Montana’s mental health crisis care system is deteriorating as Western Montana Mental Health Center, one of the state’s largest providers, has drastically curtailed services over five years. In February, Western closed three mental health crisis centers, leaving just two others to serve the rural 147,000-square-mile state. In 2018, Western closed an outpatient clinic in Livingston, a town of 8,300, telling more than 100 patients to travel 30 miles over a mountain pass to Bozeman for care. This spring, Western closed that Bozeman crisis center as well.
Systemic Financial Pressures
The nonprofit’s initial closures were attributed to state Medicaid cuts made in 2017. Since then, Western’s financial troubles have spiraled with job cuts or service reductions every year since 2019. The company’s money problems stem largely from low Medicaid reimbursement rates, staffing strains, and rising costs. By 2019, Western was spending $3.4 million more than it earned. The pandemic further disrupted revenue through school-based mental health services when learning went remote. Western opened seven crisis stabilization centers starting in 2010, but “of all of the crisis houses in the state, every one of them was started and operated by Western,” according to longtime mental health advocate Tom Peluso.
Broader Crisis
Community clinics can’t compete for staff, and private practice therapists have months-long waitlists. The Montana State Hospital lost federal funding after staffing shortages and mismanagement led to patient deaths and assaults. Almost every community in Montana lacked crisis stabilization services, according to a state-funded report released last year.
Policy Response
Lawmakers are considering a bill to spend $300 million over several years toward fixing the state’s behavioral health system and a constitutional amendment to establish a mental health trust fund. State representatives also proposed raising Medicaid reimbursement rates but haven’t agreed on amounts. Montana is exploring a statewide program modeled after bundled payment systems, though implementation is years away. Western is using former crisis beds to expand group home programs and doesn’t plan to return to its former crisis service levels.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://kffhealthnews.org/news/article/as-montanas-mental-health-crisis-care-crumbles-politicians-promise-aid/