Oppose HB76-Faith Based Exemptions

Overview of HB 76

House Bill 76 (HB 76) modifies the regulation of behavioral health services in Montana by:

• Creating certification requirements for Family Peer Support Specialists (individuals with lived experience raising children with behavioral health needs).

• Providing a licensure exemption for religious officials, allowing them to provide counseling without adhering to state licensure or certification standards.

• Altering existing regulations for behavioral health professionals, including social workers, counselors, and addiction specialists.

While the bill claims to enhance access to mental health services, its changes pose significant risks by undermining the integrity of licensed mental health care, weakening consumer protections, and failing to align with best practices in behavioral health services.

Creating certification requirements for Family Peer Support Specialists is a positive step toward strengthening Montana’s behavioral health system by recognizing the valuable role of lived experience in supporting families navigating complex mental health challenges. 

1. Research from the Substance Abuse and Mental Health Services Administration (SAMHSA) highlights that peer support improves engagement, reduces stigma, and enhances outcomes for families dealing with behavioral health needs. 

2. By establishing formal certification, Montana can ensure that Family Peer Support Specialists receive standardized training, ethical guidelines, and supervision, allowing them to provide consistent, effective, and informed support to parents, guardians, and caregivers.

3.  Certification also enhances credibility within the healthcare system, improving collaboration with clinicians while ensuring that peer specialists adhere to evidence-based practices rather than relying solely on personal experience. 

4. This bridges the gap between professional and community-based support, ultimately empowering families and strengthening mental health care access across the state.

1. Granting Religious Officials an Exemption Undermines Best Practices in Mental Health Care

What the Bill Does

HB 76 exempts religious officials from Montana’s behavioral health licensure requirements, allowing them to:

• Provide mental health services without undergoing clinical training or ethical oversight.

• Operate outside established best practices in counseling, therapy, and crisis intervention.

Why This Is Problematic

Best Practice: Mental Health Professionals Must Have Evidence-Based Training

Peer-reviewed research supports evidence-based interventions in mental health care, including Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and trauma-informed care. These treatments require rigorous education, supervised practice, and adherence to ethical codes to ensure quality care. A Licensed Clinical Social worker must complete 4,000 hours of supervised practice before being considered for licensure. 

 HB 76 would allow unlicensed religious officials to provide counseling services without any standardized clinical training, posing significant risks to vulnerable individuals who may not realize their counselor lacks professional qualifications.

 Meta-Analysis Findings on the Dangers of Unregulated Mental Health Care

• Untrained counselors often misdiagnose or minimize serious mental health conditions, increasing the risk of harm. (Lilienfeld et al., 2013; Clinical Psychology Review)

• Faith-based counseling, while beneficial for spiritual guidance, has not been proven effective for treating psychiatric disorders, especially conditions like depression, PTSD, and substance use disorders. (Koenig et al., 2012; Handbook of Religion and Health)

• Inadequate training in trauma-informed care can lead to re-traumatization of clients, worsening mental health outcomes. (SAMHSA Trauma-Informed Care Guidelines, 2021)

Key Concern: A Lack of Accountability in Cases of Harm

HB 76 would allow religious counselors to operate outside of the ethical and legal frameworks that govern licensed mental health professionals. This raises concerns about: Failure to report abuse or neglect (mandatory reporting laws may not apply). Use of harmful or coercive counseling methods (e.g., conversion therapy, anger management, and other programs which have been discredited by major health organizations).No recourse for clients harmed by negligent or unethical practices, as unlicensed religious officials would not be subject to oversight by the Montana Board of Behavioral Health.

To align with best practices, religious officials providing mental health care should meet the same educational and ethical requirements as licensed professionals.

2. Weakening Licensure Standards for Peer Support Poses Risks to Behavioral Health Services

What the Bill Does

HB 76 creates a certification process for Family Peer Support Specialists but weakens oversight by:

• Eliminating licensure requirements for peer support specialists, replacing them with a less rigorous certification process.

• Expanding eligibility to individuals with personal experience raising children with behavioral health issues, rather than requiring formal training in evidence-based practices.

• Allowing peer support specialists to work without standardized supervision or ethical guidelines.

Why This Is Problematic

Peer Support Must Be Integrated into a Regulated Mental Health System

Peer support can be a valuable supplement to clinical services—but must be properly supervised and evidence-based. The Substance Abuse and Mental Health Services Administration (SAMHSA) outlines essential peer support guidelines, including:

• Ongoing clinical supervision to ensure peer specialists provide ethical, appropriate support.

• Training in crisis intervention, trauma-informed care, and motivational interviewing.

• Clear role definitions to prevent peer support from replacing licensed therapy.

 HB 76 removes key licensure requirements, potentially allowing under qualified individuals to provide mental health guidance without adequate training, accountability, or supervision.

Research Findings on Peer Support Effectiveness

A 2023 meta-analysis in the Journal of Psychiatric Services found that:

• Peer support is most effective when integrated with licensed therapy.

• Unregulated or poorly trained peer support specialists can unintentionally reinforce maladaptive behaviors in clients.

• The absence of structured supervision leads to increased burnout and ethical concerns among peer specialists.

HB 76 should ensure that peer support specialists remain licensed under behavioral health regulations and receive ongoing professional training and supervision.

3. Broadening Definitions of Mental Health Services Without Strengthening Consumer Protections Puts Patients at Risk

What the Bill Does

HB 76 expands the definition of behavioral health services while removing key consumer protections, including:

• No safeguards against unethical practices by newly certified peer specialists and religious counselors.

• No requirement that patients be informed when receiving services from unlicensed or uncertified individuals.

• Potential insurance reimbursement issues, as many insurers require licensed professionals to provide billable behavioral health services.

Why This Is Problematic

 Best Practice: Transparency and Consumer Protection Are Essential in Mental Health Care

According to the National Institute of Mental Health (NIMH) and American Psychological Association (APA):

• Patients must be fully informed of their provider’s qualifications before receiving treatment.

• Non-licensed mental health workers should have limited roles and clear guidelines to prevent harm.

• Regulated licensure ensures minimum competency standards and protects the public from fraudulent or harmful practices.

 HB 76 fails to include informed consent requirements, meaning patients may unknowingly receive services from underqualified providers without understanding the risks.

The bill should require clear disclosures when an individual is receiving services from a non-licensed provider and include ethical guidelines for alternative mental health services.

HB76 is a Step Backward for Montana’s Mental Health System

While HB 76 may intend to expand access to mental health services, it creates serious risks by lowering professional standards, weakening licensure requirements, and allowing unqualified individuals to provide behavioral health care without oversight.

Key Concerns Based on Research and Best Practices:

Exempting religious officials from licensure undermines clinical best practices and patient safety.Weakening oversight for peer support specialists increases risks of harm and misinformation.Failing to include consumer protections may mislead patients about the qualifications of their providers.

Legislative Recommendations:

1.  Require all providers of behavioral health services—including religious counselors—to meet basic educational and ethical standards.

2.  Maintain licensure requirements for peer support specialists and require structured supervision.

3. Ensure clear disclosure requirements so patients understand their provider’s qualifications.

Montana deserves a strong, evidence-based behavioral health system—not lower standards that put vulnerable individuals at risk. The Legislature must reject or amend HB 76 to align with peer-reviewed research and best practices in mental health care.