When budget cuts led Western Montana Mental Health Center to start curtailing its services five years ago, rural communities primarily felt the effect. But as the decline of one of the state’s largest mental health providers has continued, it’s left a vacuum in behavioral health care.
It started in places like Livingston, a town of 8,300 where, in 2018, Western closed an outpatient treatment clinic and told more than 100 patients to travel 30 miles over a mountain pass to Bozeman for stabilizing mental health care. This spring, Western closed that clinic too, a crisis center in one of Montana’s fastest-growing cities.
The private nonprofit’s initial closures were attributed to state Medicaid cuts made in 2017. Since then, Western’s financial troubles have spiraled. It cut jobs or retrenched services every year since 2019. In February, Western closed three mental health crisis centers, leaving just two others to serve the rural 147,000-square-mile state.
Western’s money problems have built slowly and are due largely to low reimbursement rates from Medicaid, staffing strains, and rising costs. Former Western board members and employees say poor management has also played a role. The company has said it is losing money by subsidizing crisis services for the state.
“We’ve become the face of the failure of the system because we’re the only organization providing these services,” said Levi Anderson, Western’s CEO.
The decline illustrates a national problem: a U.S. health care system that doesn’t adequately pay for mental health care. Clinics nationwide have shuttered programs they can’t afford and left …
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