Having retired from a hospital administrative position, I can say that even in the wealthiest communities and states, the number of capable and well trained mental health workers is woefully inadequate. And while there is a robust and reasonably well organized system for routine and hospital medical care, there is almost nothing equivalent on the mental health side. If a hospital is impacted by a major influx of patients beyond it's capacity to respond, there is a network that helps by either bringing in more resources, or helping distribute cases to other facilities. We saw this in the pandemic, albeit with the system still highly taxed. But on the mental health side, while docs and social workers try to get mental health patients the type and quality of care they need, there is frequently a lack of beds, staff and alternate facilities to take them. It is not unusual for a patient to present at the ER, get his/her medical issue treated successfully, but then getting stuck there due to an underlying mental health issue, sometimes for weeks and even months. This is most acute for lower income and even many people that have insurance. Given mental health needs in the population that seem to be growing exponentially, fueled by broken families, illicit drugs and income inequality, the situation is only going to get worse.

is the PAY! It's pitiful. I know, I checked. Western State Hospital near here is still trying to recruit me, even though I'm 79 and I let my nursing license lapse last year! The salary schedule they quoted me was pathetic. I wouldn't consider it even if I were young and able-bodied, which I'm not.

The other reasons are working conditions (chronic understaffing, inattention to security and patient violence), the fact that many people don't like and aren't suited to psych nursing, and the biggie---that so many places really have NO interest in getting patients (no called "clients&quot well at all.

Montana can be considered a shithole...

https://montanafreepress.org/2022/04/11/montana-state-psychiatric-hospital-to-lose-federal-funding/

The body-slammer, billionaire governor is all about privatizing what few state services we have and so is trying to kill those services to come full circle with his self-fulfilling prophecy. Shit, we can't have anything, really. The only social services in the state are federal programs that are mostly funded by the federal government. Anything else is a nonprofit.

He only wants millionaires and billionaires to live in Montana and he wants to sell our public lands and national parks to them too. None of them pay taxes so we can't have nice things.

So, in order to kill the only mental health hospital in the state's inventory, he's allowed it to fall into irreparable decline. It was already in trouble, for years, but this governor hammered the last nail into the coffin.