by Jim Hajny, Executive Director

August 5, 2025

When I first got involved with mental health advocacy in 2009, we were urging the legislature to address the broken mental health system. In 2025 advocates are still urging the legislature to address the broken mental health system in Montana. Back then we had funding for a community-based crisis system. We had twice as many crisis beds available, and we had a psychiatric hospital that encouraged and promoted mental health recovery. Today we do not have sustainable funding for statewide crisis services, we have less crisis beds, and we do not follow national standards for Montana State Hospital or for crisis response in Montana. In 2022 Montana lost its federal funding for Montana State Hospital because it repeatedly failed to meet minimum federal standards for health and safety. I would also include the increase in unhoused individuals in nearly every community in our state, many of whom have a mental health diagnosis. From 2007 to 2023 the increase was 89%, second highest in the nation according to the 2023 Annual AHAR Report to Congress. Data also shows Montana continues to lead the nation in suicides per capita. Gun ownership in Montana is one of the highest in the nation, depending on which data source you look at. Ammo.com reports Montana as the highest with 66.3%, the national average is 46%. Red flag laws (Extreme Risk Protection Orders or ERPO) allow county attorneys to petition a court to prevent someone with a severe mental illness from possessing a firearm. A sort of warning system when someone is not well. There is federal funding to support red flags laws if state chooses to enact it. Montana does not. On May 8, 2025, Governor Greg Gianforte signed an anti-red flag law. We are only one of few states who have such laws. There is fear that this will lead to the “taking away of everyone’s guns” which is a second amendment right. Which could be argued and may have some merit. But that’s for another article. My own conclusion is that Montana is moving backwards in addressing our broken mental health system.

There are individuals who will say we have increased our funding annually to DPHHS, we have a $300 million dollar allocation of funds, we had community hearings. We have plans to build new psychiatric facilities to better serve Montanans. We are surveying providers; we even gave them a raise in reimbursement rates. Look what we have done!

The United States Secret Service 2023 report on mass shootings is intended to provide critical information to a cross-sector of community organizations that have a role in preventing these types of tragedies. Among the report’s key findings:

• Most of the attackers had exhibited behavior that elicited concern in family members, friends, neighbors, classmates, co-workers, and others, and in many cases, those individuals feared for the safety of themselves or others.
• Many attackers had a history of physically aggressive or intimidating behaviors, evidenced by prior violent criminal arrests/charges, domestic violence, or other acts of violence toward others.
• Half of the attackers were motivated by grievances, and were retaliating for perceived wrongs related to personal, domestic, or workplace issues.
• Most of the attackers used firearms, and many of those firearms were possessed illegally at the time of the attack.
• One-quarter of the attackers subscribed to a belief system involving conspiracies or hateful ideologies, including anti-government, anti-Semitic, and misogynistic views.
• Many attackers experienced stressful events across various life domains, including family/romantic relationships, personal issues, employment, and legal issues. In some of these cases, attackers experienced a specific triggering event prior to perpetrating the attack.
• Over half of the attackers experienced mental health symptoms prior to or at the time of their attacks, including depression, psychotic symptoms, and suicidal thoughts.

Montanabw, CC BY-SA 3.0, via Wikimedia Commons

The avoidable tragedy in Anaconda (which does qualify as a mass shooting), according to reports, checks most of the findings in the secret service report such as gun ownership, mental illness, and warning signs from those who knew the shooter. “Everyone in the community plays a role in violence prevention,” said National Threat Assessment Center Chief Dr. Lina Alathari. “The latest NTAC report provides an unprecedented analysis to support our public safety partners and affirms that targeted violence is preventable if communities have the right information and resources to recognize warning signs and intervene.” Currently in Montana if an individual is not an “imminent threat” to self or others there is largely nothing law enforcement can do. They do not have the power to arrest the individual for having a mental illness. In Illinois the law states that involuntary admission to a psychiatric facility prohibits the individual from possessing a firearm. The court decides how long this is for depending on circumstances. Montana does not have such a law. What we do have is an emergency hold law. If an individual is in a mental health crisis they can be taken into protective custody on a 72 hour hold so a mental health professional can evaluate them. Again, they must be an “imminent threat” to self or others. If it is not imminent, they are released. If the individual is determined to be imminent, then a facility with an open bed has to be located. Montana lost 50% of its crisis beds during the COVID pandemic, making locating a bed much more difficult. The state of Montana has not taken action to replace those lost beds in the last 5 years. The threat assessment chief said it correctly, “everyone in the community plays a role.”

The Dilemma

In this article I have tried to outline as simply as I can the challenges we face in Montana around mass shootings, gun ownership and mental health care. As an advocate I have had numerous conversations over the years and have even presented possible solutions mostly which have fallen on deaf ears. This avoidable tragedy in Anaconda is preventable. The real question here is how does society balance individual rights related to health conditions such as mental illness with Constitutional rights such as gun ownership. How do we find a balance with public safety. How do we come together to address the broken mental health system in Montana providing more options for the individual, law enforcement, behavioral health professionals, families and communities. How do we stop taking sides and work towards solutions. This is the dilemma we find ourselves in. Everyone wants their way to be right instead of finding common ground, such as improved mental health care balanced with laws increasing public safety and private gun ownership where we all give a little bit. For the good of all. So, we can feel safe in our own communities. Now that is mental health.

by Jim Hajny, Executive Director

July 21, 2025

It is hard to not see suffering on a daily basis around the world, in the United States and here in Montana. When I tune in for my daily dose of news, I am often struck by the lack of awareness around mental health related issues. For example, in Texas where the extreme flooding occurred there is virtually no reporting on mental health counseling, or peer support for the massive amount of grief and loss that is taking place. In the nearly weekly reporting of mass shootings at places of work, schools and in our communities across the nation, we fail to address mental health needs.  

