Local officials hopeful new mental health hold law can help those in crisis
The Montana Legislature approved a law change during their 2025 session that local officials are hoping will help address a portion of mental health challenges in Great Falls.
Senate Bill 435 created an option for a 72-hour hold for a person in a mental health crisis.
Previously, medical professionals could only hold a person until the next regular business day and could not administer life saving medication.
Now, they have the option to hold someone in a mental health crisis, within certain parameters, for up to 72 hours at a local healthcare facility and administer “life saving” medication.
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“We’re hoping it will be a really good tool for us,” Cascade County Attorney Josh Racki said. “We have a lot of people that it could really help.”
The new law also opens the types of professionals who can make a referral to the hospital for a mental health hold, such as licensed counselors, doctors, nurses and family therapists, among others.
Those professional referrers have to refer the person to a mental health facility, where a doctor evaluates the person and makes the call on whether a 72-hour hold is warranted.
Law enforcement officers also still have the option to take someone to the hospital for an evaluation, if the hospital agrees.
At that point, the healthcare facility must immediately notify the offices of the county attorney and public defender of the hold, starting the 72-hour clock.
Within 24 hours of detaining the person, a mental health professional must evaluate the person and provide a report to the individual, county attorney and public defender’s office that includes recommendations for further treatment, if any; and whether it is the opinion of the mental health professional that further commitment, including a petition for civil commitment may be necessary.
During the 72-hour hold, the individual may consent to take any medication to stabilize their mental disorder, but “may not refuse any life saving medication considered necessary by a professional person,” as defined in state law, under SB 435.
Racki said his office has been meeting with Benefis Health System, Great Falls Clinic/Hospital, Indian Family Health Clinic, Many Rivers Whole Health in recent weeks and planned to meet with Alluvion Health.
The challenge is that Benefis is currently the only facility with physical space for the 72-hour holds, he said.
The county received a $1 million state grant last year for crisis intervention that’s going toward hiring and training a response team and renovation of space within Indian Family Health to establish a crisis intervention center.
Once that facility is operational, it may be another option for the 72-hour holds, Racki said.
A person may be released before the 72 hours has elapsed if they stabilize and the mental health professional determines treatment is no longer required, Racki said, or at the end of a 72-hour hold, the county attorney’s office can petition the court to civilly commit the person to the Montana State Hospital at Warm Springs, under a separate legal process.
So far, local agencies have used this new law five times, with four of the five agreeing to go to Benefis for the hold. One was civilly committed, Racki said.
One of the five was encountered by a law enforcement officer who recognized the potential mental health crisis and called Benefis to check if they’d do an evaluation, which they did.
“We’re hoping that this will help us keep civil commits down,” Racki said, but it gives the county a legal way to help those in mental health crisis. It also can hopefully help people in crisis out of jail.
But if someone on a mental health hold were to get unruly at the hospital and assault an employee there, it becomes a crime and “those things are real,” Racki said.
The same is true of a person experiencing a mental health crisis who hits a law enforcement officer, firefighter, EMT or paramedic, and then faces criminal charges.
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An issue they’re sorting through is the police enforcement of the 72-hour hold and using force to get someone to the hospital, Racki said, such as a person on the street who appears to be in crisis, but hasn’t yet committed a crime and doesn’t want to go to the hospital for an evaluation.
“We don’t have that answer yet. We certainly don’t want to create criminals,” Racki said. “It’s not against the law to be mentally ill. They still have rights.”
So far, Benefis has covered the cost of the mental health holds, Racki said, and “is being a good community partner.”
Sarah Yoder, Benefis’ director of marketing and communication, told The Electric that the new legislation gives Benefis more time to complete the protocols they already have in place for those experiencing a mental health crisis, but little has changed in terms of their process.
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They still assess patients in the emergency department, “work as a medical and mental health team to discuss the appropriate next steps and create strong safety plans with input from the county attorney’s office, and determine whether the patient needs to be admitted to one of our units, or if they can be discharged with the appropriate resources,” Yoder told The Electric.
The struggle with mental health cases, Racki said, is that if a person says they’re suicidal or homicidal, they may then say they were kidding or no longer feel that way.
Intoxicated people can also be held but they can’t do a mental health evaluation until they’re sober.
The 72-hour hold is a good option, Racki said, as it’s common for people to experience something traumatic or stressful, get drunk or high and become suicidal or threaten harm to others.
After a few days, typically they’ll stabilize and realize that wasn’t good behavior, or that they need more help.
