Community Services

Medical Care

Introductory Information

The medical system is highly complex.  Describing the medical system as a whole is beyond the scope of this project, but here we describe the medical system as it pertains to youth with mental health concerns.

Eligibility

Medical care is strongly impacted by insurance coverage. If your youth has very high needs, consider applying for Healthy Montana Kids Plus. 

Primary Care

Includes Doctors, Nurse Practitioners, and Physician's Assistants

For many youth and families, their doctor is the first point of contact. Youth will see their doctor for physical exams, vaccinations, well checks, and any sicknesses or injuries that require medical attention. Doctors are also the first place parents should express concerns about their child’s emotional and/or behavioral issues. Doctors can make sure that the issues or concerns are not a medical problem, and offer consultation and referral to other medical and mental health professionals as needed. Doctors also prescribe a wide range of medications for mental health-related issues including anxiety, attention, depression, and sleep.

Specialty Care

There may be times when a youth needs more than can be provided by their general physician. In cases where youth in crisis require more intensive or specialized care, the primary care doctor can make referrals to other providers. One common specialty care referral is to psychiatrists or advanced psychiatric nurse practitioners (APRN’s) for medication management. This may be considered when medications prescribed by your doctor have been adjusted multiple times and are still not working, or when children are on many medications at once. Referral for psychological, neuropsychological, or developmental testing may also be a helpful next step. Other specialty care referrals your doctor may make are occupational therapy, physical therapy, and/or speech therapy.

Urgent Care

Urgent care refers to walk-in, same-day or next-day appointments for a variety of health concerns. Walk-in clinics are able to perform the same tasks as primary care doctors, but most likely will not know the youth or family as well. This may be a barrier in cases where families need their doctor to sign off on assessments or authorizations for specific services. However, some walk in clinics offer appointments and serve as a family practice as well.

For mental health crises that can be addressed with next day response, the available option is St. Peter's Hospital.

Emergency Care

The Emergency Room is best used when all other options have been tried, or the situation requires immediate care for safety and well-being.Youth can be evaluated in the Emergency Room for mental health issues and possible placement in the hospital. They can arrive with parents, or with the support of law enforcement and/or other professionals. 

Youth must go through the process of medical screening, which can take several hours. The doctor determines whether to call in the on-call mental health professional. This is most common when considering a placement in acute inpatient hospitalization. Law enforcement and other professionals are unlikely to stay through this process.

If a youth needs a hospital placement or more intensive services, the Emergency Room staff explore options. For youth under 12, Shodair Children's Hospital and Billings Clinic are the in-state options. For youth over 12, Saint Patrick Hospital’s Adolescent Inpatient Program and Pathways Treatment Center are also options. If these facilities do not have available beds, there are out of state options. Parents should attempt to transport youth, but can access an ambulance under certain circumstances. Parents must be present through the intake/admission process.

If the youth does not need a hospital placement, Emergency Room staff will explore other options with the family. This may include shelter care, partial hospitalization, a safety plan, and information for follow up services. (See Mental Health for more information)

Under some circumstances, parents may decide against the recommendation to hospitalize their child. This is a parent’s right, and other community based options are available. It is important to know that not following this recommendation may result in a report to Child and Family Services from the mental health or medical provider