In the 17 years I have been working as a peer advocate, I have watched a revolving door of organizations, programs and good people with great intentions come and go. Regardless of the quality of the work. Here today, gone tomorrow it seems. As a person with a mental health diagnosis, I can recognize that stigma for both self and society play a major role in our inability to address the mental health needs for all. In fact, I would say its number 1. There are others of course. It is not lack of funding. We spend a lot of money funding programs and defunding programs without consideration as to their effectiveness. For example, the shuttering of SAMHSA which has been a strong supporter of mental health recovery for 20+ years, for political reasons rather than updating or upgrading it as we say these days. Here in my community of Madison County we have no crisis support services.  When I brought this issue up to my local legislator it was “passed up the chain” with no results. When I spoke to the hospital is also went nowhere. It’s just not a topic anyone wants to talk about. My local advisory council has 6 openings for more than 1 year.

This topic weighs on my mind because I feel a lack of mental wellness is what leads to so many of these societal issues such as gun violence, homelessness, substance use, suicide and incarceration. Without urgently seeking long-term solutions we cannot make progress. These days when we cannot find the answers we are looking for, we search the internet, more specifically AI. So, I did just that. I asked AI “what are the societal issues around mental health.” Here is what it identified.

Key Societal Issues Affecting Mental Health:

• Stigma and Discrimination: Negative attitudes and stereotypes surrounding mental illness can lead to social isolation, reduced likelihood of seeking treatment, and difficulty finding work or housing. Stigma can prevent individuals from disclosing their mental health challenges and seeking help, making their conditions worse.
• Social Inequality: Poverty, lack of access to education and healthcare, and discrimination based on race, gender, or sexual orientation can create chronic stress and feelings of helplessness, contributing to mental health issues.
• Social Isolation: Poor mental health can lead to social isolation, disrupting relationships and potentially leading to family breakdown.
• Lack of Access to Resources: Limited access to affordable healthcare, including mental health services, can prevent individuals from getting the support they need.
• Adverse Childhood Experiences: Exposure to violence, neglect, or other traumatic events in childhood can significantly increase the risk of developing mental health conditions later in life.
• Media Portrayal: Sensationalized media coverage of mental illness can perpetuate negative stereotypes and contribute to public misunderstanding.
• Social Determinants of Health: Factors like housing, food security, and employment opportunities significantly influence mental health. Unequal distribution of these resources can disproportionately affect certain populations.

Consequences of Societal Issues on Mental Health:

• Increased Risk of Mental Health Conditions: Social factors can increase the likelihood of developing mental health conditions like anxiety, depression, and psychosis.
• Difficulty Accessing Treatment: Stigma, discrimination, and lack of resources can make it harder for individuals to seek and receive mental health treatment.
• Impact on Relationships and Social Functioning: Mental health conditions, exacerbated by societal factors, can negatively impact relationships with family, friends, and colleagues.
• Economic Instability: Mental health conditions can affect employment and educational attainment, leading to economic insecurity.
• Strain on Families and Communities: Mental health issues can place a strain on families, impacting caregivers and leading to economic burdens on communities.
• Increased Risk of Incarceration and Homelessness: Individuals with serious mental illness may face criminalization or become homeless due to lack of support.

Here is some data I searched for further consideration.

Mental Health America, the nation’s oldest mental health advocacy organization releases a report each year ranking states on mental health service. Montana ranks third to last.

Montana mental health and substance use levels are generally higher than national averages and Montana often ranks near the top in suicide rates, substance use related deaths, and prevalence of mental health conditions. Individuals in rural and frontier areas are often underserved and under-resourced. The following table is taken from SAMHSA’s National Survey on Drug Use and Health.

I was recently watching a video on gun deaths per state, and I was shocked to find that Montana ranks near the top along with New Mexico, Louisiana, Mississippi and Alaska.  States such as Illinois, New York ranked much lower. I was surprised by this. CDC data can be found here.

Montana saw the largest increase, 551%, of individuals experiencing chronic patterns of homelessness from 2007 to 2023, according to the 2023 Annual Homelessness Assessment Report to Congress 2024.

I do not assume to have the answers. I don’t think anyone has all of them. But I do dedicate my work to addressing mental health recovery the best way I can each day along with staff and board of directors at MPN.

by Jim Hajny, Executive Director

July 1, 2025

The certified behavioral health peer support specialist workforce has faced many challenges since its inception 8 years ago. We fought to establish ourselves in the behavioral health system, we have had to educate and inform the public, and we have had to grow the workforce. MPN has been training peer supporters since 2015 long before certification went into effect in 2018. The basis for the training then and now is the National Practice Standards from SAMHSA. We have trained more than one thousand peer supporters during the last ten years which has provided us with a unique perspective on the workforce. We are not new to the game as are some of the other trainers. Nor are we from out of state here to get wealthy, then disappear after we get a check. We want to see a strong behavioral health peer support workforce now and into the future. In order to do that there needs to be a platform for identifying and addressing the issues. Montana lacks that platform. One that is free from outside influence. At MPN, we have tried many times over the years to participate in such an effort only for it to get corrupted, forcing us to step away. In this article I have broken down the most notable challenges in the behavioral health peer support workforce and some possible solutions.

Recovery experience

This is probably not a fixable challenge. Yet, it needs to be mentioned. There is a large difference between say the role of a sponsor in a 12-step program and a CBHPSS. The move to professionalism requires training, ethics, confidentiality and overall wellness. Sponsorship does not. Yet, this is where many CBHPSS come from. In the role of a CBHPSS we can offer many tools for recovery, not just one. Drop-in centers for example have difficulty finding qualified staff to employ, either the candidate doesn’t have enough time in recovery or is too fixed on one pathway. An effective CBHPSS needs stability, this is difficult work at times. Far too many peer supporters do not have the healthy foundation of recovery.

Training competencies

There are a number of 40 hour training courses approved by the Montana Board of Behavioral Health. Most are lacking and one should question how they ever got approved. For example, one is completely virtual and has no instruction on working in Montana. Another one is only for substance use peer support, despite Montana having a behavioral health focus on both mental health and substance use. MPN has been training for peer supporters since 2015 following the national standards outlined by SAMHSA and is also approved through the Veterans Administration. The MT Board of Behavioral Health needs to regulate the training curriculum they have approved.

Lack of sustainable funding

Despite there being millions of dollars available for peer support services funding is an issue due to the limited nature of availability. There is an effort underway to expand provider types for peer support Medicaid funding so maybe this will change soon. Private insurance (BCBS of MT) is making no effort to include peer support in its billable service array. Even though Minnesota BCBS approved it in 2024. This is the one area that needs strong advocacy here in Montana. Another challenge in this area is where organizations who cannot bill for peer support seek other service roles such as community health workers, behavioral health techs, life coaches instead of CBHPSS. This limits the number of peer supporters statewide because they are being replaced by other roles that are fundable.

