The county’s five-year public health improvement plan, shaped by a resident survey, highlights behavioral health and basic needs as top challenges. (Photo/Montezuma County Public Health Department)
The county’s five-year public health improvement plan, shaped by a resident survey, highlights behavioral health and basic needs as top challenges. (Photo/Montezuma County Public Health Department)

Public health officials surveyed the lived experiences of residents in 2024 to assess real-life health issues facing the community today.

Montezuma County residents say poor mental health, substance use and basic needs such as food and housing costs are the most pressing challenges. Those top concerns drive the county public health department’s new five-year improvement plan.

Required by state law, county officials say the plan’s purpose is to translate community feedback into specific health priorities.

2026 PHIP.pdf

Montezuma County public health planner Katy Maxwell led the charge to put the plan together and compile the data informing it. She said she spent hours collecting community-led information.

“It is a requirement we do this every five years. How we do it, how we involve the community is really up to us. It’s really important for us to have back-and-forth communication with the community,” Maxwell said.

Top concerns are alcohol, drugs and mental health

The 2026-2031 plan is based on a community survey that drew 800 responses and aimed to include underrepresented groups such as men, tribal members and Spanish speakers.

Mental health ranked as the top concern among 13 issues listed in the survey. More than 20% reported poor mental health lasting more than two weeks in the past month. Suicide has been cited at higher rates in the community for some time. In 2020, as part of the previous improvement plan, the department adopted the Colorado-National Collaborative suicide prevention program. This program remains a core part of its current efforts.

Top findings from Montezuma County’s community health survey

84% of respondents said lowering the

cost of food is one of the greatest needs related to food access69% said a lack of

affordable, quality housing is a major concern68% identified

substance use – including alcohol, marijuana, tobacco and illegal drugs – as a top health issue65% said

mental health is among the top three health issues most important to them, making it the most-selected response for that question63% reported using

alcohol in the past year54% named

neighborhood safety as a major concern53% said

child abuse and neglect prevention is a top social issue49% said a

lack of available appointments or long wait times has prevented them from receiving healthcare or mental healthcare46% said the

cost of food is a barrier to eating healthy, balanced meals42% said accessing healthcare in the community is

not too difficultSource: Montezuma County Public Health Department’s 2025 Community Health Assessment

Additionally, substance use disorder is another top challenge, including alcohol, marijuana, tobacco and illegal drugs.

In the survey, about two-thirds said they use alcohol, aligning with state drinking trends. The survey linked alcohol use to fatal crashes and a liver disease death rate 3.6 times the state average from 2020-23.

What’s in the plan for targeting improvements

For improvement strategies, public health officials hosted a listening session.

“These were people with lived experience or those working in direct service to people that are experiencing mental health or substance use, and they guided the most concrete part of the public health improvement plan, because we asked them specifically, and it was a facilitated listening conversation,” Maxwell said.

Maxwell says stigma, community culture and ways people talk about mental health or substance use, if they talk about it at all, affect outcomes. To address these factors, the new plan suggests normalizing conversations about how individuals deal with addictions or mental health disorders.

The goal is to make people feel comfortable talking about these issues and reaching out for help. Other strategies involve education and awareness. Assessing the interconnection of trauma, how people experience and cope with it in relation to mental health and substance use, is another targeted area for education.

“Some ideas were social media and marketing campaigns or community events for intervention and awareness,” Maxwell said. “There’s really a lot of interest in getting youth involved, promoting healthy safe spaces and alcohol-free spaces.”

Priority goals, areas, objectives and strategiesGoal 1Target areaObjectiveStrategyReduce substance abuse and improve mental health in Montezuma CountyPrevention and early interventionProvide education to families on the risks of early exposure to substances and the importance of parental/guardian support and guidance around mental health and substance useCommunications and marketing campaign (social media, print flyers, movie theater ads, etc.)Cultural and social normsIncrease awareness of how social norms influence behavior, especially for children and youth, and promote healthy social normsPartner with others in the community to (potentially plan and) promote healthy, safe local events and places/spacesPromote a youth-led platform (beginning at elementary age kids and up to young adults) to raise awareness, teach coping mechanisms, brain/body effects related to substance use, and peer pressure resistance skills

Improving food access as directive two

The highest response to any question concerned food costs. About 84% said lowering food costs was a top need. Respondents cited prices as a barrier to healthy meals.

“Access to food is just scarcer here too, because people have to go longer distances, and there are fewer options. We do have a higher percentage of people using SNAP than the state average. So, a little bit more of a lower-income community,” Maxwell added.

Affordability and housing were other major concerns noted in the survey, with 11% of households living in poverty and struggling to afford basic needs, and 35% of households not meeting the county’s targeted cost of living. For Montezuma County children as of 2023, 22% lived in poverty.

Addressing affordability and food access, according to the plan, includes promoting local food resources such as WIC and seeking more grant funding.

Priority goals, areas, objectives and strategiesGoalTarget areaObjectiveStrategiesImprove food security and accessSupporting local food resource providers and initiativesPromote local food resources among current health department clients (e.g., WIC and NFP clients) to raise awarenessAttend local food security collaborative meetings to identify ways the health department might supportSeek out funding opportunities (grants) to increase food access and food securityDisseminate food-access services (e.g., summer feeding sites) and program information to WIC clientsResearch funding opportunities; apply for funding

How local experiences compare statewide

The findings align closely with conversations occurring statewide, where, Maxwell said, public health officials see similar pressures, especially with food access and barriers to housing. However, some statistics are uniquely linked to the local region.

“For example, like we do have historically – this year may be different – but historically, we have a higher suicide rate than the state average. Being in a rural area and having access to resources – that all impacts that rate,” she said.

The suicide rate in the county has trended downward over the past year. But Maxwell said the data should be viewed over several years to ensure it isn’t a fluke, while also saying the decline is worth celebrating.

Plan designed as community reference

Further, the assessment serves as both an internal guide and a transparent community reference.

“This is community-level information,” Maxwell said. “People deserve to know what’s going on – what people are saying and what they’re experiencing. It’s our community, and we all deserve access to that.”