Lawmakers Grapple with Solutions to Montana's Youth Mental Health Crisis

The bell rang once to signal members of the Montana House of Representatives to punch in their votes, and the result was a dead heat: 50 for “yes,” 50 for “no.”

That was enough to kill House Bill 27, the first in a stream of bills working to address gaps in support for Montana students’ mental health. Sponsored by Rep. Moffie Funk, D-Helena, the bill would have permitted schools to implement “handle with care” programs -- allowing law enforcement to contact a child’s school and alert staff to handle the student with extra care because of a potentially traumatic experience.

Funk, a former middle school social studies teacher, said the bill was an effort to reduce childhood trauma without breaching concerns of privacy. But after resistance from House Republicans both in and out of committee, the bill’s failure didn’t surprise her.

“I had steeled myself for that,” Funk said in an interview. “Maybe people will hear about it and just start doing it themselves.”

Just two days later, on Feb. 3, the House Education Committee voted to table House Bill 227 from Rep. Mary Ann Dunwell, D-Helena. That measure was set to establish grant money for mental health screening programs in schools.

The Montana Legislature is grappling with how best to support mental health programs in schools, an issue experts say was important even before the COVID-19 pandemic brought on new and stressful challenges for students.

With HB 27 defeated and HB 227 on ice, questions remain over whether enough support exists among lawmakers to pass future measures addressing mental health in schools -- especially those with money attached.

The most recent data from the Department of Health and Human Services shows the state’s rate of suicide among children age 11–17 -- 12.6 deaths in every 100,000 -- is nearly triple the national average.

The Montana Office of Public Instruction’s 2019 Youth Risk Behavior Survey indicates that depression and suicidal ideation in children and teens are on an upward trend with 23.4% of respondents reporting that they had seriously considered suicide in the previous year -- up from a low of 15.2% in 2011.

And, the COVID-19 pandemic has added new challenges onto the crisis as children are increasingly isolated from peers and adult mentors in schools. The Centers for Disease Control reported in November 2020 that mental health-related visits to the emergency room for children increased in April and remained elevated through October, with a 31% increase for children age 12–17 compared to 2019.

That added new urgency for Dunwell, who introduced legislation -- for the fourth time -- to kick start mental health screenings in schools.

House Bill 227 would have allocated grant money to schools as part of a “pilot program” to screen students for red flags that might indicate increased risk for depression or suicide.

Dunwell said the bill is personal.

“I was a parent of a child who had some challenges,” she said in an interview. “It’s just always been close to my heart. I always believe that health and mental health is essential to being the best you can be.”

When Dunwell first introduced a similar measure during her first session in 2015, she said there were five suicides in four years at Helena High. In fact, Dunwell recalled one point in which she was presenting the bill and expecting the principal of Helena High to speak, when it happened again.

“I got a text from him in the middle of the hearing saying ‘I’m sorry, I can’t make it -- we’re dealing with exactly what you’re talking about right now,’” Dunwell paraphrased.

Dunwell’s bill would fund screenings in about 10 schools, which would then compile their findings and report back to lawmakers in time for the 2023 Legislative Session to consider an extension of the program.

But, the biggest hurdle for the bill in sessions past is present this year, too: its $1 million price tag.

Dunwell said the bill made it out of its first committee in 2019, but the House Appropriations Committee cut its funding down to $250,000 -- enough for just two or three pilot programs. The bill ultimately died before reaching the full House.

Republicans again raised the issue of money during HB 227’s first hearing this session. Rep. Scot Kerns, R-Great Falls, questioned why the Legislature wasn’t taking greater steps to put additional mental health experts in schools. He took particular issue with the program’s steep price, saying he would rather fund more mental health providers in schools directly.

“It’s almost like giving a Band-Aid to a gushing wound,” Kerns said. “I see this is a gushing wound that we have right now, and I want to make sure we’re getting it to the hospital.”