Non recovery culture

Many behavioral health organizations across the state still do not embrace peer support services or support a recovery culture. Without a positive, healing environment peer support staff will not survive. Organizations need to start within before adding individuals in recovery. A culture that supports health and wellness. Most organizations are overworking their staff and lack a focus on their well being. If peer support staff are added to a medication-based culture of treatment it rarely works. Treatment is not recovery. Recovery is a person’s whole life not a check list for a specific amount of time. Support is an action itself. Recovery requires action too. A handful of former CBHPSS have moved forward on their career path to become licensed counselors. This is the best way to change the culture within behavioral health organizations. Fill them with professionals in recovery.

Lack of mental health support

The workforce lacks CBHPSS who have a recovery journey in mental health. At one time there was a mentoring program at Montana State Hospital, but it was ended right about the time certification went into effect. MPN was part of shaping that program. Most of the peer supporters who come through MPN’s training have a background in substance use with criminal justice backgrounds. This is being promoted within the justice system but not within mental health. We need more balance and finding the right fit for a CBHPSS plays a crucial role. A peer supporters lived experience should match their organization.

These are just a few of the challenges facing the CBHPSS workforce. In addition to this article, visit our training platform for a full presentation on this topic. Where I go in depth on each of the challenges and possible solutions. My hope is that we can work cohesively to address these challenges and find positive solutions. My fear is that peer supporters are overtaken and become part of the broken behavioral health system we in the recovery movement are advocating to change.

by Jim Hajny, Executive Director

May 1, 2025

May is Mental Health Awareness Month. At least for now. I say that because with all of the federal changes one never knows. What the Department of Government Efficiency will deem inefficient is anyone’s guess. May was first established as mental health awareness month in 1949 by Mental Health America the oldest mental health advocacy organization in the United States. You can take a number of mental health screenings for free on their website. They also have resources for further support. Now more than ever mental health advocates need to work to bring awareness to the importance of mental wellbeing. We are only in the first few months of 2025 and we seem to need a mental health day. I know I do. There are many changes taking place in our country. There are threats to funding for mental health support and services, discrimination towards certain groups of people, certain words are now deemed unacceptable and general uncertainty seems to be the course federally. With all the law and rule changes it is challenging to know what is acceptable from day to day. None of which helps one with mental health challenges feel settled, positive and stable. It is also discouraging to advocates such as MPN because we have worked for 14 years to reduce stigma, raise awareness and promote the many initiatives set forth by the Substance Use and Mental Health Administration. Which is now, sadly, being dismantled and defunded.

In uncertain times we need elected leaders to step up and reassure our society that things will be ok. This is not happening, instead there appears to be a misguided use of power felt not only across America but across the world. Even our allies are looking at America as mentally unhealthy. Instability causes anxiety, worry and a general lack of mental wellness. I understand that some elected officials are unaware of mental health challenges and the impacts. It is probably difficult to understand what living on the street without food, water, or sanitation can do to one’s mental health when you are a billionaire. Or the impact on one’s family’s mental health when their life’s work is deemed inefficient and eliminated.

There are some elected officials who are aware of the importance of mental wellbeing. At this critical moment we need those elected officials to step into those leadership roles and speak out. Guide us to something better. In difficult times leaders do emerge. President Franklin Roosevelt created the CCC or the Civil Conservation Corps to help Americans out of the Great Depression. The program put 3 million men to work from 1933-1942. That made America great. In the sixties musicians such as Bob Dylan wrote songs such as “Blowin’ in Wind,” which spoke to the troubling times and went on to be an anthem for the civil rights movement, which in turn led to massive changes in this country. In 1996 the Clinton-Gore Administration advocated for and signed into law the 1996 Mental Health Parity Act. Requiring insurance companies to pay for mental health services as they do any other medical service.

In uncertain times we need advocates to step up and lead also. We cannot rely upon others to be the change we want to see. The recovery movement needs to step up and lead. We've come too far to turn back decades of progress. We have created far too many supportive, compassionate, empowering, recovery orientated programs to close the doors. We also cannot allow for “lists” to be created so the government can keep track of those of us with mental health challenges for “research purposes.” This is utter nonsense. We have laws that protect the medical rights of Americans. I write this knowing that speaking out, the act of advocacy itself is under threat. Those in power do not want to hear anything that is not in line with the master plan. Advocacy cannot be suppressed. Ever. There have been many advocacy movements in this country that led to cultural changes for the good around issues such as disability, gender, race, equality and recovery. What will historians call this movement. I do not know. It is too early to say. But this mental health month I am challenging you to speak out, step up and join others in raising awareness for mental health.

by Jim Hajny, Executive Director

November 27, 2024

(Some information collected via AI)

This is one topic I am very familiar with and have spent years advocating in Montana. Our website has specific information on various demonstration projects MPN have operated over the years. It is one of the most asked questions I get when it comes to the implementation of peer supporters. This article will attempt to provide resources, and the “how to” for implementation of peer supporters into your crisis program.

One of the earliest presentations I am aware of was one in which SAMHSA invited me to join a panel of other peers to discuss the role of peer support as providers. Each of panelists were providing some type of support around crisis response. From warms lines, peer respites, emergency rooms to our project in the community. Leah Harris was the moderator, and I remember the overwhelming response we got. I received so many emails afterwards with follow up questions. It was so popular, we had to do the webinar twice because we overloaded the SAMHSA server, and it crashed for many people. Over the years I have been asked about our work in this area. Just last summer I did a consultation with another state that was implementing peer supporters into their crisis response system. The SAMHSA webinar Peers as Crisis Service Providers was presented on August 7, 2015, and discussed the benefits of peer specialists in crisis services. The webinar was sponsored by SAMHSA and presented by the National Coalition for Mental Health Recovery. (https://www.ncmhr.org/) If you would like to review it. Today there are many other webinars on this topic. One really good one is “Providing Peer Support Services in Crisis Service” by Cheryl Gagne which goes in depth to the Crisis Now model.

