Guest opinion: Montana's mental health system must be transformed

2014-03-16T00:00:00Z Guest opinion: Montana's mental health system must be transformedBy JOHN WILKINSON The Billings Gazette
March 16, 2014 12:00 am  • 

In the 10 years since our youngest son became seriously mentally ill, he tried to commit suicide five times rather than continue to live with his disease.

During this time we have gotten to know many other families that have tried to help their mentally ill family members. We have known four young adults who died by suicide, unable to live any longer with their mental illnesses. We know the pervasive grief and guilt each suicide caused their families.

All of us have tried to get help in Montana, and despite our best efforts, our son was sentenced to Montana State Hospital’s forensic unit as a guilty but mentally ill offender/patient, where he has been for more than three years.

Community-based care

Our state needs to do a much better job of supporting our seriously mentally ill citizens in our communities. Our state needs to transform its mental health system from an institutional to a recovery-oriented, community-based system. In FY2014, Montana will spend $31 million from our state’s general fund to treat 190 mentally ill patients at Montana State Hospital, while Western Montana Mental Health Center will spend $39 million to serve 11,000 mentally ill persons during the same period.

The United States has acknowledged our mental health system needs to be transformed. The President’s New Freedom Mental Health Commission uses the U.S. Supreme Court’s Olmstead decision as a cornerstone for that transformation. Olmstead affirmed the right of individuals, including the mentally ill, to live in community settings. The Mental Health Commission called for nothing short of fundamental transformation of the mental health care delivery system in the United States.

The word "transformation" was chosen carefully by the commission to reflect its belief that mere reforms to the existing mental health system are insufficient. Transformation is a powerful word with implications for policy, funding, and practice, as well as for attitudes and beliefs.”

In the wake of the New Freedom report many states initiated transformation efforts, developing evidence-based practices that are recovery and community based. Achieving these outcomes has required sustained commitments from states’ governors and legislators.

Hospital readmissions

Montana’s institutionally based mental health system is costly and ineffective, as evidenced by the Montana ACLU’s threat to file a lawsuit in federal court if the Montana departments of Corrections and Public Health and Human Services do not significantly improve the treatment of Montana State Prison’s mentally ill prisoners.

Nearly half of Montana State Hospital’s admissions were persons admitted within a year of discharge. In other words, half of Montana State Hospital’s admission are readmissions.

Other states are making long term commitments in transforming their mental health systems to comply with the Olmstead decision and are successfully and safely transitioning their seriously mentally ill back to their communities, while “moving” state hospital beds closer to communities.

Montana needs to transform its system to one that effectively supports our mentally ill citizen’s recovery within communities guided by evidence based practices. We can look to our neighboring states in developing our visionary plans and implementation strategies in achieving this paradigm shift. An effective mental health system transformation will require ongoing commitments from the governor and other executive branch agencies, in partnership with the Legislature, county governments, along with mental health advocates, family members, consumers and providers. Montana has an unparalleled opportunity to develop a partnership with our newly formed Montana Healthcare Foundation to support transforming our system to a community-based and recovery-oriented mental health system.

John Wilkinson lives in Helena.

Copyright 2014 The Billings Gazette. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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