In April 2020, a mother was hiking the “M” trail in Missoula with her 13-year-old son for a needed respite from the COVID-19 lockdown. Their peace was shattered when they ran into Jared Kuntz, who repeatedly punched her and smashed her face with a rock. Her son ran down the mountain for help while uncertain of his mother’s fate. While the mom lived, her body and sense of security were shattered.
This tragedy was not inevitable. It was the predictable result of Montana’s deficient mental health system.
This was not Jared’s first mental health crisis. Like many people who suffer from severe mental-health disorders, he had a familiar pattern. He stopped taking his medication. His behavior was increasingly bizarre. His family sought help. They could not get it. His crisis nearly killed a woman, traumatized a young man and took away Jared’s liberty.
By the time he was sentenced, Jared was back on his medications. He was no longer in psychosis. He was rational, remorseful and sorry. He was sentenced to a lengthy incarceration at the Forensic Unit of the Montana State Hospital – the facility where criminal defendants with severe mental health conditions go.
Most people with mental illnesses are non-violent and pose little risk to the public. They should be treated with dignity and compassion in alternative systems to criminal justice. Unfortunately, a small subset of people with mental illnesses are violent or continually disruptive. These people are overrepresented in our criminal justice system because our mental health system is under-resourced, undersized and lacking options that do not involve handcuffs and bars.
The Missoula County Attorney’s Office civilly commits approximately 250 people a year to the Montana State Hospital. We also prosecute dozens of individuals with serious mental health issues who committed crimes each year. Thirteen percent of Missoula’s current jail population are people who have been legally committed to the Montana State Hospital due to their mental health conditions, often waiting a year or more for an available spot. They need mental health care. They sit in jail instead. While mental health is not the largest contributor to crime, it represents the greatest opportunity to make rapid improvements to make our communities safer and ensure better individual and community outcomes.
The Montana Legislature has made good-faith attempts to fund improvements to our mental health system. This includes a $300 million investment in 2023, and funding for a new forensic mental health hospital in 2025, which is in the early stages of development in Laurel. These good intentions have hit a bureaucratic wall though and have had negligible results on the ground.
I share some sympathies with the people of Laurel who oppose a new mental health hospital in their community. They are rightfully frustrated by the lack of information from the state. At a recent public meeting in Laurel, the State sent two staff members with no information or authority to answer questions, leaving the community frustrated and hostile. This silence breeds a predictable “not-in-my-backyard” backlash.
There are reasonable questions about the facility. Is Laurel the best place for a new hospital? What will it cost to run it? Are there more affordable options with the same or better outcomes? These are legitimate concerns.
Montana desperately needs more forensic hospital beds as a middle ground between doing nothing and prison for mentally ill criminal offenders. These individuals are already in our communities. They fill up beds in our jails, clog our hospital emergency rooms and roam our streets — without help and without treatment until it’s too late. A hospital is a safer, secure and more dignified option than the status quo.
But building an effective mental health system requires more immediate, proactive solutions: Re-funding mental health case managers that were cut in 2017, increasing Medicaid reimbursement rates for mental health services to provide community services, funding community group home residences, developing viable discharge plans for the mentally ill instead of dropping them off at homeless shelters, and partnering with local hospitals to treat mental-health issues on the front end. Had some of these resources been in place in 2020, Jared Kuntz may never have started up the “M” Trail that day.
Mental health care can follow a preventative path to intervene before a crisis, or it can serve people after a crisis. Focusing only on building a new lock-down forensic hospital fails to seize an opportunity to prevent disruptive incidents in the first place and is generally more costly than prevention. A new hospital is expensive and would not be operational for years. It is necessary but should not be our only investment. Money is best spent on preventative measures to intervene in mental health crises before they result in a crime.
The money for the Behavioral Health System for Future Generations was appropriated three years ago and could have transformed our mental health landscape. Much of it has either not been spent or squandered in studies, training and bureaucracy that has little practical impact on the ground.
While additional hospital beds are being built, the state must invest in jail-based mental health care and restoration of fitness to stand trial to divert people away from hospital beds before they deteriorate. Jail-based competency restoration does not require new buildings, and the operation costs are a fraction of a new hospital. Montana could transform its mental-health system in a matter of a couple of years under existing appropriations while a new facility is being constructed.
Tragedies like the one on the “M” Trail can be prevented with real and viable solutions. Communities across Montana have numerous solutions to reduce crime, alleviate jail pressure, reduce homelessness, help families with mental-health crises and reduce recidivism for less money and better outcomes.
What we need now is State support and funding to make these solutions a reality.