Ten years ago, the idea of implementing non college credentialed people in recovery was a new concept being promoted within the recovery movement in an effort to change the status quo. The way in which we did things back then and by in large the way in which we operate the crisis system today is ineffective. Peer Support in crisis response was supported by SAMHSA then and is today. A great document to review is SAMHSA’s Crisis Services Meeting Needs Saving Lives. by Debra A. Pinals. This document is built upon a handful of other documents on the subject of crisis response and on the title page it says, “behavioral health best practices toolkit”. Peer Support is mentioned at every level of response in this document. It states specifically, “Best practices call for peer support (i.e., those with direct experience with the behavioral health system and who are trained to support individuals in crisis) as part of the mobile crisis team to decrease engagement of law enforcement.” There is an over reliance on law enforcement. I worked directly with the Gallatin County Sheriff’s office for 4 years on a peer support pilot project and in the vast majority of crisis calls there was no need for law enforcement. Yes, there were times when law enforcement involvement was necessary. (i.e. someone has a gun) My experience was one in which people needed someone to talk to, not a pair of handcuffs. An effective peer supporter can deescalate and support not just in the moment of crisis but ongoing. Many people need ongoing support not just a one time shot. Law enforcement is insufficiently trained and quite frankly it is not their job to respond to people in mental health crisis. Now before all the law enforcement people cry out, “We have CIT training!” I am a graduate from CIT. Crisis Intervention Team (CIT) training is a 32–40-hour course developed in Memphis, TN that teaches law enforcement officers how to respond to people with mental illness in crisis. We have a very active CIT Montana organization here in Montana. CIT is the best we have right now, but very inadequate in the long term. I would term the training as an “introduction” or a level I course in crisis intervention. Again, it is all we have for now. The time has come for level II. I am not aware of this being available today but maybe in the future.

If this is the case then what do we do with so many individuals with untreated mental illness, substance use, and homelessness?

That is not a simple answer. It will require many changes to improve the current situation. Let’s start with the responsibility of the community and the behavioral health system to address mental health crisis. The behavioral health system is always short staffed and underfunded and untrained in crisis response. (As is law enforcement) The behavioral health system overly relies on government funding which ebbs and flows. Licensed counselors get very little education at the college level on mental health crisis. The community has a responsibility to fund and appropriately staff crisis services. Would communities not fund fire fighters? Or EMTs? This should be the same for crisis response. Fund it locally. Government officials in Montana have been dancing around the behavioral health system for years. Relying on old models and even older beliefs about mental health. Pull yourself up by the bootstraps. That is until it is one of their loved ones. DPHHS has more than enough funds to address crisis response across the state. Look up the Montana budget, it comes in around $2 billion, give or take a little either way. We only have 1.2 million people statewide. We have been operating with a surplus for years, but we somehow don’t have enough funds for mental health services. This is why we must shift the responsibility to communities to create new models for crisis response. The current system should be replaced by one that provides care, ongoing support and does not rely on government funding.

What does peer support in the crisis system look like?

Peer Supporters who have direct experience in crisis are particularly effective at providing support to others. This should be considered when developing your own program. SAMHSA recommends hiring credentialed peer support workers with direct lived experience. They also recommend that crisis services include a no-force-first approach and supportive environments. I would also echo this recommendation. Certification means public safety. It means training, supervision and continuing education. In June 2022 SAMHSA released a 17-page advisory entitled, Peer Support Services in the Crisis System. Here are the keys they listed.

• Peer support services are an integral component of the behavioral health continuum of care—from prevention and early intervention to treatment, recovery, and crisis services.
• Crisis care provides services to anyone, anywhere, at any time. Three essential elements comprise crisis care: crisis phone lines, mobile crisis teams, and crisis receiving and stabilization facilities.
• There are several benefits to including peers in crisis care, including strengthening engagement in treatment and improving outcomes for individuals experiencing a crisis who receive these services.
• Peers working in crisis service care settings provide opportunities for individuals in crisis to talk with someone who has similar experiences, embodies recovery, and can offer messages of encouragement and hope.

Peers may experience challenges related to role integrity, stigma from co-workers, and sustainable employment. They also face challenges unique to providing crisis care, including the complexity of managing crisis situations and, often, a lack of specialized crisis training. Another benefit worth noting here is that peer supporters are plentiful. Psychiatrists are not. There is a health care worker shortage across the US. In Montana 51 of the 56 counties are designated as “health professional shortage areas (HPSA).” For a variety of reasons, Montana lacks enough well-trained healthcare professionals to fill the gap.

Possible solutions

The inclusion of peer supporters into crisis response across the state. Including warm handoffs, peer respites, recovery residences and Drop in Centers. This is one piece, but the issues run much deeper than just the inclusion of people in recovery. Communities need to heal themselves; we have a “me first” mentality that has taken over society. Some of this is from unresolved trauma, some is from fear, some is the culture of drinking and pill popping to solve what ails us. Which is driven by relentless ads from pharmaceutical companies focused on profits rather than healing. (If you got an ill, we got your pill) A lack of care for one another. These issues are not going to be solved by peer support in crisis response. They also require additional articles or maybe even a book.

Might a starting point be communities developing wellness centers for healing, spiritual awakening, rejuvenating, education and support. Why wait for crisis? That’s what the system does now. We know someone is deteriorating mentally. But we don’t look to support the person with compassion. We wait until they commit a crime, and place them in jail or until they have deteriorated to the point where we take them in handcuffs for mental health evaluation fully knowing for weeks even months this individual was not in balance mentally, emotionally or spiritually. That is a broken system that needs to change. We all have smoke alarms in our homes, this provides an early warning system before the whole house is on fire. We should be promoting wellness centers as prevention for mental health issues and healthier communities. I would envision these are places to go to get everything from counseling, massage, acupuncture, yoga, meditation, peer support and spiritual growth. There could be naturopaths and healers available. There could be facilitators of Wellness Recovery Action Plan workshops.

We need to stop referring to practices such as Reiki as “alternative”. It is not an alternative if it has been utilized for a couple thousand years. None of this can happen if communities keep waiting on the government to solve their issues. Community recovery organizations should be supported by the community not the government alone. If you don’t know what community recovery organizations (RCO) are then check out Faces and Voices of Recovery.

