88. Montana Medicine: Behavioral Health, Bottlenecks & Big Sky Policy

In this episode, we dive into the complicated and often chaotic state of healthcare delivery in Montana—with a whiny farmer intro and a serious question: why don’t we have corn ice cream in the Midwest? From emergency departments overwhelmed due to a lack of psychiatric beds, to the legislative push for expanded forensic capacity at Warm Springs, Montana's behavioral health system is under strain. We unpack the data, discuss what "community benefit" really means for rural hospitals, and explore the persistent turnover among hospital leadership in states like Montana and Nebraska. Plus, we close with a policy debate that’s been brewing since 2019: should a retirement community in Cowsbell be allowed to serve wine on the lawn during summer concerts? Buckle up—Big Sky country’s healthcare challenges and quirks are as wide-ranging as the state itself.

In this episode, you will be able to:

• Understand the key challenges in the behavioral health system and how to address them effectively.
• Gain valuable insights from a rural mental health conference, uncovering new perspectives and innovative approaches.
• Explore the significant impact of remote and frontier healthcare on patient outcomes and community well-being.
• Learn about the unique challenges and strategies for addressing substance abuse issues in rural areas.
• Discover the pivotal role of hospitals in promoting and improving community health through collaborative initiatives and innovative solutions.

The key moments in this episode are:
00:00:02 - Introducing the Stepping In It Podcast
00:00:15 - Challenges in Accessing Behavioral Health
00:01:30 - Differences in Accessing Behavioral Health
00:05:31 - State Institution Challenges
00:10:17 - Doom and Gloom in Montana
00:12:07 - Lack of Connectivity in Rural Areas
00:13:16 - Substance Use in Montana
00:15:42 - Mental Health Redesign and Community Benefit
00:17:45 - Data and State Hospital Issues
00:22:30 - CCBHC Legislation and 988 Awareness
00:24:41 - Issues with House Bill 491
00:25:27 - Challenges with current liquor laws
00:26:48 - Conflict of interest with the Tavern Association
00:27:07 - Recovering from travel challenges
00:28:53 - Potential impact of federal changes

Links:

• https://dailymontanan.com/2025/02/01/montana-eyes-30m-revamp-of-mental-health-developmental-disabilities-facilities/
• https://kffhealthnews.org/news/article/troubled-montana-state-hospital-slow-overhaul-legislative-limbo/
• https://www.tac.org/reports_publications/state-psychiatric-hospital-beds/?utm_source=chatgpt.com 

Connect with us: 

https://ruralpolicypartners.com/ 

https://www.linkedin.com/linkedin.com/company/rural-policy-partners/ 

https://www.facebook.com/facebook.com/ruralpolicypartners

https://www.youtube.com/@ruralpolicypartners

Watch this episode on YouTube: https://youtu.be/pM8QPMRJfWQ