Over the past several months, The Billings Gazette has worked to raise awareness of mental health issues through the State of Despair series by reporter Cindy Uken. The series focuses on suicide, which has been a leading cause of death in Montana for decades. Recently, Montana has had the highest suicide rate of any state — double the national average.
Four hundred fifty Montanans took their own lives in 2011. Some were young teens, others were senior citizens. Every age group in between was part of the toll. In Yellowstone County alone, an average of more than 60 people a year have committed suicide in recent years.
The terrible toll of suicide is a symptom of systematic problems in our state. Lack of access to timely, effective mental-health care, shortages of mental-health professionals, lack of insurance and overwhelming stigma that makes people reluctant to seek needed care all contribute to suffering that all too often ends with suicide.
Knowing that we have a problem is the beginning of understanding how to solve it. But action is needed on the state level to ease Montana's suicide problem.
Fortunately, numerous members of the Legislature have presented bills this session that address various facets of mental-health needs.
"We have some positive legislation and we're getting some traction," said Jani McCall, a longtime children's advocate who represents Yellowstone Boys and Girls Ranch.
Good mental-health bills still alive midway through the 90-day session include:
-- House Bill 100, which would establish a pay-for-performance children's mental-health pilot project. The idea is to base Medicaid payment on outcomes for children, not just on inputs.
-- House Bill 16, which would revise involuntary civil commitment laws to clarify that an emergency exists when a person with mental illness is unable to take care of his own basic needs.
- House Bill 12 requested by the Children, Families and Human Services Interim Committee, which would retroactively increase Medicaid provider rates that were reduced in fiscal year 2011 because of a forecast of decreased state revenue. About 10 percent of the $6.4 million general fund money that HB12 would direct to providers would go to the Addictive and Mental Disorders Division and it would be matched with federal funds.
-- House Bill 2, which includes Medicaid provider rate increases of 2 percent for each year of the upcoming biennium.
House Bill 2 also needs to preserve and augment community mental-health crisis funds, known as HB130 funds, for the bill that started the program several years ago.
The Community Crisis Center in Billings receives a crucial portion of its funding from HB130 and uses it to serve 11 counties of south-central Montana. In addition to 24-hour crisis services, the center trains law enforcement officers from all over Montana to appropriately and safely intervene in mental-health crises.
Sheriff Mike Linder is among the proponents of HB130. He recently wrote to lawmakers saying: "We are grateful for the crisis center and for the Crisis Intervention Training for our law enforcement officers. Both have made a tremendous difference in the way we do business. Law enforcement appreciates the knowledge they've gained and the fact that they have a safe place to take vulnerable citizens."
The funding bills reflect the austerity that historically has been applied to community services. Private, community services struggle to recruit and retain good staff with the limited dollars appropriated in the state budget.
The state must take action to assure that it gets good value for its money, as HB100 seeks for children's mental-health care. But state leaders also must figure out how to pay enough that good services will be available to Montanans who need them.
Advocacy for mental health is an unending struggle. It's encouraging that mental health is being discussed in the Capitol. We urge lawmakers to support legislation that will help Montanans get the timely, effective care they need to live healthy, productive lives.