Editor's note: You can find Part 1 of this series on Catalyst for Change here.
Mental health problems continue to squeeze the life out of Montana.
According to the most recent CDC data in 2022, the state had the highest suicide rate of any in the country: 28.7 deaths per 100,000 people. It's affecting even the most innocent: Montana’s children. But it’s not hopeless.
Catalyst for Change is a nonprofit prioritizing mental health help in rural communities. It started in Sweet Grass County and expanded to Wheatland County, with incredible success in both. Now, it’s coming to Musselshell County.
"It’s been a hole that we haven’t known how to fill for years," said Musselshell County Attorney Adam Larsen.
Larsen sees his community’s struggles on a daily basis, especially in children.
"I have experiences with youth that end up in the criminal justice system because they have serious mental health issues that aren't being treated in the community, but also aren't severe enough to justify putting them in a psychiatric hospital," Larsen said. "So a youth who really just needs a hands-on counselor to help and guide them through this process gets shuffled off to a detention center instead, which is atrocious."
Several cases have progressed to the worst outcome: suicide.
"In Roundup, if a child takes their life, the whole community is affected," he said. "If we can prevent even one of those, it’s worth every dollar we spend on it."
Catalyst for Change began with a pilot program in Sweet Grass County in 2019, with a focus on helping the town’s teenagers: bringing telehealth therapy appointments directly into the schools.
"Asking a kid and/or a parent to do weekly therapy appointments an hour away is unrealistic," said Catalyst founder Amber Martinsen-Blake. "It's going to hurt the family financially and hurt the kid academically. So we brought telehealth in, set up a room that was discrete and private. They’d do their appointment and go back to class."
Before Catalyst began, nearly one in five Sweet Grass County high school students had attempted suicide, according to the 2017 Youth Risk Behavior survey. That number was down to just 8.5 percent in the most recent poll, even as the statewide average rose from 9.5 to 15 percent over the same time period.
"I believe this is the first year where stats in Big Timber are better than the statewide stats," she said.
The numbers are also worth celebrating in Wheatland County, Catalyst’s second home. Across the board, suicidal thoughts, plans and attempts are all way down in just four years. Local community health supervisor Briana Dolbear has noticed one other huge trend.
"The big thing I’ve noticed is kids have removed the stigma," she said. "Now they're saying, 'Hey, I’m going to my therapy appointment!'"
"I like to think that's because of Catalyst," Martinsen-Blake added.
Catalyst for Change wants to expand, but that takes money. Roundup’s guardian angel is the Jody Alise Foundation, which is paying all the program’s costs for the first year. It will include bringing the telehealth program into the Roundup schools and hiring a community health worker to facilitate help to the county as a whole.
"As a government entity, we can’t spend money on a problem until we can prove we have a good solution to that problem," Larsen said. "We hear from Sweet Grass and Wheatland all of their praise for Catalyst, with statistics to back it all up.
"We're given essentially a free year now where we can look at that data ourselves and see if this program works. If it does, we can go to the taxpayers and say, ‘Look at the benefit this has on our children and the youth in our community.'"
Mental health services are generally as sparse as the population in rural Montana towns. There isn’t believed to be a single full-time therapist living in Roundup, which means a lot falls on school counselors who are nowhere near equipped.
"They're inundated and overwhelmed," Larsen said. "All day long they have youth coming to them with these weighty, severe issues and (they) don't really have the ability to take care of them. A school counselor is really more expected to be a guidance counselor - to help you figure out what career you want to pursue - not to help you deal with abuse or trauma at home, or friend or relationship situations."
"They're doing the work psychiatrists should be doing," Martinsen-Blake added.
Dolbear, who grew up in rural Garfield County, knows the help is needed.
"I like to say a community is only as healthy as its sickest members," she said. "The farther (Catalyst for Change) expands, I’m always excited."
Because for so many places, change is necessary.