I will end with this bit of history. The ancient Egyptians valued wellness centers they called them, temples. Not in a religious context as we might today but in a healing aspect. Some temple precincts had centers where patients could receive treatments and therapy. For example, the Temple of Hathor at Denderah used water from the temple's Sacred Lake to bathe patients. The Greeks copied the Egyptians with healing sanctuaries dedicated to the God of medicine and healing, Asclepius. The Sanctuary of Epidaurus, located on the northeastern coast of the Peloponnese, embodied a belief in the restorative qualities of nature. Central to Native American healing practices is the concept of balance and harmony. These cultures believe that when an individual's equilibrium is disrupted, whether physically, emotionally, or spiritually, it leads to ailments. Healing is seen as a restoration of this balance, and the land plays a crucial role in facilitating this process.

by Jim Hajny, Executive Director

October 28, 2024

At the time of this article there are 210 certified behavioral health peer support specialists in Montana. Since the first peer supporter was certified by the Board of Behavioral Health in September of 2018, there have been a total of 400 peer supporters certified. Roughly half or 50% are still working today. The other way to look at it is 50% or half are not. Losing half of its workforce in just over 5 years is not a sign of a healthy workforce. Historically MPN trains around 100 peer supporters a year, half of those who complete Peer Support 101 will not go on to get certified, which is a topic for another article. Half of those who do complete training and are certified will not be for long. The CBHPSS workforce in Montana needs additional support.

Workforce development has been at the heart of our efforts since our inception in 2011, training peer supporters, the employers of peer supporters and advocating for funding to support peer services. MPN has been training peer supporters since 2015 when we facilitated the first 40-hour Peer Support 101 training. Three years before the first certified peer supporter. Right after certification was sign by then Governor Bullock we launched a peer supporter mentoring program to address the well-being of peer supporters regardless of employer. In 2019 we successfully advocated for peer support services to be a Medicaid billable service. ($6.25 million) In 2020, during the pandemic and shutdown, MPN continued to offer Peer Support 101 training in a virtual environment. In 2021 we advocated for and successfully secured a seat on the Board of Behavioral Health for CBHPSS and launched PS 102. In addition, we have been the technical assistance and training contractor for the state of Montana funded recovery Drop-in Centers for 4 years. Assisting in the development of the now 16 Drop-in Centers statewide. In June 2024 we launched an on-demand training platform for people in recovery, peer supporters and their employers. These are just a few of the workforce development efforts MPN has led.

Despite these efforts by MPN, collectively we still have a 50% turnover rate for CBHPSS in 2024. High turnover costs all of us. Replacing an employee costs employers and clients lose their support. Peer supporters lose their employment status and can often feel embarrassment or shame around losing their footing in recovery after relapse or crisis and are unable to seek the support they need to get back in balance. This plagues the peer support workforce. We hear this year after year and therefore list it as the number one cause of turnover. I have stood firm in my belief that encouraging recovery growth, and regular clinical supervision are the two best options for preventing CBHPSS turnover and increasing their mental well-being. The Board of Behavioral Health has identified a high number of ethics violations and peer supporter related grievances and are addressing these through the rules they enforce.

I have outlined some of the reasons for the turnover below.

• Relapse, Crisis, Mental well-being impacted, and emotional toll of the job
• Termination for ethics or policy violations
• Employers lack of planning, development and implementation of peer support services
• Not right fit, misaligned expectations, lack of recovery stability
• Replaced by other positions (Life Coach, Community Health Worker, Behavioral Health Tech, Care Coordinator, etc.)
• Financing peer support service (funding ends, low wages, financial incentives to switch careers)
• Professional Development/Growth (earning a degree and license such as LAC)

MPN does not have the answers to all the reasons on this list. It will take a combined effort to decrease turnover in the CBHPSS workforce. Some places to consider. The CBHPSS workforce needs to step up and begin to take responsibility for one another. If you see a colleague struggling, offer them support not isolation. We need employers to continue to grow their understanding of how to better support CBHPSS. Recovery is holistic and peer support thrives with flexibility. We need the funders of peer support services to include additional support and accountability in their funding. This may help create new avenues for the CBHPSS workforce. We need the Board of Behavioral Health to increase the required number of hours for certification training and audit clinical supervision hours. These are just a few ideas; others may have better ones. Improving the CBHPSS workforce is not a challenge MPN can take on alone. The healthier the peer support workforce is the more effective the support will be across communities.

by Jim Hajny, Executive Director

July 30, 2024

About a month ago the US Supreme Court ruled communities can cite and fine homeless individuals for sleeping outside. This ruling empowers city and county commissioners in Montana to implement a ban on sleeping outside such as in a tent, in a park or on the street. The ruling was 6-3 so it was not unanimous. This ruling overturns the 9^th Circuit Court which rules over the following states, Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada, Oregon and Washington. All these states all have high housing prices, a lack of services and tend to lean towards anti homelessness. In Montana we have seen a number of communities such as Kalispell and Lewistown become very vocal when nonprofits have attempted to implement services or temporary shelters for homeless individuals, with a, “Not in my town!” attitude. This of course begs the question. If not in your town, then where? Where exactly should individuals go if they cannot afford housing? This is a complex issue for sure. It seems to me that our leaders lack insight into that complexity. We can’t just move people down the road. The road only leads to another town. Where is issue starts all over again.

Instead of creating laws that say what citizens “can’t do.” Maybe we need leaders who have a “can do” approach to issues such as homelessness. For example, how about we build apartment complexes subsidized by the state of Montana to house homeless individuals in all major communities. This would stimulate the economy. The residence would be mostly on Section 8 assistance, so the rent is guaranteed to the landlord. The building trade would benefit, there would be tax revenue coming back and we wouldn’t have so many homeless individuals. There could even be a requirement of employment and or recovery to live in these apartment complexes. Some individuals may choose not to live there because of the requirements but I would imagine that the vast majority would. Very few people want to live outdoors. Shelters or temporary housing is an option and is being implemented successfully in Missoula, for example by Hope Rescue Mission. They have 30 pallet homes. Each home costs about $15,000 which is about the cost of a year’s rent for a studio apartment, if we had rent controls in Montana. We don’t of course and rent is now double that is some communities. Yet, the wages don’t support that level of rising costs. Pallet homes are temporary, and we have to remember that. The shelter is temporary. The apartment complex is permanent. We need long term solutions to address this growing issue. But pallet homes and shelters are a start until we build more apartments. This is innovation. We are building rockets to Mars, but we can’t solve homelessness here on Earth.

