Community Services

Mental Health

Introductory Information

The mental health system has many different services, and each has their own criteria and providers. The mental health system is different from other systems in that families have more choices of providers. This is both a benefit and a challenge. The benefit is having options to choose from, and the challenge is knowing how to navigate those options and select the best one. Here we provide some tips for selecting a provider, and an overview of the available types of mental health services. The services are listed in order of intensity, with the exception of crisis services.

Eligibility

Many services require a serious emotional disturbance. Click here for a definition of serious emotional disturbance in Montana.

Healthy Montana Kids Plus is also known as Medicaid. Healthy Montana Kids Basic or Extended are known as HMK and were previously known as CHIP. You can apply for either program online, or visit the local Office of Public Assistance.

The state agency that oversees Medicaid mental health for youth is the Children’s Mental Health Bureau within the Department of Public Health and Human Services (DPHHS). 

Tips for Selecting a Provider

The best way to find a good fit is to ask people you know for recommendations. Consider friends, family members, school counselors, school psychologists, teachers, and your doctor. Have an idea of what you would like to be different in your family’s life, and what the goal of seeking counseling/services would be. Also think about what type of personality or style might be a good fit for the youth or your family, and what might not be. Feel free to ask about their approach and the types of strategies they use. Also feel comfortable asking whether they have a specialty and what their experience is. Ask about scheduling flexibility and how they can respond in crisis. For mental health centers, what is the process to get services set up? How long does it take? If you want in-home services, what does that look like? How many hours a week? For how long? Shop around. Also express any concerns or worries you have upfront.

Outpatient Therapy

Outpatient therapy provides individual, family, and group counseling. Mental health therapists can be: licensed clinical social workers (LCSW), licensed clinical professional counselors (LCPC), and psychologists. Most insurance covers outpatient therapy, but it varies based on the diagnosis, how often sessions happen, and for how long. There may be some restrictions on what services a youth can receive during the same time as outpatient therapy. Additionally, private practice therapists have their own specializations, insurances accepted, and individual eligibility requirements. Most outpatient therapists see clients in an office setting, though some will also come to the home. Therapists through licensed mental health centers are more likely to provide in-home sessions.

Drug and/or alcohol use in youth can disrupt normal development and cause and/or exacerbate many problems for youth and their families. Substance use disorders occur on a continuum and there are many different levels of care available in Yellowstone County. Services in this field are broken down into several different levels outlined by the American Society of Addiction Medicine (ASAM). Identifying the appropriate level of care is important to promote positive outcomes.  Substance use disorders can occur alone, or they can be present alongside other mental health and/or medical conditions. It is important to seek treatment and interventions that can address all of a youth’s problems to try to help them enter a long lasting recovery. Licensed Addiction Counselors (LACs) receive specific training and supervision in working with substance use disorders and are the professionals that typically provide counseling and evaluations in this area. 

Medication Management

Medication management refers to medications for mental health issues and can be provided by a primary care practitioner, a psychiatrist, or an Advanced Psychiatric Nurse Practitioner (APRN). It generally requires an initial medication evaluation, with regular follow up appointments with the youth and family about how the medications are working. It is covered by most insurances. Some practitioners require a referral from another professional, and some will accept self referrals from parents.

Case Management

Case Management provides linkage to resources and helps coordinate services. It is helpful when a child and family has complex needs across many areas of life, and are receiving several types of services.

Case Management is a licensed mental health center service and requires a serious emotional disturbance. It is primarily covered by Healthy Montana Kids Plus. 

Family Based Services

Family Based Services provide in-home therapeutic supports for children and families. They focus on parenting skills, family dynamics & relationships, and other skills needed for the child to be safe and successful in the home.

Family Based Services are a licensed mental health center service and require a serious emotional disturbance. Youth must have attempted other community services. They are primarily covered by Healthy Montana Kids Plus, generally up to one year. Healthy Montana Kids Extended may cover shorter periods of this service if the youth is at risk of out of home placement. Each licensed mental health center has its own model for how they deliver this service. Some models include additional hours of behavioral support with a therapeutic aide. This service is also known as Home Support Services.

School Based Mental Health

School based mental health provides in-school therapeutic support for youth. A therapist and behavioral specialist offer individual & group therapy and classroom support. They focus on social skills, emotional development, and behavioral support.

School based Mental Health is primarily covered through Healthy Montana Kids Plus, though other insurance may cover it to some extent. It requires a serious emotional disturbance. This service is also known as Comprehensive School and Community Treatment (CSCT). It is a different resource than a school counselor or psychologist. For more information, see Yellowstone County Schools.

We have listed the mental health centers providing school based mental health in Yellowstone County. However, the school the youth is attending will determine which provider the youth will work with.

In addition other community agencies work with Billings Public Schools to provide school-based supports such as substance abuse counseling,  mental health counseling and crisis supports. Contact your local school to determine if school-based mental health supports are available.

Contact Information

Yellowstone County CSCT Providers
Agencies Which Provide Supports in Billings Public Schools

Therapeutic Group Home

Therapeutic group homes provide mental health support, stability, and supervision to youth who are struggling to be successful at home. Most of the therapeutic group homes in Billings are in local community/neighborhood settings, though some others  are campus based. Therapeutic group homes in Billings may house up to 6-8 youth, and specific ages depend on the group home and agency. They have support staff and a home manager, supervised by a licensed therapist.

