For Whom The Mental Health Bell Tolls

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This week we published a story about a new behavioral health system studycommissioned by the state health department. You’d be forgiven if your eyes just inadvertently glazed over — government studies aren’t always riveting. 

But this particular report grabbed my attention and wouldn’t let go. A rarity in Montana’s research on mental health and addiction services, this study by JG Research and Evaluation was qualitative, which is to say the findings were drawn from interviews with 26 real people who have either personally navigated Montana’s behavioral health crisis system, supported an immediate family member in crisis, or worked in the system as a health care provider or law enforcement officer.

The interview excerpts were hard to read. Former patients described feeling isolated and afraid in the backseats of police cars, solitary jail cells and hospital emergency departments during their crises. A man who was suffering from suicidal thoughts drove himself three hours to a hospital in Great Falls because there was no psychiatric service in his hometown. A parent said she’d begun caring for her young adult child full-time after a residential care facility allegedly mismanaged his medication and left him living in “horrific” conditions. A mother struggling with postpartum depression and drug use said she asked police to take her to jail instead of a hospital during her crisis in hopes that other incarcerated women would have “treated me like a person.”

Earlier this week we published two different stories about related topics. One, written by education reporter Alex Sakariassen, explored the fragile landscape of school-based mental health services after an upheaval in how those services are funded. The other parsed Montana’s plan for expanding institutional psychiatric and addiction treatment services, even as state health officials remain undecided on “the best use,” in their words, of the beleaguered state hospital in Warm Springs. 

Mental health care policies like these are central to the work of state government, from the Department of Public Health and Human Services to the Office of Public Instruction to the complicated calculus of the state budget — all of which can seem intimidatingly distant to the lived experience of everyday Montanans.  

So it seemed fitting to round out the week’s coverage by reporting on the new study foregrounding the first-hand experience of Montanans on the receiving end of all that policy and debate. These accounts of Montanans in crisis are an important reminder of what’s really at stake as the state struggles to repair and reconceive its threadbare health care systems: the suffering of too many of our families, friends, and neighbors. 

We’ll continue to center mental health and addiction in our broader coverage of health and human services. And as always, we want to hear from you — the readers and fellow Montanans who undoubtedly have personal stories to share about such critical topics. 

You can reach out to us by emailing [email protected] or contacting me directly at [email protected] 

—Mara Silvers, Reporter


By the Numbers 🔢

Number of public school students who were receiving comprehensive in-school mental health services through the for-profit provider Altacare of Montana prior to the company’s closure last month, according to the Montana Department of Public Health and Human Services. Altacare terminated its operations in the wake of a controversial change to Medicaid-funded Comprehensive School and Community Treatment programs statewide, and its unpublicized departure has raised questions about the continuity and sustainability of community-based supports for students diagnosed with serious emotional disturbances.

—Alex Sakariassen, Reporter


Hot Potato 🥔

The Bureau of Land Management announced Thursday that it has approved an application by the American Prairie Reserve to graze 63,000 acres of BLM landin Phillips County after taking comment on a 2021 environmental impact statement. The grazing application is noteworthy because APR, which aims to conserve prairie species by acquiring large private parcels and connecting them with large tracts of public land, will be grazing bison rather than cattle, sheep or goats on the allotments. That, and APR’s unique model and large — and growing — footprint in central Montana made the grazing proposal a lightning rod for opinions about APR itself.

BLM received 2,700 comments on the proposal. Groups ranging from the National Wildlife Federation and Alliance for the Wild Rockies to the Montana Wool Growers Association and the PhillCo Economic Growth Council weighed in, so it was no surprise when statements from industry groups and elected office-holders started rolling into MTFP inboxes and popping up on social media platforms shortly after BLM’s press release announcing the approval.

Montana Attorney General Austin Knudsen criticized BLM’s public comment and outreach process in his statement, arguing it was “not a surprise that President Biden’s Bureau of Land Management would rubber-stamp this radical proposal that is another step toward displacing northeast Montana’s livestock industry and replacing it with a large outdoor zoo.” Knudsen also said his office “is reviewing the decision closely to determine our next steps.”

Gov. Greg Gianforte also said the state is considering its response, and questioned whether BLM has “statutory authority” to enact the proposal.

The Montana Stockgrowers Association said its staff and members had raised concerns about “impacts to rangeland health, riparian areas and socioeconomic impacts to the rural communities and the livestock industry.” Those concerns weren’t addressed in the final decision, the group said, adding that the approval “will have serious repercussions on BLM grazing throughout the West.”

Alison Fox, APR’s CEO, said her organization is “extremely pleased” with the outcome. “This decision is grounded in sound science, complies with all local, state, and federal laws, and recognizes the important ways bison grazing has and will continue to improve rangeland health,” Fox said. 

APR says approval of the application will create jobs, improve land and water quality, and benefit local wildlife by improving habitat conditions for aquatic and riparian species including amphibians and birds.

