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.

About Travis Mateer

I'm an artist and citizen journalist living and writing in Montana. You can contact me here: willskink at yahoo dot com
This entry was posted in Uncategorized. Bookmark the permalink.

33 Responses to Montana’s Mental Health Crisis

  1. It is good that marijuana has medical uses, as from my view, recreational use lowers the IQ and causes carbohydrate abuse.

    What mental illness there is is overstated, as we all have (and should have) ups and downs and periods of depression. Getting through them naturally is the best remedy available as it forces changes in behavior and attitude. The DSM-5 ranks up there with The da Vinci Code as top-shelf fiction. Every normal reaction to the hand that life deals us is a disorder, and for every disorder, there’s a drug.

    But there is a lot of anger out there – as evidenced by Trump’s ability to stir the masses. It’s not mental illness, just anger, and for cause, as we are a sociopathic country with spooks that are constantly diddling us with fake events to keep us frightened and under control. Add to that a major economic crisis where only the wealthy got bailed out, and I’d say we’re mentally stable, just righteously angry.

    • JC says:

      This is one of the stupider comments I have seen you write. Sure, the DSM manuals have turned more into marketing than diagnostic manuals, but that doesn’t diminish the depth of the problem we have with mental health issues, rationed care, and poor outcomes.

      Mental health isn’t an issue many of us are willing to accept flippant statement about, and your statement above ranks right up there with Pogie’s incessant referrals to mental health problems in commenters he finds distasteful.

      I’d keep your misinformed opinions about mental health to yourself, as until you’ve spent some time in the trenches, you don’t have a clue about what’s really going on in our communities.

    • I agree whole heartedly with JC. you don’t know what you’re talking about here, Mark.

    • I beg to differ … I would warrant without even looking that the tragic shootings recently up there in Montaan were done by people on antidepressants or other legal drugs.

      Unless you’re positing that anger and depression are mental illness, I see most of us as normal and reacting normally to a fucked-up environment. Good grief, after 9/11 I thought I was going insane, and it was all delivered to my doorstep by a TV show. It took years to understand what had been done to me and everyone that day. But we are OK. The spooks that ran that show are the goofballs.

      And TV is reality for most people even though it is a hypnotic tool that influences their emotions and mental stability. I am at a point in my life where I am convinced that virtually all people are normal and stable, and that what we call mental illness is a normal reaction to a crazy environment. Add to that the pills, the antidepressants, that actually enhance and magnify the supposed “illness” and you have your mental health crisis. And tragic murders.

      • Rob Kailey says:

        So, you are ‘surmising’ a cause, with no evidence whatsoever, yet extreme confidence that you are correct. And you wonder why people react negatively to that? Some here have followed the evidence. You don’t seem to be one of them.

        • Most people are immune to evidence, you for instance. I plainly stated it was speculation, but given that I know most people are normal and rational and the behavior here is aberrant, there is probably an outside mitigating cause. Given what I have read about the untoward side effects of antidepressants, it is not illogical to speculate that the Montana murders can be traced back to that source. That is how people react not just to a drug, but a mixture, as psychiatrists don’t allow reasonable withdrawal time from one drug before prescribing another. It’s quite a quagmire.

          We’ll see. It will take some journalism to uncover it, and we don’t have journalists, so it will have to be via word of mouth or a leak.

        • Rob Kailey says:

          Yes, an “outside mitigating cause”, like mental illness, dumbass.

        • Highly unlikely … It has not been prevalent in history, so an upsurge now would not be due to a change in our genetic makeup. We are virtually all sane, even you. It is most likely outside causes, and this bath the American population is taking in prescription drugs is a good place to look.

          Read something sometime dumbass, rather than just reacting to media stimuli.

        • Rob Kailey says:

          Just a curiosity: The authors round this spot take Pogie to task for putting up with Larry, but y’all have no problem putting up with Tokarski who claims (essentially) that mental illness doesn’t exist. Speaking of being hypocritical or immune to evidence, why would that be?

        • Ah, you want me banned. The Democrat way. You equate me with Kralj, a passive-aggressive snarl, your specialty.

          And of course I did not say mental illness does not exist, but rather something far more sublime, that people are induced by media and PhRMA and the psychiatric profession to imagine they have mental disorders when they are merely sad, angry, or confused and enraged by agitprop. It is power of suggestion. Mental illness, which exists, is not a major problem. It is overblown. Legal and overused prescription drugs have far more to do with aberrant behavior than mental illness.

          What about you – are you on antidepressants, like half the population? You do seem to have mood swings and bouts of anger. That is a side effect.

        • Rob Kailey says:

          I just asked a question, Mark. It wasn’t even directed at you. Nor was it indicative ‘of anything I want’. It was based on observation without a preconceived notion of truth. You might try that sometime yourself.

