Montana’s Mental Health Crisis

by William Skink

Mental health is a serious issue that impact tens of millions of Americans (I had the wrong link and can’t find the original article, so I took the link out):

Nearly 20 percent of Americans — 44.5 million adults — experienced some sort of mental illness over the last year, according to a new report from the U.S. Substance Abuse and Mental Health Agency (SAMHSA).

The report details state by state the percent of the population who has suffered a mental illness.

“Mental illnesses are treatable and people can recover to live full, productive lives. Unfortunately in the past year only 37.9 percent of adults with mental health problems received any type of care,” SAMHSA Administrator Pamela S. Hyde said in a statement. “The chasm between need and care is costly both in terms of personal health because of missed opportunities to prevent disability and health care expenditures related to illness such as cardiovascular disease, diabetes, and obesity.”

The tragedy of missed opportunity was horrifically evident this week in Bozeman where an episode of untreated postpartum depression appears to have contributed to an unimaginable act of violence. Jessica Hunter allegedly shot and killed her husband, her 6 month old baby and herself with a gun she legally carried as a part of her job with Fish, Wildlife and Parks.

After a tragedy like this it’s natural to wonder what more could have been done to help Jessica. Friends and family are especially haunted with the what-ifs. The stigma of seeking help is often discussed, among other factors that make it difficult to get the necessary help.

For those who haven’t had to deal with hospitals and mental health providers, it might be difficult to understand why someone wouldn’t seek help, or if they did seek help, why that help wasn’t adequate. Thankfully we have new media outlets like Last Best News providing a first-hand account of one woman’s experience trying to get a prescription of Zoloft filled.

Please go and read the whole piece. Tahini Nelson, the woman who shares her terrible experience, should be commended for having the courage to not only advocate for herself, but to then use her story to help others understand how a simple need to get a prescription filled can turn into a traumatizing 6 hour ordeal in an emergency room that resulted in a bill of over a thousand dollars and a patient who ended up leaving the emergency room that day WITHOUT the medication she needed to treat her depression.

We have an ongoing mental health crisis in this state with a lack of access to treatment and significant gaps for other critical services.

It’s so bad in Montana that a recent piece from The Guardian about the alarming 20% uptick in suicides for white men ages 45-54 since 1999 singled out Montana specifically for its disturbing suicide rate:

Lowney lives in Butte, Montana, where local officials see the Princeton study’s findings reflected in their community but struggle to explain them. The state has the highest rate of suicide in the US at nearly twice the national average and rising – up 7.3% in 2014. Those most likely to kill themselves are 45 to 65 years old.

“What’s been lacking in our town is an explanation for why this demographic in particular has been dying by suicide,” said Karen Sullivan, health director for Butte and the surrounding county, Silver Bow. “We want to take a look at what we’ve got going on in Butte. Is it economic in nature? Is it middle-aged white people discontented with where they landed in life? Is it isolation? A lack of a social network? Is it drug and alcohol issues? What do we have going on?”

Other officials see a number of interconnected forces at work and the rising rate of middle-aged deaths as indicative of crisis wider than those who kill themselves.

Growing economic inequality and increasing financial struggles are intertwined with other issues such as health and addiction. Some people living on low incomes hesitate to go to the doctor even if they have medical insurance because of the cost of out-of-pocket expenses. Chronic conditions can go untreated and become debilitating.

Pain is a driver of alcohol abuse and addiction to opioid painkillers, which in turn is feeding a growing heroin epidemic in the US. Stress and mental health issues are sometimes driven by constant worries about money and fear for the future as growing numbers of Americans look into a financial abyss at retirement.

This is not the story an incumbent Governor wants his constituents to be talking about during an elections season, but low employment and money in the bank does not a healthy state make.

I haven’t written anything yet about the terrible decision by the Montana Supreme Court to uphold atrocious legislation aimed at destroying medical marijuana providers, while simultaneously punishing sick people in Montana, but the fact state officials are callously recommending only 49 days to transition to the 3 patient regulation is absolutely disgusting:

Last month, the court upheld provisions of the 2011 law that limits marijuana providers to selling the drug to no more than three patients each. Medical marijuana advocates who sued to block the law asked the Supreme Court last week to reconsider the three-patient limit and delay implementation of the restrictions until after the 2017 legislative session, which is more than a year from now.

The state Department of Justice opposes the request to reconsider the limit and a lengthy transition period, Assistant Attorney General Stuart Segrest wrote in response to the advocates’ request. Only 49 days passed from when the state Legislature passed the bill in May 2011 and it was to go into effect that July, officials said.

“If the court is inclined to delay things at all, it should follow the same 49-day period that was in the law,” attorney general spokesman John Barnes said.

Destroying patients access to medical marijuana, combined with the new CDC guidelines for prescribing opioids (read James Conner’s critical look at this issuehere) certainly won’t help Montana’s suicide rate.

Where is the Governor on this issue? Where are Montana Democrats? Maybe the guy Democrats finally found to oppose Tim Fox–Larry Jent–can make this an issue, that is of course assuming Jent isn’t just some cutout candidate who filed 5 hours before the deadline in order to pretend that Democrats are going to actually run against the MEA-MFT backed Fox.

Yeah, I’m not holding my breath.

Sometimes I imagine the possibilities of having leaders with vision, people who can see the potential of what full legalization of cannabis could do for this state. Unfortunately it appears our political leaders don’t support creating new small businesses, reducing jail overcrowding, saving taxpayer money and creating new streams of tax revenue that directly divert’s money away from the criminal black market.

We need resources to increase access to mental health treatment in this state. What we are doing right now in Montana isn’t working. I hope we hear some specifics in the upcoming months about how the candidates who want to lead this state plan on dealing with this crisis.