As the pandemic closed down schools in 2020, Tracy Jacobson’s daughter, like many kids, started to struggle with mental health.
“That was probably the beginning of the significant mental illness for Jayden,” Jacobson says.
Jacobson says she didn’t know how much her daughter was struggling until Jayden told her she was having thoughts of harming herself. Jacobson, who lives in Big Sky, immediately sought out a psychiatrist in nearby Bozeman. That kind of outpatient therapy wasn’t enough.
A year later, Jacobson got the call no parent wants to receive. Jayden, who was 14 at the time, had attempted suicide.
Doctors in the Bozeman ER were able to help Jayden physically recover but finding a mental-health provider was difficult.
“I recall being in the hospital in Bozeman numerous times upward of 10 days because they couldn’t find an in-residential bed for Jayden anywhere,” Jacobson says.
Jacobson has been through this cycle several times. She’s sent Jayden to residential psychiatric facilities in Utah, California, Colorado and Arizona.
There are two such providers in Montana, but beds are often full. One of them is Yellowstone Boys and Girls Ranch. CEO Mike Chavers says the youth mental health crisis sparked during the pandemic hasn’t slowed down.
“We're averaging about 150 referrals a month,” Chavers says.
That’s more than double what his team received prior to 2020.
“We can serve somewhere between 15 and 20 of those kids,” he says.
Kirsten Smith with the Gallatin County Behavioral Health Coalition is working to change that.
“I had seen an article about this place being for sale but had no idea what it was,” Smith says.
She’s standing on a 30-acre ranch outside of Bozeman with views of the Bridger Mountains. The property will be the home of Lighthouse Ranch.
Smith has been working with the county, state and local nonprofits to start the program.
Yellowstone Boys and Girls Ranch will staff the facility to provide a range of psychiatric services, from outpatient therapy to long-term residential treatment for kids around the state.
Smith says the property was a perfect fit for the project.
“This was built as a school for troubled youth.”
It already has a gym, a commercial kitchen and some housing for kids and staff. Smith says many of the structures need remodeling and more buildings will be constructed.
Stepping inside, she points to a model complete with tiny trees and buildings.
“The brown ones are existing structure. The sort of clearish ones, those are new structure. Some of this is really planned, and some of it will get a lot more detailed,” she says.
Smith has raised nearly two-thirds of the $8.5 million needed to start remodeling.
Later this year, Chavers’ team will start providing day services and outpatient therapy for local kids.
Eventually, Lighthouse Ranch will provide schooling for residential patients and local kids who struggle to stay in local classrooms because of behaviors tied to a disability or mental health diagnosis.
Chavers says the facility will also start a program for short term crisis care that will take kids who would otherwise wait in hospitals.
“Those families need some support, and we need to get a good psychological and psychiatric assessment to say, how do we put the supports together to keep that child back in their family and community?”
That would be the first time that kind of care is formally offered in Montana.
It could be a year or more before residential care begins. Chavers says that can’t start soon enough.
“Today, we're serving more kids in the state of Montana than we ever had before, which is great news. But we're also at the same time sending more kids out of state than we ever have before.”
State lawmakers and health officials have put funding toward opening more psychiatric beds for kids, but it’s unclear whether that will be enough to meet demand.
The state health department plans to spend $1.2 million to open up 20 more residential psychiatric beds for kids. Money from the state’s $300 million mental-health fund is also flowing to providers to increase capacity.
Long term, the state is reworking Medicaid payments for providers in the hopes they will open more beds.
Since the pandemic, about 280 kids on Medicaid go out of state each year. More children with private insurance are in the same boat.
Lighthouse Ranch will start with 10 residential beds. It could take a decade to get the 200 staff needed to serve 60 kids at a time.
Angella Kimball is with Inseparable, a think tank that advocates for mental-health policy reform. She says Montana isn’t alone.
“In most states there is a lack of capacity to meet the demand”
Families have sued states like Colorado for sending too many children out of state for residential psychiatric care. They argue that violates Medicaid requirements to provide care in-state.
Kimball says increasing Medicaid payments for providers is one way to increase bed space.
Montana is currently reworking how it pays providers.
Kimball says states should pass laws requiring private insurance companies to cover residential psychiatric care. Funding is also needed to develop a supply of qualified workers.
Even with those efforts, Kimball says states will likely continue to struggle to meet demand.
“So it's not just that there are more kids with mental health problems, but the severity of those mental health problems is increasing,” she says.
Jacobson knows it will be an uphill battle to tackle this crisis in Montana.
After multiple rounds of treatment, her daughter Jayden, who’s now 19, is doing well. She even has a job at her former school.
“It is such a relief to know suicide attempt is not right around the corner, at least for now,” Jacobson says.
Jacobson has become a Lighthouse Ranch board member. She hopes the facility will prevent another Montana family from sending their child thousands of miles away to get lifesaving care.
