Officials talk services, funding challenges for county's mental health care

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

By Alex Miller

Members of the county’s mental health coalition gave an update on their work to bolster behavioral health on Friday at Montana State University.

Representatives from Gallatin Behavioral Health Coalition, Bozeman Health, Connections Health Solutions and Community Health Partners participated in an Osher Lifelong Learning Institute forum at MSU on how the different organizations were working to solve the lack of mental health care in Gallatin County.

A variety of topics were touched on, including how the behavioral health coalition works, Connections’ growing role in the mental health landscape and the future of mental health care in the county.

Kirsten Smith, coordinator for Gallatin Behavioral Health Coalition, said that behavioral health and substance abuse disorder have been ongoing issues in the area.

Nationally, behavioral health services have been underfunded since the 1980s, Smith said. That system of services was further corroded by the state Legislature in 2017 when funding was cut to targeted case management services in Montana.

“(That) was really sort of a lynchpin to making our not great system kind of function,” Smith said.

The loss of that funding has left gaps in addressing behavioral health issues across the state and in Gallatin County. Initiatives like the state’s Healing and Ending Addiction through Recovery and Treatment Fund, or HEART, and the Montana Department of Public Health and Human Services funding coalitions like Smith’s have helped address those gaps.

The HEART Fund, for instance, launched the Crisis Now model, which is a national behavioral health care model that employs high tech crisis centers, 24/7 mobile crisis units and crisis stabilization programs.

Smith said that the model will have overlap in services, like from coalition members Connections and Bozeman Health.

Paige Bichler, vice president of clinical operations for Connections Health Solutions, said that the mobile crisis service offered by the organization has been successful since its launch in July.

Bichler said the goal of the mobile crisis service is to keep people in the area, and not elevate them to a higher level of care, like an involuntary commitment.

The mobile crisis teams operate on seven days a week, 12 hours a day cycle, and have seen an increase in calls for service. Bichler said that service tripled its call volume in January. Of the 89 calls received last month, only four saw people elevated to a higher level of care.

Bichler said the hope is to expand the service to a 24/7 model. For now, the most calls related to behavioral health happen most often between 10 a.m. and 10 p.m., Bichler said.

Bichler also gave an update on the crisis response center Connections plans to open. The facility is under construction, she said. The plan is to have urgent care in the front of the building and short term acute inpatient care in the back for additional stabilization time for people in crisis.

Nicole Madden, behavioral health system director for Bozeman Health, said that the inpatient psychiatric unit at the hospital could be completed in 2024.

She said that the Psychiatric Emergency Services area, which opened in December, has been working well, but would not “be able to provide enough volume to address all of the community’s needs.”

Madden said that in order for behavioral health care to be successful in Gallatin County, all the member organizations of the coalition need to work together.

Long term funding and staffing are hurdles that the entire coalition faces for future sustainability.

The Gallatin Behavioral Health Coalition, for instance, is funded by a three-year, $225,000 grant from the Montana Health Care Foundation.

Madden said that long term sustainability could be a complicated process, particularly for funding.

Future funding for the coalition could rely on philanthropic support, grant funding, fundraising and money from member organizations, she said.