500 people in the final months of 2024, the facility is slated to open an eight-bed unit this summer to serve youths 12-17 years of age, complementing its two 16-bed units, available only to those 18 and older.

“Adding that eight-bed adolescent unit is going to fill a huge need for our community,” said Brian Ferrans, deputy executive director at Longview, Summit Stone Stone Health Partners. “A lot of times, we don’t have those types of beds available for youths in Larimer County, and we end up having to send them to Colorado Springs, Denver and even out of state.”

Ferrans said Larimer County’s Acute Facility has access to another 16-bed unit that the facility is working on expanding to bring the total number of beds to 56.

“Larimer County hasn’t had its own sort of withdrawal management services other than the hospital,” Ferrans said. “Until this facility opened, we had been sending folks to Greeley and North Range Behavioral Health. Our approach was ‘let’s get these services open and let’s continue to assess the capacity, the need, and the volume.”

A one-stop shop

The scope of behavioral care has undergone a remarkable transformation over the years in Colorado and throughout much of the United States.

Credit research, enhanced resources, greater awareness and, yes, COVID, to a degree, for helping change the perspective many Americans once had regarding mental health care and withdrawal management.

“We have made tremendous inroads in awareness and particularly reducing the stigma around mental health, particularly post-COVID,” Ferrans said. “Nationally, Colorado is right up at the top of awareness, resources and funding. One of our biggest advantages is we’re a Medicaid expansion state. Most Medicaid expansion states have taken on behavioral health a little bit more aggressively.”

The sprawling 60,000-square-foot facility on the Longview Campus is a prime example. Larimer County’s Acute Care Facility is equipped with an on-site pharmacy, laboratory, observation rooms, comfortable dorms, food services and a port for multiple emergency vehicles.

“This is not some scary institution,” Ferrans said. “This is a place where people want to and can get help for themselves or someone they care about. We want this place to provide a feeling of recovery and wellness.”

That is visibly evident by the vast amount of natural light that radiates through the center’s open windows located throughout multiple floors.

It’s also visible in some of the less noticeable devices used at the facility, such as Oxevision — the first patient monitoring platform for mental health facilities.

Oxevision uses pulse and breathing rate measurements and activity data to assess patients’ sleep/wake patterns, with a level of accuracy comparable to the gold-standard, polysomnography. Staff can view automated, objective sleep reports for patients to support clinical decision-making.

“Oxevision is something we really wanted,” Ferrans said. “There was an awful lot of thought that went into the design of the facility.”

Third time’s a charm

Larimer County’s Acute Care Facility came to fruition after a 2018 tax initiative passed with 61% voter support. Funding for the facility comes via a quarter-cent sales tax that runs through Dec. 31, 2038. Two previous efforts to pass the tax failed.

“This is absolutely a community-driven initiative,” said Larimer County’s Behavioral Health Services director, Amy Martonis. “I have such a deep appreciation that our community made the forward-thinking decision to make the investment of taxing themselves to invest in critical behavioral health services for our community.”

Madeline Novey, a communications specialist with the county’s Behavioral Health Services, believes there was an ideological shift in perception from Larimer County residents when they supported the tax and resulting center in 2018. Part of that was the de-stigmatization of mental health care and withdrawal and crisis management.

Still, there have been a few growing pains. In its first year of operation. SummittStone laid off 75 employees last summer — about 10 percent of its workforce.

Ferrans said many of those layoffs can be attributed to a Medicaid rollback that led to hundreds of thousands of Coloradans losing Medicaid coverage due to the end of the pandemic public health emergency. He added that the payment model in how behavioral health providers are reimbursed has also changed.

Ferrans, though, remains optimistic. He believes Larimer County’s Acute Care Facility has community support behind it.

“I think the county really had a lot of foresight in designing this as a sales tax initiative in order to make funding for this facility stable,” Ferrans said.

Although officials said the layoffs did not affect the services provided, they raised some potential red flags and trust concerns. The agreement between the county and SummitStone was modified in late 2024. The financial oversight committee now meets monthly instead of quarterly.

Martonis said that committee, along with the quality outcomes committee, were formed to support both the first year of operations and moving forward.

“This public-private partnership has few peers across the country,” Martonis said. “It’s a new and emerging approach. We are looking at it from the perspective of how can we best support this type of care in our community.”

Perhaps an even bigger takeaway from the first year of operation is who the facility serves.

“I think it’s notable that over 80% of folks who are receiving care at Longview walk through the door independently,” Martonis said. The majority of clients, as they are referred to, live in Larimer County, with about 71% being adults (ages 25-64); 25% were adolescents and young adults (under 15-24); and 4% were seniors.

“They come seeking services because they know that care is available. We’re meeting a critical need.”

A place of hope

As Terrell Keith gazes from the facility out to Horsetooth Mountain, he can’t help but reflect for a moment.

After all, he is not too far removed from being in the same spot in which many of his patients find themselves.

“I had no reason to suggest that I would be sober,” Keith said of his final visit to detox as a patient. “Something though went from my head to my heart like other people told me would happen. I became completely willing to do whatever anybody suggested to me. I moved into a sober living residence in Fort Collins. After that, I changed all my associations. I only surrounded myself with people in recovery. I made (staying clean) the highest priority of my life.”

Keith is not naive enough to believe everyone he encounters at Longview will make the full jump to sobriety, but he is hopeful and has plenty of reason to be optimistic.

“For someone who was sitting in detox, really, not too long ago, I could have really used somebody who knew what it was like to be in those shoes and had found a way out,” Keith said. “I get to be that person now and everybody on my team gets to be that person. It’s really, really epic.”