Youth must have attempted other community services, and must have a serious emotional disturbance. Healthy Montana Kids Plus and Healthy Montana Kids covers the therapeutic component, but generally another funding source needs to pay room and board. This may include Youth Court Services,Child and Family Services, or Children's Mental Health Bureau.

Partial Hospitalization, Day Treatment Services and Alternative Education

Partial hospitalization provides daytime therapeutic services in a hospital setting. This includes evaluation, medication management, individual, group & family therapy, occupational therapy, and academics. Youth are under medical supervision, with access to nursing staff, a physician and psychiatrist. It can be a step down from acute or residential care, or to prevent an inpatient admission. Youth remain in their home or community while attending partial hospitalization.

Youth must be 7-18 years of age, have attempted other community services, and have a serious emotional disturbance. In order to qualify youth must be in at least 1st grade if they are 7 and not exceed their 18th Birthday. Partial hospitalization is covered by most private insurances, Healthy Montana Kids Plus, and Healthy Montana Kids (HMK). The length of stay for partial hospitalization is 2 to 3 months on average but can be shorter or longer based on need and authorization. Billings Clinic Youth Partial Hospitalization program or YPHP is the only program that offers partial hospitalization services for youth in Yellowstone County.

Day Treatment Programs provides accredited therapeutic and educational services. All services and activities are tailored to meet the unique needs of each participant.  Day Treatment Programs are available to youth in group homes, but is also available to youth in the community. The staff can include licensed mental health therapists and licensed chemical dependency counselors, who trained to work with youth of varying abilities and learning styles. The staff are trained to acknowledge every accomplishment, and to provide feedback, correction and recognition that help youth learn new and positive behaviors. Day Treatment is covered under Healthy Montana Kids Plus and in some cases can be paid through public schools if it is recommended as an alternative to a regular public school setting.


Billings Educational Academy is an alternative school setting in Billings that honors the individual learning style of each child. Their teaching philosophy builds self-esteem, produces self-thinkers and fosters individuality. This individualized education plan utilizes parent involvement, certified teachers and knowledgeable and creative members of the community. They promote respect and responsibility along with healthy living through community involvement and care of our animals. Their student teacher ratio of ten-to-one, children have access to the kind of learning experiences that are possible only when class size is limited. Their teaching philosophy is centered on small class size, a relaxed environment and alternative testing styles to help their students overcome learning challenges.  Tuition is $700 a month with scholarships available.


Acute Inpatient Hospitalization

Acute hospitalization provides short-term, inpatient services in a secure hospital setting. It focuses on evaluation, stabilization of symptoms, and referral to other services as needed. Treatment is provided by clinical social workers, nurses, occupational therapists, addiction counselors, pharmacists, dietitians, and other healthcare professionals under the direction of a psychiatrist.

Youth access acute care through the Emergency Room. Healthy Montana Kids Plus and most insurance covers acute hospitalization. It has an average length of stay of 7 days but can be shorter or longer based on need and authorization. With some insurance programs, all other mental health services must stop while youth are in acute care except for limited discharge planning. 

Residential Care

Residential Care provides longer term mental health services in a secure hospital setting. Youth are placed on a unit with other youth of similar age. They receive group, individual, and family therapy, and other therapeutic and recreational activities. They may also receive specialized treatment depending on the youth’s identified issues and needs. Residential care provides for all of the day to day needs for a youth in care, such as medical, mental health, and school.

Residential care is for youth who cannot receive the level of intervention they need in the home and community safely. Youth must have attempted other services and have a serious emotional disturbance. Length of stay can span several weeks to a month or longer. Coverage varies across insurance companies. 

Crisis Services

There are options available for youth crisis services in the Billings area. For youth already receiving services through a mental health provider, the mental health provider is responsible to offer some form of after-hours crisis response. This sometimes takes the form of a crisis hotline, an on-call worker through the agency. 

In addition, the Tumbleweed Program is another option for families and youth needing supports in a crisis. Tumbleweed has a runaway program, a drop-in center, and offers crisis prevention; family counseling; adolescent support groups; information, advocacy, and referral to other community services; parenting courses; aftercare and assistance with location runway youth and reuniting them with their parent/legal guardians. Tumbleweed program also has a Human Trafficking Program to support and connect victims of human trafficking with community supports.

Youth and families needing after hours crisis response are also frequently directed to

9-1-1 or the Emergency Room.

The Montana Rescue Mission also provides shelter for women and children as well as offers programs to help support them during crisis situations.

Gateway House through the YMCA offers secure emergency shelter for women and children as well emergency legal advocacy and other supports. Gateway has a 24 Hour Help Line:406-245-4472 and a 24 Hour Text Line: 406:702-0229.

The Community Crisis Center serves persons 18 years and older who have a crisis due to mental health, social service needs or substance abuse.  The CCC is open 24 hours a day/365 days a year for mental health assessments, chemical dependency assessments, short term case management and stabilization services for those in need. The CCC phone number is (406) 259-8800.

The Yellowstone Youth Crisis Network offers crisis intervention  to facilitate access to existing services, help families organize services, and provide information regarding resources.  This intervention can occur within 24 business hours of referral.  The crisis line number is (406) 200-0559. 

The Crisis Text line: offers 24/7 access to crisis counselors through a familiar format that is especially appealing to youth: text message. To access this service, Montanans who prefer to communicate via text message can text ‘mt’ to the number 741-741 and a Crisis Counselor will respond immediately to provide assistance.

The free service is available 24/7 with crisis counselors on the other end ready to help.