The House Education Committee tabled Dunwell’s bill on Wednesday, Feb. 3, meaning no further action will be taken on the bill unless the committee votes to revive it.

In recent years under a Republican majority, Montana’s Legislature has been traditionally conservative when it comes to spending. Now, COVID-19’s squeeze on the economy is fueling increased scrutiny for all but the most essential programs.

Rep. Llew Jones, R-Conrad, chairs the House Appropriations Committee and is carrying House Bill 2, which sets the state’s two-year budget. Jones said that all bills that pull money from the general fund -- the state’s primary “checking account” -- will likely be challenged this session. But, Jones didn’t rule out the possibility of lawmakers funding new mental health programs.

“The need for mental health in Montana is significant,” Jones said in an interview. “I think the executive [branch] and the Legislature recognize that.”

Advocates agree that mental health support for students is a critical need in Montana’s schools, and some see promise in the proposed legislation.

Kindle Lewis is the executive director of the Montana School Counselor Association, and its only employee -- all other members are working counselors around the state. She said Dunwell’s bill could serve as a solid starting point to gathering more data on the condition of Montana students’ mental health, but noted that statewide plans to address mental health in schools often face an uphill battle.

“Our state is just so different in what our little individual communities need,” Lewis said in a phone call. “Missoula is totally different in what it needs than Malta.”

Lewis said Montana law affords schools a large degree of local control, in part due to the vast differences between schools in terms of size, location, and need. Such diversity and sovereignty can make it hard to legislate solutions to the issue of depression and suicide risk in children, Lewis said.

Currently, Montana schools employ a wide array of mental health curriculum in combination with school counselors’ expertise to support students’ needs. But, the COVID-19 pandemic brought unprecedented challenges on counselors and teachers as face-to-face contact became a thing of the past.

“So many school counselors were reaching out and asking, ‘what am I supposed to do here?’” Lewis said.

But ultimately, Lewis praised the ingenuity of school counselors and teachers, who she said pooled resources and ideas and found ways to continue to help students.

Funding for mental health curriculum and programs comes from a variety of sources, Lewis said, making permanence difficult to achieve. One bill in the works from Sen. Edie McClafferty, D-Butte, is working to change that.

The bill, which has yet to be introduced, would fund grants for “school-based mental health promotion and wellness programs” using 5% of the revenue from the statewide alcohol tax. The funds would be appropriated statutorily, meaning they would be available each year without need for renewal by future Legislatures.

McClafferty has successfully pushed other mental health bills in previous sessions.

In 2019, she helped shepherd House Bill 660, which established a “mobile crisis unit program,” across the finish line and into law. The bill granted funds for additional mental health professionals to respond to “mental health crises.” And, in 2015, McClafferty sponsored House Bill 374, which required the Office of Public Instruction to develop suicide awareness and prevention programming for school district employees. It also passed into law.

McClafferty teaches 5th grade in Butte, and like Dunwell, was touched by personal experience to help reduce suicides in Montana.

“We had three suicides very, very close together, and you see the impact it has not just on your students, but on the whole community,” McClafferty said in an interview. “We were just torn.”

One of her goals for this session is to make funding for school mental health support programs more permanent -- and she’s confident she’ll get her bill this session signed into law, too, despite a tightening budget.

“I think everybody is aware of the problems we‘ve been having. Especially right now, COVID has brought them out even more,” McClafferty said. “I think it’s got a great chance of passing.”

Dunwell, who is terming out of the House of Representatives after this session, said the issue of providing support for children’s mental health is too big to ignore -- price tag aside.

“What’s a life worth? A million bucks? A life is priceless, you can’t put a price on a young life,” Dunwell said.

Austin Amestoy is a reporter with the UM Legislative News Service, a partnership of the University of Montana School of Journalism, the Montana Broadcasters Association, the Montana Newspaper Association and the Greater Montana Foundation. He can be reached at austin.amestoy@umontana.edu.