Montana Mental Health Statistics

Montana faces a significant mental health crisis, characterized by high rates of mental illness and suicide, coupled with profound challenges in accessing care. Factors such as rural isolation, provider shortages, and cultural stigma contribute to the state's low national rankings for mental health outcomes^[7]. In 2021, an estimated 163,000 adults in the state had a diagnosable mental health condition, while 18% of children were diagnosed with at least one mental health disorder^[1]. These figures underscore the widespread nature of the issue and the urgent need for effective, accessible services for all Montanans.

Accessing mental health care in Montana is exceptionally difficult, a reality reflected in its low national ranking for access to care. A primary driver of this crisis is a severe and persistent shortage of qualified professionals. In 2020, over half a million residents lived in designated Mental Health Professional Shortage Areas (HPSAs)^[1]. This scarcity translates into long wait times, with Montanans waiting an average of 30 days for an initial appointment—more than double the national benchmark^[10]. Financial barriers also loom large, with about half of adults who needed therapy reporting that cost prevented them from receiving it^[1].

Native American communities in Montana face disproportionately severe mental health challenges, rooted in historical trauma and compounded by systemic inequities. The 12-month prevalence of any mental illness among Native American adults is a striking 30.1%^[12], significantly higher than other demographic groups. This vulnerability is reflected in tragically high suicide rates, which reached 28 per 100,000 among Native American adults in 2024, nearly double the rate for White adults^[13]. Barriers to care are immense, including a lack of culturally competent providers, insurance gaps, and stigma, leading to lower treatment rates and poorer long-term recovery outcomes^[14].

Geography plays a crucial role in mental health outcomes within Montana. Rural residents face higher rates of depression and suicide compared to their urban counterparts, a disparity driven by isolation, economic stressors, and limited access to care^[17]. Provider shortages are especially acute in these areas, with some counties having no mental health professionals at all, forcing residents to travel long distances for services^[3]. While telehealth has helped bridge some gaps, inconsistent broadband access in rural Montana remains a significant barrier^[18].

Montana's youth are facing a mental health crisis of growing proportions. The COVID-19 pandemic exacerbated existing issues, leading to a dramatic increase in depression and anxiety among adolescents^[2]. A staggering 51.3% of teenagers with depression receive no professional care, pointing to a massive treatment gap^[1]. The situation is also dire on college campuses, where high rates of anxiety, depression, and suicidal ideation are common, yet resources are stretched thin, with a counselor-to-student ratio far below recommended levels^[11].

Montana's approximately 95,000 veterans face unique mental health battles, often linked to their service^[20]. Conditions like Post-Traumatic Stress Disorder (PTSD), depression, and substance use disorder are significantly more prevalent among this population. For instance, 12% of Montana veterans have been diagnosed with PTSD, and 25% have clinical depression^[22]. Accessing timely care through the VA system can be challenging, with average wait times for mental health appointments at 35 days^[22]. The consequences of these combined factors are severe, as evidenced by the extremely high suicide rate among veterans.

Recent years have seen concerning trends in mental health across Montana, particularly following the COVID-19 pandemic. Rates of severe psychological distress and anxiety surged in 2020 and 2021, and while there are early signs of recovery, levels remain elevated compared to pre-pandemic baselines^[8]. The state's already high suicide rate has continued to climb, reaching 32 deaths per 100,000 people in 2022^[1]. A significant factor in these deaths is the high rate of firearm access, which accounts for approximately 55% of all suicides in the state^[24].

Substance use disorders (SUDs) are deeply intertwined with Montana's mental health landscape. The state's prevalence of Opioid Use Disorder (OUD) among adults, at 2.3%, is roughly 1.5 times higher than the national average^[26]. This contributes to a high rate of drug overdose deaths, which reached 15 per 100,000 persons^[26]. Use of other substances, including methamphetamine and cannabis, is also prevalent. The state is working to combat this crisis through harm reduction strategies like naloxone distribution and increasing access to Medication-Assisted Treatment (MAT)^[27].

Eating disorders represent a serious and often fatal mental health challenge in Montana, yet access to specialized care is severely limited. The state ranks 45th nationally for the density of eating disorder specialists, making it difficult for individuals to find appropriate treatment^[30]. Adolescent females are particularly affected, with a 3.5% prevalence rate^[30]. The consequences are dire, with one death occurring approximately every 60 minutes from an eating disorder nationally^[30].

The economic consequences of mental illness in Montana are staggering, affecting individuals, employers, and the state budget. In 2022, lost productivity from absenteeism and presenteeism cost the state's economy $3.5 billion^[33]. Untreated mental illness adds further strain, costing an estimated $2.0 billion annually in lost tax revenue and increased public spending^[1]. However, investing in treatment is not only a moral imperative but also an economic one, as every dollar spent on mental health care yields an estimated 4:1 return on investment^[7].

Montana has enacted laws to ensure mental health parity, requiring insurers to cover mental health services at the same level as medical care^[1]. Despite these laws, significant disparities persist in practice. Mental health claims are more likely to require prior authorization and are denied at a much higher rate than medical claims. Furthermore, self-funded employer plans have shown a parity violation rate of 22%, nearly double the national average^[37]. In response to the broader crisis, the state has taken steps like passing the Montana Mental Health Improvement Act and investing in crisis services, school-based mental health, and telehealth infrastructure^[1].

Several key trends are shaping the future of mental healthcare in Montana. The COVID-19 pandemic served as a major catalyst, accelerating the adoption of telehealth and unfortunately increasing the prevalence of conditions like anxiety and depression. Psychiatric emergency department visits increased by about 25% from 2020 to 2025^[39]. In response, state funding for mental health has seen a 15% increase over the same five-year period^[40]. One of the most significant shifts has been the rapid expansion of telehealth, which has become an indispensable tool for reaching underserved rural populations.