Per BLM rules, yesterday’s announcement starts a 30-day timer on any appeals to its record of decision.

—Amanda Eggert, Reporter


Glad You Asked 🙋🏻

Montana elects its state senators to staggered, four-year terms, with half the chamber up for election every two years. But this election cycle will see one more Senate race than anticipated, and it could be a doozy. The unexpected May death of Sen. Mark Sweeney, D-Philipsburg, created a vacancy for the last two years of his term in a Senate district that’s proved reliably Democratic in the past, but is now a bonus target for Republicans heading into November. The process for filling legislative vacancies is laid out in statute: If the vacancy occurs 85 days or more before the next general election, commissioners from the counties contained within the district have to select a replacement. They did so in June, selecting Teamsters official Jessica Wicks to hold Sweeney’s seat during the legislative interim. Separately, county party central committees forwarded candidates to run for the seat in the 2022 election: newspaper publisher Jesse Mullen, a Democrat, and Anaconda-Deer Lodge County Commissioner Terry Vermeire, a Republican. Both are now on the campaign trail hoping to win the seat and serve out what would have been the final two years of Sweeney’s term — and protect, or swing, the balance of power in the 2023 Legislature in the process. 

—Arren Kimbel-Sannit, Reporter


The Viz 📈

Gov. Greg Gianforte touted a win this week as his administration released job creation figures indicating the state has met a goal he articulated last year: 10,000 new Montana jobs that pay at least $50,000 annually during his first year in office.

Figures from the state labor department, based on unemployment insurance payroll records, estimate Montana’s economy had 145,462 jobs paying at least $50,000 in the fourth quarter of 2021, nearly 13,000 more than a year prior. That figure represents about a quarter of the overall jobs in Montana.

The governor, a Republican, attributes the job creation to his leadership. “We got there by cutting red tape and other unnecessary burdens on job creators, attracting new cutting-edge businesses to bring good-paying jobs to Montana, and investing in our workforce to ensure Montana workers have the skills they need,” he said in a statement.

In comparison, the first year former Democratic Gov. Steve Bullock was in office, 2013, saw the state add about 4,400 jobs at or above the $50,000 level. In 2019, the year before the COVID-19 pandemic upended the state economy, Montana added 7,878 new $50k-plus jobs.

Of course, inflation — particularly rising housing prices — means $50,000 doesn’t buy a Montana worker what it used to. With national inflation at 9.1% over the last year, a $50,000 job this year is roughly equivalent to a $45,800 job last year. And taking out a commercial mortgage to buy the typical home available for sale in Montana — priced at $448,875, according to Zillow — now requires a household income close to $100,000.

—Eric Dietrich, Deputy Editor


Viewshed 🌄

Credit: Missoula Public Library

The spacious new Missoula Public Library picked up some major bragging rights and a $5,000 prize this week when the International Federation of Library Associations named it the globe’s “Public Library of 2022” during the organization’s World Congress in Dublin, Ireland. The library opened its doors last year after a complete $38 million rebuild — $30 million of which was funded through a voter-approved public bond. According to Missoula County, it’s the first library in North America to snag the international award, having out-classed newly designed libraries in Saudi Arabia, Denmark and Latvia. 

—Alex Sakariassen, Reporter


On Our Radar 

Amanda — Wednesday’s announcement that Democratic U.S. Sens. Joe Manchin (West Virginia) and Chuck Schumer (New York) finally landed on a climate proposal that both could support caught many people, including me, by surprise. It’s certainly a long way from being signed into law, but I found The Atlantic’s overview of the deal — including what it could mean for renewable energy investment, electric vehicle sales and federal energy leasing — a helpful explainer.

Alex — NPR’s Planet Money podcast featured a brief look this week at Montana’s regulations regarding milk expiration dates. Turns out our current 12-day limit for how long milk can stay on store shelves is among the shortest shelf-lives in the country, and results in drinkable milk going down the drain on a daily basis.

Mara — The Missoulian has recently published a series of articles about maternal health and health services for Native Americans in Montana. The latest piece is about how Indigenous doula training can help improve health outcomes— and save lives — when people are pregnant and parenting. It’s a powerful and enlightening read. 

Arren — Montana marijuana industry policy whiz (and MTFP contributor) Max Levenson published a quick dive this week on roadblocks that four Crow tribal members have hit in their attempt to open a recreational cannabis dispensary outside of Hardin. Their dilemma illustrates the daunting challenge that tribes and Indigenous Montanans face in navigating a patchwork of federal and state marijuana regulations following the legalization of recreational pot in Montana.

Eric — In case you were wondering, the U.S. Forest Service does in fact have an illustrated instruction manual detailing official best practice for “obliterating animal carcasses with explosives.” (Hat tip here to Twitter user @tuckthetech.)

*Some articles may be behind a paywall. 


#Mental #Health #Bell #Tolls

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