Jim Duncan

Billings Clinic Foundation president Jim Duncan speaks during a press conference Monday announcing a grant for an endowment supporting Billings Clinic's new psychiatry residency program. 

Blue Cross and Blue Shield of Montana on Monday donated $250,000 to the Billings Clinic Foundation's push to create the state's first psychiatry residency program — an initiative aimed at combating Montana's lack of mental health care and high suicide rate. 

The foundation is hoping to raise $3.3 million for an endowment that would provide a sustainable funding source for the program after initial start-up costs. 

“Once it’s started it still loses $577,000 per year," said Jim Duncan, president of the Billings Clinic Foundation. "This endowment helps sustain the program into the future.”

Only three states have no psychiatry residency program — Montana, Alaska, and Wyoming. All three have suicide rates that are consistently among the highest in the country, and the states' rural nature and isolation often means that medical specialists cover large regions. 

“Mental health doesn’t discriminate," said Dr. Eric Arzubi, a child psychiatrist for Billings Clinic. "This problem includes all of us.” 

Billings Clinic's program will be a regional track under the University of Washington. Officials have said the program will have an emphasis on training psychiatrists who have a "strong desire" to practice in Montana and especially in rural areas. 

“Montana has half of the psychiatrists compared to the rest of the United States. There are 14 per 100,000 nationally, and seven per 100,000 in Montana,” said Dr. Julie Kelso, a Billings Clinic psychiatrist and Montana native who will direct the program. “Residents tend to stay where they train. We expect 70 to 80 percent of residents will stay and practice in Montana.” 

After finishing medical school, residents will spend two years training in Seattle and then two more years in Montana. 

So far, the program has more than 400 applicants, and will begin matching psychiatrists in early 2019. The class will start in Seattle that summer and move to Billings in 2021. 

Each class will have three students, for a total of 12 residents in the four-year program when it's fully operational.

Kelso said that each resident’s third year will encompass the broad spectrum of treatment, including inpatient and outpatient care, emergency room interactions, child and adolescent care. The fourth year will be developed in conjunction with the resident and will focus on their needs and desires, with a rural focus.

“That fourth year will be the time to send them to reservations and critical access (hospitals),” she said.  

In September, the Leona M. and Harry B. Helmsely Charitable Foundation announced that it gave the clinic $3 million to establish the program and cover its first three years' costs. 

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