When 26-year-old Charlie Brereton joined the Montana Department of Public Health and Human Services in December 2021, a few veteran state employees playfully referred to him as “the Intern.” Little did they know that this seemingly inexperienced newcomer would soon ascend to the role of director within and bring reform to the mental health system of Montana.
Brereton, armed with an undergraduate degree in political science, three years of experience as a policy staffer in D.C., and no prior healthcare background, had arrived at the agency to serve as its chief of staff.
Today, he leads the department with an ambitious mandate: to overhaul Montana’s fragmented mental health care, addiction treatment, and developmental disabilities services system, with the help of an unprecedented $300 million allocation from the 2023 Legislature.
Standing at over six feet tall, with a measured baritone voice, Charlie Brereton finds himself at the helm of one of the most significant initiatives within the Gianforte administration’s agenda.
The administration’s exact vision for the systemic restructuring remains somewhat unclear, but consensus is growing among those in the behavioral health and disabilities services field in Montana that substantial and coordinated change is urgently needed.
This aspect of Montana’s healthcare “system” has been under considerable strain due to rising costs, a small and thinly stretched workforce spread across the state’s vast rural landscape, and recurring budget shortfalls.
In recent years, group homes for individuals with developmental disabilities have closed, as have short-term mental health crisis facilities. This has left vulnerable individuals with fewer services, and their families and caregivers in states of distress and overwhelm.
It is not uncommon for Montanans in the midst of a mental health crisis to spend hours in the back of a sheriff’s vehicle en route to the state psychiatric hospital in Warm Springs.
Furthermore, even after losing federal accreditation last year due to safety concerns, the Montana State Hospital continues to admit psychiatric patients who have no alternative placement.
Charlie Brereton’s rapid rise within the Montana Department of Public Health and Human Services is nothing short of unconventional. His transition from “the Intern” to the department’s director underscores the need for fresh perspectives and approaches in addressing Montana’s complex behavioral health and disabilities services landscape.
While he lacks formal healthcare experience, his political acumen and willingness to tackle pressing issues head-on have earned him the trust and responsibility of leading a critical reform effort.
Mental Health System Of Montana and Disabilities Services Crisis
Montana’s behavioral health and disabilities services sector has been grappling with numerous challenges, making reform imperative. Rising costs, limited workforce capacity in a sparsely populated state, and chronic budget shortfalls have strained the system to its limits.
The closure of group homes for individuals with developmental disabilities and the shuttering of mental health crisis facilities have left many Montanans without essential services, placing additional burdens on their families and caregivers.
One particularly distressing aspect of the crisis is the extended journey some individuals experiencing mental health crises must undertake before receiving appropriate care.
Hours spent in the back of a sheriff’s vehicle en route to the state psychiatric hospital highlight the glaring gaps in access to timely mental health services.
The Montana State Hospital’s loss of federal accreditation due to safety concerns underscores the dire need for reform. Despite this, the hospital continues to admit psychiatric patients, demonstrating the lack of viable alternatives for those in need.
Charlie Brereton’s leadership comes at a crucial juncture in Montana’s efforts to revamp its behavioral health and disabilities services. The unprecedented $300 million allocation from the 2023 Legislature represents a substantial commitment to addressing the pressing issues within the system.
While the specifics of the reform agenda remain unclear, the urgency for change is evident. Montana’s healthcare system demands a more cohesive and efficient approach to meet the diverse needs of its residents.
Coordination among stakeholders, policy experts, and healthcare providers will be essential in shaping the future of behavioral health and disability services in the state.
Charlie Brereton’s unconventional ascent to the directorship of the Montana Department of Public Health and Human Services exemplifies the need for innovative leadership in addressing complex healthcare challenges.
Montana’s behavioral health and disabilities services sector is at a crossroads, with daunting obstacles to overcome. The $300 million commitment to reform provides a significant opportunity to reshape the system, ensuring that individuals in need receive timely and effective care.
As the state navigates the path forward, collaboration and commitment to the well-being of all Montanans will be paramount in achieving lasting change.
