Reimbursement rate cuts by the Montana Department of Health and Human Services at the direction of Goveror Steve Bullock are causing significant losses in the number of mental health case managers across Montana. Psychiatric Nurse Practitioner Kay Jennings runs the Winds of Change Mental Health Center in Missoula and says she knows of around 45 job cuts in the Missoula-area alone. She believes the loss of these case managers will lead to more homelessness, crime and suicide in Montana.

"We take care of their money for them so they don't overspend it, so we keep them from homelessness,' Jennings said. "We keep them seeing their psychiatrist or therapist to get them their medications so that they don't end up doing something erratic, if you have something like bi-polar or schizophrenia.  With depression and suicidality: those populations are really at risk and I think we're going to see a trickled-down effect from the elimination of many, many case managers in Montana."

Jennings runs five group homes in Missoula for those transitioning out of the state hospital and back into daily life and work. She says the average stay is over 260 days but that a current proposal would slash that.

"The state is talking about cutting that back to 120 days," Jennings said. "I mean, the homelessness problem is just going to get worse. If you have a person that has a psychiatric illness that has a family or children ... if you have a sick parent, it's going to affect those children. The institutions are full and over-bedded, the jails are full, everything is full: These cuts will be felt by all of society."

Even without cuts in case management and group home stays, Montana regularly has one of the highest rates of suicide in the nation. Early numbers aren’t promising for 2018. Dr. Will Stratford of Missoula says he knows of 11 suicides that occurred during just one week so far this year.

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