Lawmaker on state's suicide stats: 'What we're doing isn't good enough obviously'

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Montana’s suicide epidemic is getting some attention in the state Capitol, with at least two bills aimed at better understanding the complex issue and helping suicidal children.

The number of people killing themselves is so consistently high that mental-health leaders have called it a public health crisis.

“We just keep having suicides all across the state,” said Rep. Jenny Eck, D-Helena. “This is a real issue affecting our communities. What we’re doing isn’t good enough, obviously.”

During 2010, at least 227 Montanans killed themselves. In 2011, the number dropped slightly to 225, although Montanans kill themselves with greater frequency than residents of every other state. An estimated 15 Montanans attempt suicide every day.

Against this backdrop, Rep. Rob Cook, R-Conrad, has introduced House Bill 583, which would create the Montana Suicide Review Team. The team would be composed of professionals such as a psychiatrist, psychologist, county coroner, nurse and clinical social worker. The team would study the incidence and causes of suicide in Montana and make recommendations for community or statewide change.

The Montana Department of Public Health and Human Services, the umbrella organization for the state’s suicide prevention coordinator, is not taking a position on the legislation but is “monitoring” it.

Montana’s chapter of the National Alliance on Mental Illness supports the legislation, saying it recognizes that suicide is a public health crisis in the state. Stopping future suicides demands an in-depth, multidisciplinary approach, said Matt Kuntz, executive director of NAMI-Montana.

“Cook’s legislation will ensure that we have all hands on deck — and it’s more than time for that to happen,” Kuntz said.

The team’s activities would be paid for with a $65,000 appropriation from the general fund in each year of the biennium beginning July 1 this year.

Cook was not available for comment Tuesday.

Eck has drafted legislation, which is awaiting a bill number, designed to help provide safe and effective care for children experiencing a mental health crisis. It would create a funding source for children who are not actively a threat to themselves or others, but are too deeply in crisis to safely return home.

It will help provide care to suicidal children who were taken to the emergency room, Eck said. After a few hours, when the imminent threat of danger may have passed, they may still be experiencing severe symptoms of mental illness but their parents are ill-equipped to cope with them. In many cases, the child is either sent home or sent to a psychiatric treatment center where the care is more intensive and expensive than may be necessary, Eck said.

In state fiscal year 2010, at least 421 clients received psychiatric residential treatment facility services. The number of clients dipped in fiscal year 2011 to 374, and rose to 443 clients in fiscal year 2012, according to the Children’s Mental Health Bureau within the Department of Public Health and Human Services. The total expense for the psychiatric treatment facility services was $13.1 million in fiscal year 2010, $13.05 million in fiscal year 2011, and $14.01 million in fiscal year 2012. So, total expenses increased by 7.4 percent or nearly $1 million.

The average stay at Pine Hills Youth Correctional Facility in Miles City during fiscal year 2012 was 219 days at an average cost per day of $333. The average cost of a stay was $73,000. Pine Hills is a 120-bed facility for juvenile males ages 10 through 17.

The Montana Mental Health Trust awarded the Children’s Mental Health Bureau $850,000 to distribute to providers and communities as grants to help communities develop crisis diversion programs across the state. Six proposals were reviewed in February; four grants are scheduled to be awarded this month. Bonnie Adee, chief of the bureau said it’s too early to speculate on how Eck’s legislation might fit in.

Eck’s legislation calls for $300,000 for the biennium, or $150,000 per year, to help place suicidal children in youth homes or with highly trained foster homes near their families, schools and community. Those ties are essential to the child’s long-term recovery and well-being, Eck said.

If Eck's legislation were to pass, the Children’s Mental Health Bureau estimates the average stay would be three days and cost $600. The $300,000 would pay for 500 average stays.

“That is 500 opportunities to prevent suicide in Montana, 500 opportunities to prevent broader tragedies,” Eck said.

Eck’s legislation also has the support of NAMI Montana. Kuntz said the program is patterned after a similar program for adults, which has a proven track record of keeping people safe in their communities and preventing unnecessary hospitalizations.

“We believe that it will help many Montana children who are in the midst of a mental-health crisis get effective treatment in their community,” Kuntz said. “Rep. Eck’s bill lays out a program that will not only prevent tragedy, but will also likely save the state a significant amount of money through preventing unnecessary hospitalizations.”

This story originally ran in the Billings Gazette on March 13, 2013.