For over two years, up to 60 mentally ill patients with criminal backgrounds were shoehorned into a secure wing of Montana State Hospital meant for only 32 people. The overcrowding stressed both clients and staff to near breaking points.
These patients are committed to our care by the courts. We are responsible for and dedicated to providing them therapies that will help them succeed when they move back into community settings. But with the severe overcrowding, our focus by necessity became simply keeping the patients and our staff safe. The therapeutic environment our patients needed and deserved suffered.
The Legislature knew all about the crisis. We told them about it throughout the 2015 legislative session. Gov. Bullock highlighted it — and called on the Legislature to help him fix it — in his State of the State address.
We presented the Legislature with a comprehensive plan to address the mental health needs of people in our state; everything from funding for community settings to an expansion at Warm Springs so we could more safely serve the criminally committed. However, the Legislature failed to pass a bill that would have funded infrastructure projects throughout the state, including investments in the infrastructure necessary to solve the overcrowding at the hospital.
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We’ve all read about the thousands of jobs that the Legislature failed to deliver — and the roads and sewer systems and other public investments that would have come had the bill passed. Few knew it would have also invested in a safer and more therapeutic environment at the state hospital. Many people were upset when the infrastructure bill failed on the last day of the session because of partisan politics. I was devastated. This was our chance to help Montanans in need and protect the hospital’s workers.
And while the legislative body failed to fund construction of a building to address the census problem, they did authorize $4 million per year to staff and operate one. So we were left with staffing and funding for more space, but not the space itself.
Months after the session, we found a solution. A mere few miles from the state hospital, a private and secure facility in the town of Galen was available for lease. The Forensic Mental Health Treatment Facility can hold up to 54 patients securely. Each patient has their own bedroom. The layout gives us the opportunity to separate male from female patients, something that was not possible at the state hospital in Warm Springs. The grounds are secure, so patients can walk outside or get exercise. The proximity to the state hospital allows us to share administrative staff between the two facilities, which saves money.
Best of all, it alleviates the dangerous overcrowding problem and creates a better therapeutic environment in both facilities. Patients need to feel safe in order to receive treatment, but when you’re living in a crowded environment, it naturally creates a level of irritability. The safety and security this facility provides will positively impact our ability to treat these patients.
Leasing a facility was not our first choice. But when construction of state-owned beds was denied by the Legislature, leasing became our only option. This was a creative approach that my coworkers in the Bullock administration developed and implemented to solve a very real crisis.
Together, we all came up with a solution that is good for the patients, good for the staff who care for those patients, and good for the communities that send their patients to the hospital for the acute care they need. And in the end, all politics aside, that is what truly matters.