        • JC says:

          I can’t speak for Skink here, but I don’t believe I’ve ever taken Pogie “to task for putting up with Larry”. As to allowing commenters here free reign, we haven’t banned anybody from participating.

    • By the way, this gal, Gwen Olsen, lost a niece to PhRMA, a med student who spiraled into depression and finally suicide due to prescription drugs. Sthe gal was not mentally ill. She was messed up by legal drugs. Olsen, a pharmaceutical salesperson, had a change of course and went from a lucrative sales career to that of lonely whistleblowing. Her book, Confessions of an RxDrug Pusher, has lots of inside information about the drugs being pushed right now, how they lead to the type of tragedies experienced by her niece, and I would bet the recent tragedies in Montana.,

  2. steve kelly says:

    Thanks for highlighting the medical marijuana issue. Many MM patients can’t take opioids without severe side effects.

    Cruel and unusual punishment from politicians (R’s and D’s) who keep claiming to want only the best for us all. Lying liers.

    • Greg Strandberg says:

      Where’s the concerted effort to hold the politicians accountable?

      I dunno. What would that even look like? Currently we know that Bullock’s office got inundated with calls about the medical marijuana ruling. I’m sure that’s subsided, however.

      There’s not much outcry over the suicides issue. I brought that up a few weeks back when I heard it on the radio but it never went anywhere.

      When it comes to opiates, we see how the state cracks down on doctors that are “over-prescribing.”

      This is such a good post today because we’re getting at the rot underlying society, which I feel is the real cause of the problem. I was disappointed a couple weeks ago to see the Indy sidestep the real causes of drug abuse, going with childhood trauma as the main culprit. Well, I don’t think that cuts it.

      Back to holding politicians accountable? I don’t see how that can happen with our lackluster media and our campaign season that focuses on attacking Gianforte and nothing else. On the GOP side it’s telecommuting and coal and that’s about it. There are no other issues.

      How could you make our mental health crisis an issue? Well, it should be already – why do you think the jails are full? Why that isn’t being discussed I have no idea. I did hear a few Democrats bring it up at a meeting on the day Gianforte rolled through Missoula. They call it judicial reform, which is about as ineffective a title as there ever was for getting people excited.

      Our jails are costing tax payers a lot of money and our courts are too. This is an issue voters of both parties can rally behind. If they don’t look at the cause of those jails filling up, however, the problem will continue. I’ll again get back to the rot underlying society. It’s deep, rank, and shows no signs of subsiding.

  3. JC says:

    Nice to know how the Billings Clinic, which recently bought and took over Missoula’s Community Hospital, operates. Things should really be looking up in zoo-town with a move to corporate health care from the nonprofit model Community used — not that Community was a paragon of how to provide services. But at least they were fairly competent.

    Tahini Nelson obviously has all the makings of a lawsuit on her hands, and the Clinic’s rescinding her bill is just an attempt to placate her. But hey, republicans still believe you can get health care delivery at the ER. Not that they’d ever care about a young woman’s mental health issues, but if they pay attention here they might learn something.

    And finally, if the medical marijuana debacle continues down the current path, we can add in a whole bunch more opiod pain killer users to the ranks of the state’s problems. Stupidity ranks in the halls of the MT Leg, on both sides of the isle.

  4. maverick says:

    Stupidity bankrolling a penal punishment system that protects PHARMA TURF.

  5. Big Swede says:

    Missoula is the drug capital of MT. More drugs equals more mental issues.

    Plain and simple.

    • Big Swede says:

      The National Bureau of Economic Research (NBER) reports that there is a “definite connection between mental illness and the use of addictive substances” and that mental health disorder patients are responsible for the consumption of:

      38 percent of alcohol
      44 percent of cocaine
      40 percent of cigarettes
      NBER also reports that people who have been diagnosed with a mental health disorder at some point in their lives are responsible for the consumption of:

      69 percent of alcohol
      84 percent of cocaine
      68 percent of cigarettes
      There’s clearly a connection between substance abuse and mental health disorders, and any number of combinations can develop, each with its own set of unique causes and symptoms, as well as its own appropriate intervention and Dual Diagnosis treatment methods. Which Dual Diagnosis treatment program is the best fit for your loved one?

      • Interesting in that each of your problem drugs, alcohol, cocaine and tobacco self-reinforce, or creat their own demand due to their addictive qualities. Two are legal. I don’t know that your statistics, that in mind, mean anything.,

      • Bob Williams says:

        NBER numbers from 1991 show lower percentages:

        Please offer link to your numbers. It’s probably there, i’m old and could not easily find it.
        If addict percentages doubled from 1991 to year of your percentages, Houston has a trajectory problem.
        I’m open to discussion of the subject. Got primed by The Myth of Mental Illness Thomas Szasz.
        My preference is to hear numbers from people in the field and in the real world. I usually trust the observations of JC and WS. And often LK!
        My aged bias is seeing large percentages of the population long victimised by the nicotine and alcohol suppliers that thrive on depressions personal and societal! Then came Pharma. And now our legislators bankroll privatized penal punishment systems for the protection of Pharma turf.
        (Excepting people on meth, of the people I have known with such as mental illness challenges, most did not have chemical addictions. And among us old duffers there’s plenty of ex-addicts, that were lucky enough to be mentally healthy, but got sidetracked by assorted addictions. Therefore we intentionally act, on different occasions yes, to assist and support a more sustainable living environment for people that got short changed by genetics and an oppressive//repressive society.)
        Sorry for the length. Most important trajectory would be addiction trends in USA since 2006-7 recession, for the producers, and for the wealthy, and for other classes.

