A Letter from JFM: Specific Examples of Harm and Racism from Across Colorado Behavioral Health Stakeholders

Recently, Chris Osher, a journalist with The Denver Gazette published an in-depth article about turmoil at the Behavioral Health Administration (BHA) and Dr. Medlock’s removal. Osher’s article presented a lot of information, and JFM appreciates the coverage. The JFM team also feels the piece was missing a critical analysis of the connection between the information shared and a diversity, equity, and inclusion (DEI) framework.

Dr. Medlock's story exemplifies the challenges Women of Color (WOC) face in leadership positions. Colorado was ranked as having one of the worst mental health care systems in the nation when Dr. Medlock accepted the role as BHA Commissioner and launched the BHA in July 2022. In one year, the BHA’s efforts significantly improved the National Behavioral Health Overall Ranking and the Youth Ranking. Her tenure as BHA Commissioner was marked by accomplishments and positive contributions, yet she ultimately faced removal from her position. When analyzing the circumstances surrounding Dr. Medlock's removal, it is crucial to consider the broader systemic factors that may have influenced the decision-making process. Despite efforts to promote diversity, equity, and inclusion initiatives, many WOC find themselves marginalized, facing biases and barriers that hinder their career progression particularly when it comes to WOC ascending to positions of power and authority. Dr. Medlock was simultaneously expected to conform to established norms while challenging the status quo.

The public and private criticism of Dr. Medlock’s removal highlighted in Osher’s article singularly hold Dr. Medlock accountable without considering the broader context of organizational structure and comprehensive accountability. Accountability is a fundamental principle in any leadership position. However, true accountability should be comprehensive, considering the roles and responsibilities of all individuals involved. Many of the issues raised in the article were the direct responsibility of other BHA leadership team members, including the Deputy Commissioner, Chief of Staff, and Division Directors. This includes but is not limited to BHA ARPA spending, statewide programming, and rules promulgation. The criticism continues to be primarily levied on Dr. Medlock, holding her solely accountable without giving due consideration to the broader leadership structure and the respective responsibilities of all BHA team members. The differential treatment of Dr. Medlock, a Black woman, and other non-Black members of the BHA leadership team raises questions about unconscious biases and double standards. Unconscious biases can influence judgments and decision-making processes, leading to unequal treatment and the perpetuation of systemic inequities. It is crucial to recognize and address these biases to ensure fair and impartial evaluations of individuals in leadership roles, which Dr. Medlock did not receive. 

Dr. Medlock's leadership has been instrumental in advancing equity and inclusion in Colorado's behavioral health system, including addressing disparities in access and quality of care for communities that have been historically harmed and excluded. It continues to inspire the JFM team that Dr. Medlock was working for the people of Colorado, carrying that weight as a cabinet leader and also as a human. Dr. Medlock’s job description required her to bring an “anti-racism” approach to behavioral health, and she did her job. Osher’s article boldly lifts “racial insensitivities” as a general act, but JFM sources have shared specific examples of harm and racism from across Colorado behavioral health stakeholders. White leaders continue to applaud Dr. Medlock’s removal publicly as those with identities that align with the global majority continue to try to voice support despite fear and roadblocks. In recent meetings, county officials began publicly criticizing the BHA’s emphasis on DEI and anti-racism. In a meeting with advocates, Dr. Medlock was asked to explain why she “talks so much” about the mental health needs of Black, Indigenous, and People of Color (BIPOC) communities. This was set against a backdrop of behavioral health stakeholders and vendors using racial slurs, including the N-word. During public testimony with the Joint Budget Committee, legislative members rolled their eyes and scoffed in response to Dr. Medlock’s presentation. She uniquely received this response. When Dr. Medlock testified to the Colorado House Public and Behavioral Health Human Services Committee, a Republican member addressed her and called the BHA a 600-pound gorilla. Referring to a Black person or an agency led by a WOC as a gorilla or any other dehumanizing term perpetuates harmful stereotypes, fuels systemic racism, and inflicts emotional and psychological harm. Recognizing the historical context, impact, and consequences of such language is essential. Portraying Black individuals as less than human, often equating them with apes and primates, was a tactic employed to reinforce racial hierarchies and perpetuate white superiority. These examples of Dr. Medlock experiencing harmful stereotypes and deep emotional and psychological harm during her tenure as BHA Commissioner are heartbreaking and the movement hopes that the stakeholders committing these acts reflect inward and that those who remained silent acknowledge their role in causing harm.

The BHA team includes the merger and acquisition of employees previously employed by the Office of Behavioral Health (OBH) under the purview of Michelle Barnes’ agency, the Colorado Department of Human Services (CDHS). Current BHA Interim Commissioner Barnes has served as the top leader at CDHS’ for years, including the period that Colorado was near the bottom in the National mental health rankings, highlighting another example of accountability gaps, double standards, and bias towards Dr. Medlock. Only two of the 27 BHA departures cited in the article reported directly to Dr. Medlock, the Chief of Staff and Deputy Commissioner. Complimentary to the 27 people who resigned, 50 were hired as part of the new BHA organization during the same period. For context, the ebb and flow of the BHA’s staffing is below the industry standard for turnover during “The Great Resignation” which is impacting workforce trends for the entire nation. JFM's growing network shared that hiring had been a mired and complicated process as the administration was dependent on CDHS HR systems and structure. In addition, JFM is hearing that since the transition current BHA hiring has slowed providing yet another example of disproportionate scrutiny of Dr. Medlock.

