Unlocking Access: Evaluation Findings from Colorado's I Matter Youth Mental Health Program

Background and Purpose: I Matter was established in 2021 through Colorado House Bill 21-1258 to expand access to mental health and substance use disorder services for youth, including addressing needs that may have resulted from the COVID-19 pandemic. I Matter provides up to six free counseling sessions for Colorado youth 18 years of age or younger (or 21 and younger if receiving special education services). Managed by the Colorado Behavioral Health Administration and administered by Signal Behavioral Health Network, I Matter services are provided statewide in person or via telehealth.

Methods: This pilot study aimed to understand how I Matter participants and/or their parent/guardian perceived their well-being after enrollment and to gather feedback on improving services. Data were collected via a survey administered before a young person’s 3^rd therapy session. Surveys were sent via the MIYO Health telehealth platform to the primary email address on file (whether youth or parent). Participants received a $10 gift card incentive. The survey measured youth and parent/guardian perceptions of general well-being since enrollment (at personal, interpersonal, and social levels), perceived change, and youth perceptions of their counseling sessions. Results are based on 68 youth and 93 parent/guardian responses (22% response rate). Comparison of administrative data revealed that characteristics of the youth who completed the survey generally mirrored those of the larger population who were invited to complete the survey, suggesting some generalizability.

Results: Results indicated that 85% of respondents reported improvement in their or their child’s well-being since starting I Matter: 100% of youth respondents ages 6 to 11 and 82% of youth respondents ages 12 and up. There were no statistically significant differences in improvement based on age, primary language, or assessment data from intake, including internalizing/externalizing behaviors, substance use screening, and indicators of social determinants of health. There were some differences based on youth respondents’ perception of their provider whereby participants who improved were more likely to indicate that their provider talked about what the youth wanted to talk about and was perceived as helpful. Additionally, although I Matter was helpful for most participants, proportionally more males (94%) and nonbinary participants (89%) reported improvement than did females (79%). By service type, more respondents engaging in in-person services (98%) reported improvement than did those participating via telehealth (79%). Most participants (90%) would recommend I Matter to a friend. Qualitative data indicated participant appreciation of strong connections with providers, learning new coping strategies, and the accessibility of services and expressed a desire for more no-cost sessions to support ongoing well-being.

Conclusions and Implications: I Matter is a promising program that has demonstrated feasibility through state-supported funding and strong partnerships with service providers and has been well-received by youth of all ages (and their parents) statewide. The pilot study suggests that the majority of participants experienced improved well-being as a result of participation and that it works similarly well for youth of different ages, English- and Spanish-speakers, and across levels of financial need and behavioral health risk. The program is currently undergoing longitudinal testing.