        Any RD readers able to superimpose a stock growth line since 2007 for Liquor Corporations,
        on to a chart with a stock growth line for Pharmaceuticals, and share a link??

        What i’m saying is that recessions might be a hell of a lot more costly than we are lead to believe! And that’s why Mental Health programs in Montana are of more importance than you might have thought.

        • JC says:

          You two are linking to the same report. Note the operative term “connected” is used here. Not “correlated” or “causative”.

          I think that average thinking person realizes that mental illness and substance abuse can be connected. One of the reasons they are connected is that people with untreated mental illness self-medicate. And people that abuse drugs and alcohol can become mentally ill. Psychoactive drugs of all kinds can change the way the brain works in negative ways which can lead to mental illness. And mentally ill people can become addicted through self-medication.

          This is just one scenario. And lack of resources for people to get either help with mental illness or addiction exacerbates the connection between the two.

          And Bob, you ask lots of great questions, far beyond the scope of this post and comments. I think that Skink and I may delve further into this in the future. If you want to do some further reading, Gabor Mate’s “In the Realm of Hungry Ghosts” and Carl Hart’s “High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society” are good places to start. Both authors look at addiction/mental illness from different viewpoints, but both coming to conclusions that they are largely familial, societal, political and cultural problems, thus needed changes in society and growth in our culture are necessary to solve them.

          Those who choose to view addiction and mental illness as a personal failing of the individual, or a fallacy perpetrated by a nebulous “they” are just engaging in invincible ignorance.

        • Big Swede says:

          Whch is first, the chicken or the egg? Mental iIlness is defines as this.

          “Mental illness refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors.”

          Therefore as I orginally stated, ease of availability leads to more abuse.

        • “Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors…”

          I disagree – except on schizophrenia, where there seems to be real wiring problems – calling the others “mental illness” is akin to a saying a sprained ankle a “physical disability.” All of us go through periods of highs and lows, depression, happiness, anxiety, euphoria (falling in love, for instance), and that we all handle it either poorly or well, but that handling these things poorly does not make one mentally ill. It takes practice. If we go through these periods with our senses uninhibited by drugs and alcohol, and we develop key strengths.

          People don’t become strong adults unless they face and deal with trouble. Your “mental illnesses” above can all be dealt with without the psychiatric profession and their pills. Like economists, nutritionists, financial advisors, the profession is mostly corrupted, as I see it.

  6. Bob Williams says:

    JC, thankyou for a gracious and helpful response! (Perhaps one of the books would have credence with an age 40’sh friend Psychiatrist type of person?) I’m glad that Hart and Mate are viewing the complex overlap of fields, or something like that, that leads into mental illness.

    By gosh, Pharmaceutical Stocks did steadily increase from 2006-9/+. Check the ticker: $DJUSPR

    And the figures posted above about addictive substance volumes consumed by people with a treatable metal illness, was from 1991. Same 1991 study observed that about a quarter of USA could be described as having a treatable mental illness. I mention that ONLY to offset any misunderstandings from an above post about the group that alledgedly consumes 44% of USA cocaine, etc. but neglected to mention that was in 1991.

    Maybe someone check that. I’m getting sleepy.

  7. de Tocqueville in Democracy In America in the 1830s noted that the country had a drinking problem even then. This is nothing new, this “self medicating,” but again, I don’t ascribe it to mental illness. Maybe people are not the problem so much as the environment. Maybe self medication is a perfectly sane response. Or maybe people just aren’t all that great, not ill, just not like we want them to be.

    A similar conversation I had recently, the hand wringing concern, that 50% of marriages end in divorce. Again, seen as a defect in people. I take a different view: Marriage is the problem, not the people for whom it does not work.

  8. JC says:

    Something to think about:

    • Beautiful film, very touching. Thanks. I think you and I are on the same page, basically, in that what we call mental illness are merely differing forms of dissociation or alienation from the community. I’ve wondered about the Bozeman woman as I know postpartum depression can be debilitating, and wonder if rather than being hooked up with others who have experienced it to give her hope, she was fed the buffet of drugs that pass out like candy these days. Her reaction was so alien that I suspect it to be pharmacologically induced. I hope we can learn more about it.

Leave a Reply