Osher’s article highlighted divisions and conflicts within the BHA, leading to the resignation of top officials. Government power is traditionally held by white leaders and the presence of a Black supervisor challenges established hierarchies. Dr. Medlock was tasked with implementing sweeping, transformational reform reimagining Colorado’s entire behavioral health system. Some white leaders may have viewed this as a threat to their authority and resorted to tactics such as resignation to regain control and diminish the credibility of their Black counterparts, a behavior stemming from systemic and structural racism. White leaders can employ resignation as a tool to undermine the expertise and qualifications of their Black supervisor. By leaving the position, they can create a narrative that questions the ability and competence of the Black leader, perpetuating racial biases and stereotypes. These actions severely affected Dr. Medlock by increasing scrutiny of her decision-making, isolation, and additional challenges in rebuilding trust and asserting her authority as the only Black member of the BHA leadership team. The aim of weaponizing resignation is to manipulate the perception of the situation, casting doubt on the effectiveness of the Black leader's management or presenting themselves as victims of an unfair work environment, deflecting attention from the larger issues of racial inequality.

Regarding hiring, Dr. Medlock was in the process of replacing the Chief of Staff and Deputy Commissioner roles. The Deputy Commissioner of Operations position had been posted and closed, applications analyzed, and those who had met minimum qualifications moved into the next round of screening when Interim Commissioner Barnes brought back Deputy Commissioner Gathercole after her resignation ending the recruitment. As the movement previously shared, the Chief of the Commissioner’s Office position was unanimously decided by BHA leadership, including the Division Directors. After an in-depth hiring process, the role was set to be filled by a WOC candidate who was awaiting an offer letter. After Dr. Medlock's removal, the WOC candidate was informed that she was not selected and the position had closed. The white-identifying male who had previously resigned has reclaimed his role and will continue to hold his position despite state policies around resignation timelines. No offer was dispersed to the candidate after Dr. Medlock’s removal effectively blocking the advancement and career progress of two qualified Black women. When BIPOC are excluded from or forcibly removed from positions of power and decision-making, it reinforces the idea that they are not valued or respected in the workplace.

JFM believes the cited criticism of Dr. Medlock and those applauding her removal raises ethical and accountability concerns missing from the current public narrative. The existing power dynamic places control of Dr. Medlock’s work emails and files with the people who actively participated in problematic behavior to manage these records. How did the media receive a letter about Dr. Medlock’s performance from Vincent Atchity to the Governor's Chief of Staff? The JFM movement shared an update about a group of ten, influential Black-identifying community leaders supporting Dr. Medlock and calling for her reinstatement. The Black leaders received no response to their outreach. JFM can theorize Mr. Atchity did. What is motivating Vincent Achity or Representatives Michealson Jenet and Amabile to use their platforms and privilege to comment on Dr. Medlock’s performance? Representative Michealson Jenet has now disparaged Dr. Medlock in the media twice causing more harm to Dr. Medlock and her reputation with no accountability. It is disheartening to observe some people not listening or reacting negatively to Dr. Medlock’s truth and the stories of other BIPOCs about their harmful and hurtful experiences. This lack of listening and empathy is a form of oppression and further perpetuates systemic injustice. 

Dr. Medlock’s removal has led to a loss of institutional knowledge, disruption of operations, and challenges to the overall effectiveness of the administration. In JFM’s analysis of BHA progress reporting, implementation dashboard, and strategic plan, JFM has not found any delayed timelines. Dr. Medlock’s public engagements, press coverage, and statewide tour activities were also reviewed. The movement did find the BHA's current leadership delayed timelines as their first act after Dr. Medlock’s dismissal. The BHA was on track to meet legislative deadlines under Dr. Medlock’s leadership within the next six months so it is noticeable that “behind on the timelines” is a reason widely cited for Dr. Medlock's removal, but isn’t the same standard for also holding the new, white-identifying leadership accountable. 

It is critical to acknowledge that in November 2022, Dr. Medlock received a solid performance review and was reappointed as BHA Commissioner for four years by the Governor’s prior Chief of Staff. The hyperfocus on Dr. Medlock’s performance by those in positions of power and privilege is a recognizable pattern as the same performance fixation and public DEI backlash ramped up after she hired a Latinx-identifying Deputy Commissioner of System Equity and Effectiveness and then attempted to hire a Black-identifying woman as Chief of Commissioner’s Office. Both highly-qualified candidates participated in robust hiring processes, including multiple rounds of interviews. It is clear that Dr. Medlock was subjected to additional scrutiny, performance double standards, and higher expectations than her white counterparts because of her identity. Dr. Medlock’s removal is a clear example of how bias, discrimination, and racism manifest.