Seeing the Faces of Mountains and Minds

By A. C. Johnson

Promoting Mindfulness in Montana

Montana citizens don’t have access to the mental care they deserve

From the back porch of the Hope House, one has the opportunity to watch the sunrise every morning. Some days it comes like the slow painting of a tangerine sun, gracefully planting pinkish wildflowers across the clouds as snowy hills cling to calmer colors. On other days it’s gray and cold, hiding any and all warmth. I have lived in Bozeman for four years, and in this past year, I’ve served as a crisis stabilization worker at the Hope House: Western Montana Mental Health Center’s Bozeman facility. The number of times I've looked out at colorful mountain faces, only to look back to the tired, cold eyes of another human being—trying to comprehend why they can’t find the right help—is enough to question the beauty of a sunrise. 

The function of the Hope House is to provide a place where those considering suicide can find mental stabilization during a time of crisis. This includes supplying immediate needs, such as shelter, food, clothes, a person to talk to, medication services, and assistance in finding community resources. What it doesn’t do is serve as a long-term treatment facility. The average stay is four days, and the services provided are designed to be stepping-stones before continuing to other long-term solutions. One of the valuable resources we provide is “mindfulness training,” where a crisis stabilization worker—like myself—sits down with clients and instructs various ways to practice meditation, journaling, future planning, environmental awareness, and mood-stabilization skills. Mindfulness is one of the most important practices during a time of crisis; often, it’s the exaggeration or overlooking of relevant details that prompts someone to believe their situation is less manageable than it is. This serves as a great short-term remedy, but with Montana's current lack of mental health resources, many are still unable to find complete recovery.

According to the National Alliance on Mental Illness in 2021, Montanans were 7 times more likely to be forced out-of-network for mental health care, compared to primary health care: requiring many to drive across states to get the help their loved ones—or they, themselves—needed. Forty-seven thousand adults in Montana didn’t receive much-needed mental health care, and 48.6% of that population reported cost as the reason. More than half of Montana's population—573,811 people—live in communities that lack mental health professionals. One in 20 people in the U.S. experience a severe mental illness, with 44,000 of those people being Montanans. Montana Moves and Montana Meals reported that additional factors are also contributing to mental health struggles in Montana: the social isolation promoted by its geography, a culture of commonplace alcohol use, and the high value placed on ideas of self-sufficiency and independence. This last dynamic forms cultural expectations of being able to take care of yourself, and not requiring assistance for any issues surrounding personal well-being. 

Montana's current lack of mental health care resources doesn’t allow for a diversity of treatment options, which inevitably causes people—those who desperately need assistance but don't benefit from the specific care available—to be readmitted into static, ineffective programs. The clients I work with frequently struggle to find services for individuals under 18, addiction counseling, and homelessness. Without these resources, they continuously relapse into harmful behaviors, and are often imprisoned because of the danger they pose to themselves or society. According to NAMI, about 2 in 5 adults in jail or prison have a history of mental illness, and about 7 in 10 youths in the juvenile justice system suffer a mental health condition. Thus, providing more mental health services offers a path closer to lowering the number of people engaged in dangerous or illegal behaviors, as well as towards fighting stigmas about those with mental health issues being the “rejects” of society.