Abstract
Background: Depression has a recurring negative impact on quality of life and is heavily associated with increased risk of suicide. The magnitude of this challenge is evident in the steady rise in suicide across the United States and even more so in Montana, the state with the highest rate of suicide. When considering Montana’s elevated, vast, rural geographic setting, inability to control for long, dark winters, ultimate shortage of mental health providers, and cultural stigma against any tangible mental illness, individuals who reside in Montana are at the epicenter of mental health crises.
Objective: To explore novel, systemic approaches to better serve individuals experiencing depression by discovering the array of challenges in the mental healthcare system that are elicited by both individuals and mental health providers who reside and practice, respectively, in Montana.
Methods: A mixed methods approach will be conducted over three stages. Stage 1 will employ a cross-sectional, secondary data analysis from the statewide representative Montana Behavioral Risk Factor Surveillance System to estimate the prevalence and geographic location of whom in Montana 1) has access to mental healthcare services, 2) is utilizing the mental healthcare system and 3) has a personal medical ‘home.’ Stage 2 will administer qualitative surveys to mental healthcare providers, informed by findings gathered in Stage 1, to identify the unique composition of providers’ clinical experience, patient populations, and available or recommended treatment options specifically for depression. Stage 3 will conduct in-depth interviews with a sample of providers who hold a vested interest in mental healthcare access, outreach, and engagement.
Results: Findings from this study will provide providers in Montana resources to make services more accessible, engaging, and ultimately successful and establish a mental healthcare network to allow a platform for these providers to collaborate their ideas.
Discussion: All cases of depression are different as are peoples’ attitudes, behaviors, and levels of access to the mental healthcare system. Over 90% of Montana is labeled as an underserved, marginalized region for mental health services. No research has investigated the view of the mental health system from the eyes of both patients and providers in this region.