Behavioral health providers have always competed for scarce resources and have often not been aware of key policy and regulatory opportunities. These providers have faced economic, regulatory, and workforce challenges in a rapidly evolving health care environment, and they have and continue to struggle to provide services to a group of people who are among the most vulnerable. At the same time, they have had few opportunities to meet, learn from each other, and collaborate on programs, health system reforms, strategic planning, or policy and advocacy.

Historical fragmentation of the behavioral health system has resulted in a fragmented delivery system in communities across Montana for adult mental health, youth mental health, and substance use disorders in the adult, youth, and American Indian populations.

In the past, Montana has had formal and informal state associations that reflect regulatory and oversight divisions (children, adults, substance use, mental health, and tribal) of the Montana Department of Public Health and Human Services. But these organizations had never had consistent staffing and despite dedication and passion, there were few resources with which to engage effectively. In 2016, many were beginning to recognize that a strong state behavioral health association was needed to provide a powerful tool for strengthening behavioral health services. A behavioral health association that includes substance use disorders (SUD), would inherently elevate this part of the behavioral health spectrum as a valued and important health issue as well.

In June 2016, the Montana Health Care Foundation (MHCF) brought together executives from addiction, mental health, and tribal behavioral health organizations to discuss the idea of forming a strong state association representing all behavioral health services. Meeting participants observed that this was the first time the diverse group of behavioral health leaders had met! The leaders realized that to meaningfully embrace behavioral health in the greater health system, the behavioral health leaders themselves must be aligned and united—no small task for behavioral health providers that had functioned separately for decades. Over several meetings, this group decided to pursue creation of a state behavioral health association and solidify its commitment to unite as behavioral health providers and reinforce behavioral health as a foundational component in the state’s health care system.

MHCF provided convening resources, strategic leadership, and facilitation for this group. The group developed a vision, mission, and value statements and committed to developing a business plan and achieving sustainability within three years.

After a year of work, this group formed the Behavioral Health Alliance of Montana with a Founding Board consisting of 2 representatives from the children’s, adult, substance use and Native American groups.