Gallatin County's mobile crisis team provides vital support, but more is needed

Oct. 11, 2023
Original story by the Bozeman Daily Chronicle can be found here.

By Laurenz Busch

Two women stand by the door of Richard Elliott’s home on the edge of Bozeman. “Richard!” one yells, knocking firmly on his door, knowing he’s hard of hearing. “Richard!” she yells again until, eventually, he opens the door.

In a wheelchair covered in duct tape, Elliott sits amid the makeshift walls and plywood flooring of his single-wide in the King Arthur Mobile Home Community. His long white hair masks parts of his face and a brown hat casts a shadow over his eyes.

Plants fill the room, reaching upward, bending against the ceiling.

“I’m a violent crime victim,” he said. “I’m disabled and living here alone and I get really overwhelmed with the complications of just getting by.”

Lindsey and Kristi, the two women — whose last names have been withheld for their privacy — are members of Gallatin County’s Mobile Crisis Team (MCT), a special county-funded unit of mental health professionals that respond in times of crisis. In their first year, the team has seen a dramatic growth in demand but much is still left to be desired as the availability of crisis care services in Gallatin County continues to decline.

When the team visited Elliott — having worked with him before — they were preemptively checking in on him in hopes of supporting him before another crisis occurs.

“People like me feel really alone and our problems are more than we can handle,” he said. “[With the crisis team] we have somebody we can fall back on — somebody that will come and help.”

The duo has helped Elliott with things such as receiving a new Medicare card or finding someone to help fix up his home which is currently missing insulation.

The MCT — run by Connections Health Solutions — consists of five full-time members who are dispatched in teams of two. When a call comes in during their 12-hour shifts that requires neither the police nor a visit to the hospital, they’ll respond, offering clients support and options, preventing a visit to the emergency department.

Often, their clients struggle with a variety of situations, such as suicidal ideation, substance abuse or psychosis.

Although for Elliott, Lindsey and Kristi came preemptively, the team also works with clients over the phone or via video call when not responding in person. And they have a member who speaks Spanish, otherwise, they use a translation system.

For now, the MCT’s services are free. It receives funding from the state which is allocated by the county, but that may soon change as they start to bill for their services.

“We're funded through a crisis diversion grant… and we work with the county to receive that funding [but] we anticipate that funding will go away when Medicaid comes online in November,” said Paige Bichler, the vice president of clinical operations for Connections Health Solutions. “After that, our financial support will be coming from the city of Bozeman and Gallatin County [and] there is an opportunity through the marijuana tax dollars.”

Since it formed last year, the mobile crisis team has seen a dramatic increase in demand for its services. Although other incarnations of the response team have served Gallatin County since 2017, the current one, housed in a small windowless room in the Bozeman Public Safety Center, became operational in July 2022. In September, they had 170 calls and interactions with clients — up from around 40 last December.

“In under a year, our calls have drastically increased from almost nonexistent to our days are pretty full,” said Ryan Mattson, the director of social services.

In Montana, mental health services are vital. According to the National Alliance on Mental Illness, “35.1% of adults in Montana reported symptoms of anxiety or depression” and “17.9% were unable to get needed counseling or therapy.” Recent reports have shown that Montana has the highest suicide rate in the country.

However, the county is facing a decline in availability of mental health crisis services. Since the closure of Hope House, an adult mental health stabilization center, there aren’t many available inpatient treatment services in Gallatin County. Hope House has since become a group home.

At this time, Bozeman Health has some emergency psychiatric services at Bozeman Health Deaconess Regional Medical Center and a new adult psychiatric inpatient facility is under construction and set to open in 2024.

“There's definitely gaps and I think that's a lot of our frustration and what we run into… we try to figure out how can we be creative… to come up with some out of the box thinking — how do you care for a person that's in crisis,” Mattson said. “But there absolutely are gaps.”

For now, they'll continue to support residents in Gallatin County but Mattson says that more is needed to provide those facing a mental health crisis with a fully supportive system.

And perhaps more awareness is needed that the availability of crisis services is a communal effort and a communal need.

“Every single one of us is one bad day away from crisis and this isn't serving people that are the others, this is serving all of us,” he said. “We're all in this together.”