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Report: state hospital discharging patients to homeless shelters

A sign pointing to the entrances of the Montana State Hospital in Warm Springs, MT.
Courtesy Montana State Hospital
Montana State Hospital
A sign pointing to the entrances of the Montana State Hospital in Warm Springs, MT.

The state’s psychiatric hospital for adults has been discharging patients to homeless shelters with no plan for care and sometimes without medications, according to a report from a designated watchdog group.

Disability Rights Montana’s report found multiple
instances of state hospital patients being discharged straight to homeless shelters, which the organizations says aren’t equipped to care for recent psychiatric patients who often need ongoing care or prescriptions.

Executive Director Bernie Franks-Ongoy says discharge documents reviewed by Disability Rights Montana suggest the practice of discharging patients to homeless shelters is widespread.

“There’s a line on these documents that say ‘discharge where?’ And there’s choices. One is ‘personal residence’, ‘hotel’, ‘homeless shelter’. It’s enough of a practice that it’s on the form,” Franks-Ongoy said.

Disability Rights Montana is the federally designated civil rights organization for Montanans with a disability.

“When a patient no longer meets the legal and medical criteria required to remain hospitalized at the facility, the Department cannot keep them in its custody,” said Montana Department of Public Health and Human Services spokesperson Jon Ebelt in an emailed statement.

Ebelt said patients can end up in homeless shelters because there is nowhere else to go due to a lack of community resources. He said the state health department is working to improve discharge planning.

Franks-Ongoy said Disability Rights is still looking into how the hospital defines criteria for discharge.

“There didn’t seem to be a rhyme or reason why Joe, Susie and Mary were discharged but other folks weren’t discharged,” Franks-Ongoy said.

Several homeless shelters in Disability Rights Montana’s report and others contacted MTPR said the state hospital has been “cold dropping” patients at their doors for years.

Brayton Erickson with Butte Rescue Mission said his organization sees patients discharged to their doors up to four times a month, sometimes with nothing more than a t-shirt during the cold winter months.

“They just have a sheet of paper and they’re like ‘this is who I am and these are the meds I’m supposed to be taking, can you help me?’” Erickson said.

Ericson says shelters are unable to house some patients because of violent behavior. He says that forces them back onto the streets.

“They wind up back in jail essentially,” Erickson said, adding that that often means a trip back to the state hospital

Butte Rescue Mission and other shelters say they have repeatedly asked the state hospital to stop discharging patients to their facilities.

Franks-Ongoy hopes Disability Rights’ report will push the state to end the practice of discharging patients to shelters.

She said that at least two patients documented in the report attempted suicide soon after being discharged to shelters and one patient jumped to his death from a building in Portland days after disappearing from the shelter he was discharged to in Montana.

“That should never, ever happen. He wasn’t ready to be discharged,” Franks-Ongoy said.

Franks-Ongoy said her organization is willing to take the state to court over these cases if the state hospital’s discharge practices don’t improve.

Updated: December 11, 2022 at 4:33 PM MST
Due to a misstatement from Disability Rights Montana, this story has been updated with details about documented discharges outlined in their report.

Aaron graduated from the University of Minnesota School of Journalism in 2015 after interning at Minnesota Public Radio. He landed his first reporting gig in Wrangell, Alaska where he enjoyed the remote Alaskan lifestyle and eventually moved back to the road system as the KBBI News Director in Homer, Alaska. He joined the MTPR team in 2019. Aaron now reports on all things in northwest Montana and statewide health care.
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