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Why are Health-Service Providers Treated with Lesser Value?

Our foundation as a community-based mental health center has been crumbling for years

By Jodi Daly

Western Montana Mental Health Center (WMMHC) is a community-based mental health and substance use disorder treatment center. We assist over 15,000 individuals, employ over 750 staff in 16 western Montana communities and operate a budget of over $40 million. Our economic and human impact is far reaching. Community mental health centers are a well-kept secret, quietly going about our business as we offer the vast array of comprehensive safety-net services that impact the social, health and economics of the communities we serve.

Our mission drives us to provide the safety net functions that communities have begun to take for granted, e.g., mobile crisis teams, crisis stabilization centers, drop-in programs, case management, substance abuse services, jail diversion and programming within jails, just to name a few. It is important that communities realize that much of what they have taken for granted, the very underpinnings of the safety net, is under extreme stress and threat with the impending proposed cuts to the state budget.

It also is a fact that our state mental health system is extremely fractured and disorganized. Besides our comprehensive services there are numerous other providers who offer one or two services, with no entity clearly responsible. A lack of policy and unclear statutes lead to a lack of quality and fiscal control, not to mention confusion on the part of consumers of services and communities that need and expect the services. If no one is responsible, how do communities go about aligning policy and programs in a way that deliver the outcomes they expect and deserve?

While WMMHC understands that our state is experiencing trying fiscal times and we are willing to share in absorbing a portion of the fiscal burden, it is our expectation that our partner, the state of Montana, should want to sit with us, sleeves rolled up, to work together to find solutions. We do not want to be left alone to shoulder the burden of those cuts that will affect one of our most vulnerable populations.

Our foundation as a community-based mental health center has been crumbling for years. A lack of leadership and policy development has left us and the people we serve in a very untenable situation. This latest crisis in regards to cuts could decimate services completely. Repealing or eliminating services without a plan is at the worst unethical and dangerous and at a minimum short-sighted and misinformed. WMMHC is already experiencing unintentional consequences as politics plays out in regard to who is wrong and who is right. Staff is concerned about the proposed changes and wonder what the cuts may mean to them and the individuals they serve. Some are looking for work in more secure fields as we face an already insurmountable work force shortage. Additionally, WMMHC is continuing to provide services to women and children who are trying desperately to recover from addictions with no contract renewal in place. How many businesses would be expected to engage in this type of relationship? A construction business would discontinue their work in spite of the road not being completed. Why are providers of health services treated with lesser value?

Treatment located close to home near a natural support system is more humane and less costly. WMMHC has worked hard to develop and finance a range of approaches to serve people at the right time, in the right place. Access to hope and better outcomes while treating people in the least restrictive setting is why we exist. We have invested in training for our exceptional staff to follow best practices. However, transformation takes collaboration, government engagement and persistence. It includes the willingness of government to change policy, funding and actions.

We implore our state to bring stakeholders to the table to develop a vision for behavioral health, to plan policies and services that make more sense financially and for the health of those we serve. We are anxious to get beyond the distrust.

Jodi Daly
Missoula