Missoula’s Riverwalk crisis receiving center to close

The Western Montana Mental Health Center announced late last week that it has “made the difficult decision to temporarily close the Riverwalk Crisis Receiving Center” on Jan. 31. The facility is located on Wyoming Street at the nonprofit’s headquarters.

“Unfortunately, Riverwalk Crisis Receiving Center has been operating at a loss, which is unsustainable,” said Bob Lopp, the CEO of Western Montana Mental Health Center. “Closing Riverwalk isn’t a decision we take lightly, and we are dedicated to taking care of the staff of Riverwalk and the people who need our help.”

In an interview, Lopp said the organization will work with Missoula County and other community partners, including Providence St. Patrick Hospital and Missoula County, on how to use the facility and provide care for people who need it. 

Riverwalk opened in October 2023 after three years of planning. It provides “triage, crisis risk assessment, evaluation and intervention services” for up to 16 patients. It’s for people “experiencing a behavioral health crisis related to a mental health disorder and/or a combination of mental health and substance use disorder and whose crisis response needs are deemed to be urgent or emergent.” 

Since it has opened, the facility has served over 400 people. That averages out to less than one patient per day over the 15 months the facility has operated.

In an interview, Lopp said that insufficient Medicaid reimbursement and staffing costs were some of the main reasons why the facility was operating at a loss. The center was open 24 hours a day. It employed therapists, peer support specialists, registered nurses and crisis stabilization workers on-site.

“It’s similar to running a restaurant, where all the staff have to be there to keep it open whether or not people are there,” Lopp said. “That’s the biggest issue. It’s been a really good partnership and we’ve delivered great service, but it’s a risky proposition. You don’t know whether 100 people or two people are going to show up. It depends on who’s in the community, it depends on a variety of factors.”

Lopp said that every community in the state, and across the country, struggles with providing emergency crisis services.

“If it was an easy problem to fix, it would be fixed everywhere,” Lopp said.

Missoula County pitched in $1.5 million worth of funds allocated from the federal government’s American Rescue Plan Act to help get the facility running. 

“Our goal with Riverwalk was to address the needs of our neighbors in crisis and alleviate the strain on first responders, local emergency rooms and jails,” said Josh Slotnick, a Missoula County commissioner. “The need in Missoula isn’t going away, and we aren’t giving up. We are pausing services so we can find ways to ensure Riverwalk has long-term financial stability.”

Slotnick and Lopp said the county and St. Patrick Hospital support the decision to close the center.

Lopp said a decision about how to use the facility, and how to serve people in the community who need help, will be made in the next few months.

When it opened, Slotnick told the Missoulian that about 30% of patients who are seen at the emergency room at St. Patrick Hospital are there for a behavioral health crisis. The goal with Riverwalk was to “alleviate the strain” on local emergency departments, jails and state-run care facilities.

Slotnick said crisis receiving beds save communities millions in emergency and detention costs by diverting people away from more costly services.

“Being in crisis is not a crime,” Slotnick said when Riverwalk opened. “Bringing that person to jail is a horrible misuse of expensive resources at our really well-run jail.”

So, after Jan. 31, people in crisis will still be able to have access to suicide prevention counselors and the Mental Health Crisis Lifeline by calling 988. It’s available 24 hours a day, seven days a week. Also, the Missoula County Mobile Support Team is available to people experiencing a mental health crisis by calling 911. Both emergency departments in Missoula, at Community Medical Center and St. Patrick Hospital, will continue to serve people experiencing a behavioral health crisis.

“Riverwalk provided help to so many people,” said Jeremy Williams, director of emergency and psychiatric services at  St. Patrick Hospital. “Even though today’s news is sad, we don’t want to lose sight of all this good work. We want to thank everyone in Missoula for coming together to try this innovative approach to serious issues in Missoula. Our work isn’t done. Now, we begin the next phase of this hard work, finding a path forward.”