Montana shelters discuss need for behavioral health services

Posted at 9:47 PM, Mar 28, 2024

HELENA — Leaders from shelters around Montana say they’re seeing more demand than ever for their services – and that’s showing a need for behavioral health services as well.

The state’s Behavioral Health System for Future Generations Commission has been meeting across Montana since last summer, looking at how leaders can invest millions of dollars in state funding to strengthen these services. On Thursday, at a meeting in Havre, they brought together a panel of shelter directors and staff, to talk about how their work on homelessness connects with these issues.

Leaders said the demand for shelter services has spiked dramatically, particularly in the last few years.

“These percentage increases are unprecedented,” said Chris Krager, executive director of Samaritan House in Kalispell.

The Montana Coalition to Solve Homelessness – which includes shelters, health care providers and faith leaders – shared data demonstrating that spike. They said the number of people needing shelters in Kalispell, Butte, Helena, Great Falls and Bozeman grew between 46% and 218% from 2020 to 2022.

Sam Forstag, representing the coalition, said at least 30% of the people shelters serve report mental health or substance use issues. However, he said the data on homelessness is far from perfect, and it isn’t giving the whole picture. He said people who’ve conducted surveys find many people who don’t report they’re dealing with those issues also report behavior that suggests they are.

“I think any shelter provider would tell you that that number of 30% experiencing mental illness or substance use disorder is almost certainly an undercount,” Forstag said.

Several shelters say they work to connect the people they serve with case managers, peer support workers and other specialists, to help them get the support and resources they need to stabilize their situations. However, they’re often already under a lot of pressure.

Vanessa Bond, representing Montana Rescue Mission in Billings, said she first came to the mission after becoming homeless in 2021. She said she benefited from the services they offered – but it wasn’t easy to access them.

“Because the shelter had over 100 guests and only one therapist, one case manager and one peer support specialist, it took two weeks after my arrival for me to be connected with those services, and I was only able to see them every two weeks after that due to the high demand for services,” she said.

The commission is tasked with making recommendations on how to spend $225 million the 2023 Montana Legislature set aside to support behavioral health services.

Forstag said the coalition made a proposal to the commission, to invest $9.5 million over three years to help hire more than 30 case managers, peer support workers, housing support specialists and mental health clinicians. The money would also support the space needed to provide these services on-site at shelters or at centralized locations.

“To meet people where they're at, so that when somebody becomes ready to receive those sorts of services, we're not telling them to wait a few weeks, we're not having to get them bus tickets or set up transportation that might pull from other shelter services,” said Forstag.

The goal would be to use the money to address startup costs, training and other initial needs, then get the programs ready to keep going into the future – especially as they’re expected to be eligible for Medicaid reimbursement soon. Forstag said the proposal is still in its early stages.

The commission will meet for a second day in Havre on Friday. They’ll hear from panels discussing workforce planning, and they’ll consider possible initiatives for children’s mental health and caregivers.