Let’s Talk About Mental Health: Reducing mental health stigma under the Big Sky 

By Nicole Madden GUEST COLUMNIST 

For the past 30 years, Montana has had one of the highest suicide rates in the nation. Gallatin County is not immune to the complex challenges that make these statistics our reality—the number one reason why someone comes to a Bozeman Health emergency room during a mental health crisis is due to suicidal ideation. 

So, why does Montana have such a high rate of prevalence of mental illness and death by suicide? According to the American Foundation for Suicide Prevention, there’s a variety of reasons that contribute to a higher prevalence in our state. Factors include Vitamin D deficiency, living at altitude, socioeconomic and demographic factors—we see a high concentration of veterans, American Indians and middle-aged white males—social isolation due to geography, prevalence of alcohol as a coping strategy, access to lethal means and lack of access to services due to geography. 

And most of all, stigma. 

American Psychiatric Association research shows that more than half of people with mental illness don’t receive care, often due to stigma or poor access to care. Stigma can present in the form of self-stigma, with negative attitudes and feelings internalized about having a mental illness. It can also be experienced as a public stigma or a structural stigma. In general, stigma experienced from any of these three sources is harmful, leading to hopelessness, low self-esteem, increased psychiatric symptoms, impacts to relationships, reluctance or inability to seek access to care, isolation, reduction in opportunities, and poor outcomes for both the individual and their family and friends.  

Reducing stigma is a team sport and a public health priority.  

We are not defined by our mental or physical health conditions or individual qualities. Each of us, as a member of the community, can encourage open dialogue, education and inclusivity. For those who may be experiencing stigma, it is incredibly empowering to be involved and feel connected.  

At Bozeman Health, including our critical access hospital, Big Sky Medical Center, we are committed to whole-person wellness and recognize the need for continued support of the behavioral health care continuum. We know that no single organization can sustain all the behavioral health services that our communities need, but we are dedicated to collaborating with partners to implement sustainable services. I am honored to be an active member of the Gallatin Behavioral Health Coalition and Big Sky Wellness Coalition on behalf of Bozeman Health. We are grateful for our partnering regional care and service providers, including Big Sky-based colleagues like Wellness in Action, who are also committed to strengthening the continuum as a community. 

One example of a community collaboration is WIA’s Affordable Counseling Program that aims to break down barriers of mental health supports to make services more accessible across the community. BSMC and WIA collaborate on “Referral Pathways”—an identified path to connect a person in need with critical direct services. This helps ensure Big Sky residents get the services they need, when they need them. 

Bozeman Health’s dedication to supporting the regional care continuum and stigma reduction is inspired at all levels of the health system—from our compassionate care team to the personal passion of our leadership.  

“Mental health is just health, and should be thought of just like all other aspects of health and wellbeing” said Dr. Kathryn Bertany, Bozeman Health CEO. “Removing the stigma around mental health will save lives. One of the ways we actively reduce stigma is by making it easier to access services in a variety of settings.” 

We are committed to making it easier to access mental health services including the following services offered: Outpatient psychiatry services in Bozeman and Big Sky; psychiatric emergency services at Bozeman Health Deaconess Regional Medical Center; a behavioral health walk-in clinic opening fall 2024 at BHDRMC; and an adult inpatient behavioral health unit opening in 2025 at BHDRMC.  

I am pleased to share the exciting news that Bozeman Health has begun construction on our adult inpatient behavioral health unit at BHDRMC with a planned opening in 2025. The first floor of the inpatient wing at BHDRMC is undergoing a complete remodel to create a customized care space that will serve up to 14 adult patients.  

The Big Sky Medical Center has been caring for residents of and visitors to southern Gallatin County since December 2015. As a critical access hospital providing care to the Big Sky and West Yellowstone communities, outpatient behavioral health services are available in addition to emergency department and primary care services. Behavioral health outpatient services offered at BSMC are provided by a team consisting of Kathy Damberger, nurse practitioner, Dr. Patrick Maidman, psychiatrist, and Lisa Brubaker, licensed clinical social worker. Appointments can be requested through referral from your primary care provider, or any individual may request an appointment by contacting BSMC at 406-995-6995.  

“We are proud to provide care close to home for residents of and visitors to southern Gallatin County,” said Kelly Reynolds, BSMC administrator. “It is just as vital that our community has accessible behavioral health services as it to have emergency and primary care services available locally. It is our honor to care for the mental and physical health of our friends and neighbors, our community.” 

I encourage you all to have open conversations about mental health with your family, friends and community. Together, we can reduce cultural stigma in Montana.   

To access behavioral health resources, visit Big Sky Medical Center outpatient services or call BSMC at 406-995-6995, or connect with Be Well Big Sky. For mental health emergencies or crises, dial 988 to reach the Suicide and Crisis Lifeline or visit the nearest emergency department. 

Nicole Madden is the system director of behavioral health at Bozeman Health. She is also an active member of the Gallatin Behavioral Health Coalition, Big Sky Wellness Coalition and the Gallatin Mental Health Local Advisory Committee. Madden is a third generation Montanan, born and raised in Gallatin County.