In Polson, Montana, local jails are increasingly becoming makeshift mental health facilities for individuals in crisis. The small jail cells, often no larger than a walk-in closet, have become the only option for many awaiting mental health care. In these cramped conditions, some individuals have been confined for months, illustrating a broader failure in the mental health system.
Lake County Attorney James Lapotka describes the isolation cell, where inmates have etched phrases like “love hurts” into the walls. Two individuals recently spent extended periods in the jail while waiting for treatment at Montana’s only state-run psychiatric hospital. One man remained there for 129 days, while another faced a wait of five months. They were not convicted of any crimes but were deemed unstable and required psychiatric care, yet found themselves trapped in a cycle of incarceration.
The situation in Montana reflects a nationwide crisis where nearly half of individuals in local jails have a mental illness. Many counties lack the resources to provide adequate mental health services, forcing law enforcement to detain those in crisis. In Wyoming, over half of the sheriffs reported housing individuals in crisis for months, while Nevada struggles with delayed treatments despite financial penalties for prolonged incarceration.
Montana’s psychiatric hospital has only 270 beds, with a mere 54 allocated for individuals involved in the criminal justice system. Staffing shortages further reduce this capacity. In response, Montana’s Department of Public Health and Human Services has proposed bills to mitigate liability for delays and allocated $6.5 million for jail-based mental health stabilization services. However, many local officials argue that community mental health resources are insufficient.
Mental health advocates stress the need for more inpatient beds and community support systems. Matt Kuntz, executive director of the Montana chapter of the National Alliance on Mental Illness, emphasizes the necessity of building more facilities to accommodate those in need. Recent legislative efforts aim to establish a new psychiatric hospital and require the state to fund community mental health commitments, but these changes could take years to implement.
The decline in inpatient beds for severe mental illness nationwide is alarming. Initially, this decrease was part of a movement away from institutionalization, yet the intended replacements, such as local mental health centers, have not materialized. In Montana, Western Montana Mental Health Center has had to close crisis sites due to financial difficulties, exacerbating the issue.
Vincent River, the sole mental health clinician at the Lake County jail, faces overwhelming challenges. He struggles to get individuals the psychiatric care they need, often leaving them without treatment for extended periods. Those who cannot receive care may deteriorate further in jail, leading to potential legal issues and health crises.
Local initiatives, such as a mobile support team launched to provide peer assistance, have emerged to fill some gaps in care. However, individuals in crisis still overwhelmingly face only two options: jail or an emergency room. The emergency room at Providence St. Joseph Medical Center in Polson offers limited privacy, and patients can find themselves isolated for days while staff search for available psychiatric beds.
Rebecca Bontadelli, an ER physician, notes that patients often feel imprisoned, and many refuse care during their wait. This situation underscores the urgent need for systemic changes in mental health care in Montana and across the country. Without significant investment and reform, individuals in crisis will continue to find themselves trapped in a cycle of incarceration, with their mental health deteriorating in the process.
