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Doctors should spot symptoms beyond a patient’s vital signs. That’s the mindset of an initiative starting to take root within Bozeman Health as the system partners with Montana Healthcare Foundation to weave mental health and substance use disorder help into clinics.

This week, the health system announced a $150,000 grant from the foundation to spend the next two years setting up behavioral health within its internal medicine clinics.

Chief Nursing Officer Vickie Groeneweg said that effort will hopefully become a model throughout Bozeman Health services.

“It’s realizing that behavioral health is just as impactful on the patient and their family as cancer or heart disease or high blood pressure,” Groeneweg said.

Mental health and access to health services rose to the top priorities in the 2017 Community Health Needs Assessment, which Bozeman Health pulled together with Gallatin City-County Health Department and Community Health Partners. That report found that almost half of county residents say they’ve been hurt by a substance use disorder. A third reported they’ve lived with depression for years.

“These are our friends and neighbors,” Groeneweg said. “We as an organization decided we need to step into that arena.”

Bozeman Health already has a psychiatrist on staff. The grant will help underwrite licensed clinical social workers along with support staff and education around behavioral health. Groeneweg said the goal is to do more screening, intervention and case management for patients who show symptoms of things like depression, anxiety or a substance use disorder.

Jason Smith, executive vice president of Bozeman Health Foundation, said the effort to grow these services is a piece of the health system’s $15 million Caring Forward fundraising campaign to expand services.

“I’ve not yet come across a more difficult cause to raise charitable support for,” Smith said. “[Behavioral health] is at the top of the list for us … We’re optimistic that if we can demonstrate the success and keep telling the story, our community will be there for us.”

Before the latest grant, Bozeman Health partnered with the foundation over the last year to study where to start building integrated behavioral health into its system.

The Montana Healthcare Foundation hopes to reach the state’s largest hospitals over the next two years to continue that movement across Montana.

Montana Healthcare Foundation CEO Aaron Wernham said the start of weaving holistic care into services takes time and money. He said once that’s in place, behavioral health should fold into the system like anything else, sustainable through providers billing either insurers or programs like Medicaid for the service.

“We’re now getting to structuring the system in the way that it should have been from the beginning,” he said. “It has never made any sense to dissociate mental illness from physical illness, from substance use disorder.”

Livingston Health was one of the first hospitals the foundation began the effort with roughly two years ago. The hospital’s grant helped build tools to screen patients for a mental illness of substance use disorder. It also created roles to connect people who land in the emergency room in crisis to services that lead to long-term recovery. With the hospital’s grant scheduled to end this year, Livingston officials have said they can continue the practice without grant dollars.

Foundation Senior Program Officer Scott Malloy said the organization plans to work with critical access hospitals and other networks throughout the state to continue that type of care.

“We think that we can help catalyze integrated behavioral health in the primary care system in Montana,” he said. “Up to this point, it’s been, ‘That’s somebody else’s deal’ or ‘We don’t have the tools or resources to do it.’”

Groeneweg said it’s early to know exactly how the initiative will take shape at Bozeman Health. She said the hospital has several goals unfolding alongside the foundation’s grant like expanding telehealth psychiatry.

She said the initiative doesn’t mean Bozeman Health will become the community’s one-stop shop.

“No one agency can do it all,” she said. “We will do as much as we can. In those areas where we can’t provide that service, we will partner with someone in the community doing those services.”

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Katheryn Houghton can be reached at or at 406-582-2628. Follow her on Twitter @K_Hought.

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