Examining Montana's struggle with mental health care

Some of the same things that make Montana a great place to live – its outdoor life, the stoic independence of its residents, and its rich American Indian culture -- also make it a tough place to get sick.

Montana is a vast, frontier state with many small towns scattered in rural counties. A few of those counties don’t have a single doctor or even a pharmacy. A heart attack on a remote ranch could require a two-hour ambulance ride to the nearest hospital. And, it’s not unusual for residents to make the occasional 500-mile roundtrip to see their family doctor.

But, for Montanans suffering with mental health issues, those distances can be especially devastating.

Compounding the problem is the state’s severe shortage of psychiatrists. Even if you could get to a city to see a psychiatrist, the wait for a new patient could be nine months to a year.

With the National Health Journalism Fellowship grant, The Billings Gazette will examine the impact of that shortage on Montanans.

Montana has a unique population. More than seven percent of the state’s population are American Indians living on seven rural reservations where poverty, unemployment, alcoholism, violence and the suicide rate are epidemic.

Those reservations are served by the federal Indian Heath Services, which is chronically underfunded, understaffed and overwhelmed.

Montana is also highest in the nation in percentage of military veterans, another chronically underserved population.

In Helena, the state capital, an acute psychiatric wing added recently to the state veterans hospital remains empty because officials there have been unable to recruit psychiatrists.

The Gazette recently featured the hospital’s troubles and several veterans suffering from PTSD who were forced to travel out of state, at great expense and far from their families, to get treatment. Those reports lead to the hospital’s director being forced from her post.

Our NHJF-assisted reporting will examine how the state and the mentally ill here are coping. We’ll look at innovations such as tele-medicine, and efforts to recruit psychiatrists and other trained mental health professionals to the state.