Mental illness and substance use disorders are common, serious problems in Montana. “Behavioral health” is a term that is commonly used to describe this spectrum of illnesses and the fields of healthcare that address them. In surveys of health needs carried out by Montana’s local health departments and hospitals, these issues rank as the most important health challenges in many Montana communities. In 2014, Montana had the highest suicide rate in the United States for all age groups, and Montana has been among the five states with the highest suicide rates in the nation for more than 40 years. The suicide rate is only a starting point for understanding the behavioral health challenges in Montana.
Among Montana youth, more than 29 percent report symptoms consistent with depression, and 23.5 percent of high school students report binge drinking within the past month. A recent national survey examined the prevalence of behavioral health problems and corresponding access, or lack thereof, to services for treatment in each U.S. state: Montana ranked 44th worst overall and 49th for youth.
In 2017, MHCF is announcing an intensified focus on substance misuse and substance use disorders (SUD) within our behavioral health focus area. By one estimate, 93 percent of Montanans with a substance use disorder are not receiving treatment. Among Montana adults, 20.4 percent report having been diagnosed with depression; nearly 19 percent report binge drinking in the past 30 days; almost 25 percent report illicit drug use in the past month; and Montana is consistently ranked in the top 10 states in terms of risk factors for alcohol use for 18- to 25-year-olds. Substance use disorders also account for a growing burden on social service and criminal justice agencies. The number of Montana children in foster care has more than doubled since 2011, and out of more than 3,200 children now in foster care, 64 percent were removed from the home for reasons related to substance misuse. Between 2009 and 2015, Montana experienced a 62 percent increase in arrests for drug offenses; the Montana Highway Patrol reports that the number of felony drug interdictions they initiated increased from 92 in 2013 to 292 in 2015; and the Montana Department of Justice’s Division of Criminal Investigation reports a 240 percent increase from 2010 to 2015 in the number of drug cases they handled involving methamphetamine.
A serious shortage of treatment for Montanans struggling with behavioral health disorders complicates the problem. Only twenty-five percent of Montana’s mental health professional needs are met, placing us in the bottom five of all states; ten Montana counties have no state-approved substance use treatment program; and, Montana’s substance use treatment system meets only roughly one third of the estimated need for medication-assisted therapy.
Other important behavioral health challenges include:
- Exposure to adverse childhood experiences (ACEs). Montana ranks among the top three states nationally for exposure to ACEs. Research shows that ACEs increase the risk of health and social problems later in life.
- High rates of behavioral health disorders in the criminal justice system.
- Fragmentation of the system of care for people with co-occurring mental illness, substance use disorders, and/or chronic medical illnesses.
- Meeting the behavioral health needs of veterans. Montana has the nation’s second highest per capita population of veterans. Returning veterans are at high risk for traumatic brain injuries, post-traumatic stress disorder, suicide, and other behavioral health issues.
Through making grants, conducting research, convening stakeholders, and providing technical expertise and leadership, MHCF supports collaborative, systems-based solutions to behavioral health challenges in Montana. We emphasize interventions that are likely to become financially self-supporting through establishing third-party revenue (i.e., billing insurance), creating new partnerships between organizations, and using existing resources more efficiently and effectively.