Billings doctors urge community approach to fight Montana’s mental-health crisis

Posted at 3:19 PM, Nov 29, 2018
and last updated 2018-11-29 19:14:25-05

BILLINGS- A community approach is necessary to combat Montana’s high suicide rate and mental-health “crisis,” two Billings Clinic doctors said Wednesday.

“We don’t have the luxury to wait for patients to show up and play defense,” said Dr. Eric Arzubi, the chair of psychiatric services at Billings Clinic.

On Wednesday at Billings Clinic, Arzubi and Dr. Julie Kelso, head of the residency program, presented their take on the mental health crisis as well as their vision to begin addressing the problems.

It starts with the psychiatric residency program, which was announced in September, and aims to train more mental health professionals in-state with the goal of continuing to employ them within Montana, the doctors said.

Montana annually ranks amongst the top of the country in suicide completion rates, and Billings Clinic considers this a mental health crisis.

A shortage of resources, mental health providers and geographic constraints has made mental health services a challenge in Montana.

During her presentation, Kelso showed encouraging figures that the residency program has brought about in the short time since its announcement.

Over 400 applicants have already applied for the three residency spots in the first class.

Billings Clinic has seven openings for psychiatrists, and Kelso says that Billings Clinic has traditionally interviewed two psychiatrists annually. In the time since the residency program was announced, the hospital has already interviewed five psychiatrists, who say the desire to be part of the new Billings Clinic faculty was a factor in their interest in working in Montana.

So before graduating any psychiatrists, the residency program is aiding in addressing the psychiatrist staffing crisis in Montana, the doctors said.

But even taking these positive steps into consideration, Arzubi says that adding more psychiatrists will not be enough to address the issue.

“We could hire 100 psychiatrists, and it would be the same,” said Dr. Arzubi.

Instead, he calls on an integrated approach that involves the whole community and makes the most of limited resources that are spread across the entire state.

Care chart showing the integrated approach from primary to emergent care proposed by Dr. Eric Arzubi of Billings Clinic as a way to address Montana’s mental health crisis.

Arzubi wants to take best practices based out of Billings Clinic and push these services out across the state. To accomplish this he plans to use and expand existing programs like telepsychiatry, which utilizes video conferencing to access patients outside of major centers.

Ultimately he believes that the only way to move forward on this problem is an integrated approach that enables primary care providers through programs like project ECHO, which “is a medical education and care management collaborative that empowers clinicians in remote settings to deliver better care to more people locally. By putting local clinicians together with specialist teams at larger medical centers in weekly virtual clinics,” per, and helps patients access care at other levels before being admitted to inpatient psychiatry facilities.

“Our role is to bring best practices in and then disseminate across the state,” said Arzubi.

Reporting by Connor Pregizer for MTN News