Many homeless individuals are impacted by mental illness and substance use. According to SAMHSA, 21% report having mental health issues and 16% report having a substance use issue. These numbers seem rather low, but we have to consider the source. The federal government. If you look at other studies by non-government entities such as Rebecca Barry, a postdoctoral researcher at the University of Calgary in Canada who studied data from many countries besides the US found the number to be 67% of homeless individuals suffer from mental illness. My experience tells me 67% is more accurate than a mere 21%.

Which leads me to the second part of the homelessness issue. Mental health services. We have a severe lack of mental health services for this population. Homelessness only compounds the mental health issues. Isolation, poverty, lack of medical care, hygiene, exposure to the elements, can all be traumatic. This compounds the existing mental health issues. There are very few mental health services available to homeless populations. Outreach is mostly done by people in recovery or caring individuals who work for nonprofits in Montana. These are underpaid, overworked individuals who are doing amazing work but lack the support in the form of resources, funding, respite and credentialed professional such as doctors, social workers and counselors to make deep impacts. If our leaders don’t want to address the issues, then make adequate funding available. There is a major disconnect between our leaders and the citizens. The last thing we need is another committee to discuss the issues. We all know what the issues are. The citizens have been telling the leaders for a long time.

Before this gets out of hand with city and county commissioners creating all types of “bans” on homelessness how about our leaders allow its citizens the right to sleep outside if they choose, no it can’t be anywhere. This could be added to our state constitution. There could be parameters in town. Such as private property or with businesses. An adjustment to the state constitution would be a bold move in the right direction and prevent local community leaders from creating ordinances banning homelessness while they sit in their air conditioned offices.

Resources

Mental Health Experts Decry Supreme Court Decision Upholding the Criminalization of Homelessness and Highlight Proven Solutions

Supreme Court Decision

By Jim Hajny, Executive Director

May 1, 2024

May is Mental Health Awareness month. Once upon a time that meant something. May is now arthritis, walking, women’s health care month, better sleep month, Asian Pacific Islander, amyotrophic lateral sclerosis, and brain tumor awareness month. Those are all important issues to recognize. But mental health awareness month was started in 1949 by Clifford Beers of Mental Health America. MHA is the country’s oldest mental health advocacy organization. Clifford Beers (March 30, 1876 – July 9, 1943) was the founder of the American mental hygiene movement. (Wikipedia.com) He was a peer. He was the original peer supporter and advocate in the recovery movement. Clifford Beers was a ground breaker. Laying the foundation for organizations like Montana’s Peer Network.

He first published “A Mind that found itself: an autobiography” in 1908. You can read his story and recovery here for free*.

A short excerpt I found particularly meaningful from Mr. Beers; "My heart's desire" is a true phrase. Since 1900, when my own breakdown occurred, not fewer than one million men and women in the United States alone have for like causes had to seek treatment in institutions, thousands of others have been treated outside of institutions, while other thousands have received no treatment at all. Yet, to use the words of one of our most conservative and best informed psychiatrists, "No less than half of the enormous toll which mental disease takes from the youth of this country can be prevented by the application, largely in childhood, of information and practical resources now available."

This excerpt from his autobiography could be said today rather than more than 120 years ago. Millions suffer from mental illness, some will seek traditional treatment, thousands will go outside “the system” and yet others will seek no treatment at all.

For about 30 years Clifford Beers wrote about his psychiatric hospitalizations and recovery. The Oskar Diethelm library has more than 64 boxes of writings, art, photographs and scrapbooks from Clifford Beers. I found more than dozen books on Clifford Beers and the origins of the psychiatric patient movement online. He graduated from Sheffield Scientific School at Yale in 1897. Three years later he would be psychiatrically hospitalized.

“A pen rather than a lance has been my weapon of offense and defense; with its point I should prick the civic conscience and bring into a neglected field men and women who should act as champions for those afflicted thousands least able to fight for themselves.” Clifford Beers

In 1930, Clifford Beers organized the International Congress for Mental Hygiene in Washington, DC, attended by representatives from 53 countries. The meeting launched international reform efforts and led to the development of the International Committee for Mental Hygiene. (National Library of Medicine, Manon Peery, PhD)

In 1937 he wrote, “The Manic depressive psychosis from which I suffered  is a highly recoverable form of mental trouble, and psychiatrists aside from treating a patient with consideration,  cannot do very much to bring about a cure until recovery had actually set in.” (Clifford Beers, Advocate for the insane, Norman Dain, University of Pittsburgh.)

Other notable recognitions for Clifford Beers.

• There is a clinic named after him in Connecticut
• There is a historical marker – The Extra Mile in Washington DC.
• National Association of Social Workers Pioneers
• Clifford Beers annual award Mental Health America

This May let’s focus on the original. Talk to your family, friends, coworkers about mental health and recovery. Share your story with others. Lets keep moving our struggles out of the shadows and into the light for positive change. If you would like to submit your video story (5 minutes or less) we will share it on our YouTube page. If you want to write an essay email me jim@mtpeernetwork.org. This is how we raise awareness by talking about it. If we could all be more like Clifford Beers imagine where we could be as a society.

*This eBook is for the use of anyone anywhere in the United States and most other parts of the world at no cost and with almost no restrictions whatsoever. You may copy it, give it away or re-use it under the terms of the Project Gutenberg License included with this eBook or online at www.gutenberg.org. If you are not located in the United States, you will have to check the laws of the country where you are located before using this eBook. The Project Gutenberg Literary Archive Foundation (“the Foundation” or PGLAF), owns a compilation copyright in the collection of Project Gutenberg electronic works.

by Jim Hajny, Executive Director

April 9, 2024

Idaho legislature set to pass bill on electroconvulsive therapy for 12 year olds.

This came across my desk from the national coalition on mental health recovery. I had to read it a couple of times to make sure I understood what it said. If you click on the link below you can read the Idaho bill text which would allow for electroconvulsive treatment on children. Yes, children. Whenever I see something like this I am reminded how far we still have to go to eliminate stigma around mental illness, treatment and recovery. After reading this through here is my takeaway.

The argument for this bill which does have the votes to pass the Idaho legislature, is that electroconvulsive treatment for “adults” is effective for those who are resistant to medication. The argument against…it says “12 years old” not 18 years old. It goes onto say any parent or guardian can consent to electroconvulsive treatment for their child.

Reality Check!

How can a 12 year old be resistant to medication? They are 12. Second who would electrocute their 12 year old? Would that be considered child abuse? Should the doctor call CPS? What does an electro pulse do to a child’s developing brain long term? Do we know? We don’t know as much as would like about mental illness. As a result, we do not have very effective treatment. Electroconvulsive therapy is controversial because it has been used without consent. This was illustrated in the movie, One Flew Over the Cuckoo’s Nest (1975) based on Ken Kesey’s novel. It was used as punishment not as treatment. As a person who was diagnosed with severe depression in my early twenties, I would never consent to such an extreme ‘treatment”. But some people feel it’s effective.  When I was psychiatrically hospitalized early in my recovery I was threated by staff and I observed other patients be threatened by staff with seclusion and restraint. AKA the “quiet room” or “being strapped down." These are practices that should be stopped. They are not therapeutic or helpful and can be traumatic to those of us with mental health conditions. I am going to add forced medication here which is also common practice. The Geneva Convention rules of prisoners of war does not allow for such treatment or medical care. Yet, we allow this every day in America.

I have no issue with an adult consenting to electroconvulsive therapy. Carrie Fisher, Princess Leia, utilized electroconvulsive therapy for her severe depression and said in her autobiography it helped her. She was an adult at the time. Not a teen. Just because we do not understand mental illness does not mean we should harm others. My suggestion to the people of Idaho. Send your legislators who voted for this to trauma informed training so they can better understand the impact it can have and what may cause harm.

by Jim Hajny, Executive Director

November 28, 2023

Over the years MPN has led several pilot projects where we provide peer support to a particular population or in a particular community. We collect data directly from the participants through small surveys after every peer support encounter. The survey is anonymous and is offered to the individuals who are receiving the services. We ask a limited number of questions to not be burdensome but not too few to be incomplete. Data collect drives the pilot project and assists us in creating the model for peer support in crisis teams, family settings, support groups, etc. We have been doing this for more than ten years. In every one of the pilot projects the data says the same thing. Emotional support is the number one benefit. Yes, other boxes get checked but emotional support is consistently the most common. In our recent Family Peer Support Project 77% of the peer support encounters were for emotional support while second was social support at 23%.

Resources are great and they definitely benefit those we support, but emotional support is the greatest need. The behavioral health system is not set up to support individuals or families. It is designed in 15 minutes increments with lots of check boxes and dollar signs. I not sure how this came to be. The emotional support of clients is not at the top of the list of priorities. This is where peer supporters come in. Being present with someone, listening to their story, validating their feelings is emotional support. And it is enough.

A common question I am asked by new behavioral health provider is, “What do the peer supporters do?” I have answered this question many times over. I explain the scope of practice including the highlights such as 1 to 1’s, goal setting, wellness, and recovery planning, but I like to emphasize, the act of “being there” for someone in need. Being present is invaluable. Engaging and connect before ever getting to supporting. I go onto explain this is what sets peer support apart form other professions. We understand because we have been there. We have been through it. I sometimes get puzzled looks from providers. Because this isn’t task oriented. They don’t have that “lived experience” and peer support isn’t a check box in the EMR. This is about human connection. Desensitizing happens in all types of medical care or crisis work the world over. There is a great article on this topic Natasha Abadilla, Standford School of Medicine entitled, The problematic process of desensitization in medical training, (2018). She states, “We gain a greater understanding of disease processes as we progress in our training, though, and the additional knowledge of why our patients feel pain and how they may experience even more pain sets the level of grief so much higher then before. So, we begin the process of desensitization, as a form of self-protection.”

As peer supporters how do we guard against desensitization? I believe we have a natural immunity to it because of our recovery journey. We understand the “pain” because of what we went through, what we overcame to be a peer supporter. We do this work not simply because we want to help people like other professions. There is a difference in those two positions. The engagement and connection with a peer is the fuel that drives the passion to do this work. We don’t need a degree or medical school to be an effective peer supporter. We do need lived experience and through that lived experience we find emotions. The ups and the downs. Having another person who has also felt those intense emotions sitting in front of you or on the phone listening, validating and sharing their experience without trying to fix, is emotional support and it is enough.

by Jim Hajny, Executive Director

October 17, 2023

Depression was the first diagnosis that I received from a counselor. It was nearly three decades ago but it was the first. I would receive others over the years, but you never forget your first.

Back then I recall feeling both relieved and confused. On one hand, I was relieved that there was a name for what I felt was wrong with me. On the other hand. I didn't want to be a mentally ill person. Depression tends to be a catch all for people who are having mental health difficulties. I remember being put on antidepressant. Which didn't seem to help. In fact, some of them that I was on. Made my symptoms worse. Hey man. Make changes. Dosage challenges. Changes. But having a diagnosis gave me a starting point to begin to educate myself on mental health treatment and ultimately recovery. With the diagnosis I could look up books to read books about depression. I read biographies and autobiographies of famous individuals who suffered from depression, such as Abraham Lincoln and Eric Clapton. (If you don’t know who Mr. Clapton is go online and type, “Layla”.) Life stories gave me a sense of hope that I wouldn't be this way my entire life. I could get better and I could have a better life. It also allowed me to be vulnerable, to show some of my symptoms outwardly. I was very good at hiding them. Before my diagnosis I hid them away from the outside world. I didn’t want the world to know I was sad, after all I was a man. Men don’t cry. I didn’t want the world to know my inner thoughts where I wanted to die. This would make me look crazy. I was hurting and before my diagnosis I hid that away. With a diagnosis I received treatment in the form of therapy, medication, and peer support. This was how my recovery began. With my first diagnosis. I had no idea it would lead to Montana’s Peer Network. Back then I could barely get through the day. If you feel down or have an idea something is not quite right, even occasionally make an appointment with a professional such as a counselor or a doctor to get screened for depression. They will ask you some questions, which may be uncomfortable. But maybe you too can start your own journey of recovery and stop suffering in silence. Recovery is possible but you have to take the first step.

by Jim Hajny, Executive Director

July 25, 2023

The psychologist Carl Jung wrote, “…knowing your own darkness is the best method for dealing with the darknesses of other people.” Finding meaning in our lives, understanding who we are is an important component to the recovery journey. When we are not well, we don’t have the opportunity to get to know ourselves. We are consumed by our own darkness. Once we begin the journey of recovery the light begins to find its way in and we often begin to ask, who am I. What do I like? What do I want to do with my time, my life?  We may find we need to let go of friends we hung out with. We may find we have lots of extra time to fill but unsure how to fill it. This is where I encourage the idea of volunteerism. In the twelve-step community it is referred to as service work. The Cambridge Dictionary defines volunteerism as; "the practice of doing work for good causes, without being paid for it."

In most communities there are non-profits who are looking for individuals to volunteer their time for their mission. Nonprofits often don’t have enough funds to get all of the task or jobs done so they rely on volunteers. You can volunteer for as little as a few hours a week or for a few months at a time. Volunteering your time feels great, despite not being paid. It will also open a person up to new ideas, people, and places. It is an opportunity to give back to the community.

When I ran Peer Solutions Drop in Center in Livingston we would volunteer at the local soup kitchen preparing and serving meals. We also participated in the adopt a highway program where we did roadside cleanup each spring. I always felt good afterwards, my spirit was renewed, and I walked away knowing I had done something that was greater than myself, something positive that would have a ripple effect across the community. These are two examples of volunteerism. There are many more opportunities that can be found. Here are a few to consider around Montana:

Volunteer with Montana State Parks

Montana Master Naturalist Volunteer Service Opportunities

Planned Parenthood of Montana

Become a Befriender Volunteer

Volunteer on an Indian Reservation

Volunteer Missoula

Montana Food Bank Network

by Jim Hajny, Executive Director

May 30, 2023

Keeping your CBHPSS supported in their recovery is vital for retaining your employee long term. By the very definition, "Behavioral health peer support" means the use of a peer support specialist's personal experience with a behavioral health disorder to provide support, mentoring, guidance, and advocacy and to offer hope to individuals with behavioral health disorders.” Your employee is a person who is in recovery. This means they are actively working on themselves, which may include peer support groups, medication, counseling, meditation, a regiment of diet and exercise, journaling and the list goes on and on. As their employer you may be thinking, “Where do I fit in?”

Partners holding big jigsaw puzzle pieces flat vector illustration. Successful partnership, communication and collaboration metaphor. Teamwork and business cooperation concept.

The employer’s responsibility is to provide clinical supervision and support. We have a blog post specifically for clinical supervision so I won’t cover it here. So how do we support our CBHPSS? We start with having open dialogue about what the CBHPSS may need during the interview process. Do they attend a Tuesday noon support group? Do they see their counselor across town at 3pm on Thursdays? Ask. How will this affect the workflow in the office. Is there a reasonable accommodation that the CBHPSS needs in the workplace?  Open the dialogue about their recovery and keep it open throughout their employment. Once working make sure they are utilizing their lived experience with a behavioral health diagnosis to support others. Often CBHPSS get slipped into other roles such as case managers. This moves them farther away from sharing their experience in recovery and being much more clinical. No, CBHPSS are not clinical in nature. Yes, they may work in a clinical setting. But the nature of the work for CBHPSS is recovery support not clinical. Next make sure they are keeping up on their CEU’s a minimum of 20 per year are required by state rule. We see many CBHPSS in December trying to acquire all 20. Continuing education should be all year long and promoted in the workplace.

What types of supporters does your organization offer its employees? Not CBHPSS, all of your employees? Mental and emotional wellness is important for everyone. If you don’t have support in place for all the staff you are missing an opportunity to build better relations, have more effective and happier staff. Here are some suggestions.

• Quarterly outings
• Monthly drawings for fun giveaways
• Employee of the month awards (or annual)
• Free snacks in the breakroom once a week
• Trauma informed care training
• Increasing Employee Assistance Program (3 is not enough)
• Casual Fridays

You can come up with a plethora of ideas to motivate staff and make the workplace more supportive by doing a simple search online. Or ask other organizations what they do. This should be for everyone not just CBHPSS.

by Jim Hajny, Executive Director

May 16, 2023

I hired my first peer supporter in 2009. I currently have 3 CBHPSS and 4 Family Peer Supporters. After 14 years I have learned a few things, but I still find it challenging.  Hiring anyone is challenging. Candidates often put on their best self, can embellish their credentials, and say what we want to hear. This provides us with false knowledge about a candidate and ultimately a decision which will cost the organization time, energy and dollars. Hiring the wrong person can lead to hours of retraining, coaching, and documenting an employee who will eventually be let go only to restart the process again. Then there is the shrinking workforce nationally. There simply are not as many people to fill healthcare related jobs. Getting it right the first time is important for any organization. The other challenge with hiring peer supporters is the pool of candidates typically don’t have much professional experience. Most peer support candidates have worked entry level jobs, and gaps in employment. Individuals in recovery may have a decade or more unwell, some have been incarcerated or hospitalized. This isn’t true for everyone, but the vast majority will have a less than ideal work history and therefore I do not focus on the work history. I instead focus on where they are today. Back in 2009 I didn’t really understand these complexities of hiring a peer supporter. I just interviewed candidates and hired one. Today I have a much different approach. I find the job description is vital for gaining clarity.

I start with the requirements for the position such as, the ability to achieve and maintain state certification, required weekly clinical supervision and training specific to the position such as crisis intervention training or trauma informed care. These trainings are continuing education and not part of the 40 hour certification training. These are unique to each position. A peer supporter working in the justice system will need specific justice related training. I always include these requirements in the job description, it also opens the door to interview questions.

In the ad for the position I will say, Please submit resume and cover letter including an explanation as to why you are interested in applying for this position. If I get a generic cover letter, it’s a red flag. I do not offer an interview since they did not follow instructions.

Here are some of the areas I focus on in the interview.