Montana teens struggle with their mental health, access to help. A new tool hopes to change that.

For some who work closely with youth, the tool's launch this spring marked a milestone in the long-standing effort to break barriers for young people seeking mental health support.  

That's important, they say, because about 29.9% of Montana youth report persistent feelings of sadness or hopelessness, according to the 2025 Montana Youth Risk Behavior Survey, and the state currently ranks worst in the nation for teen suicide rates.

This is compounded by the fact that 53 of Montana's 56 counties are federally designated mental health professional shortage areas, according to recent Health Resources and Services Administration data.

Locally sourced

Dr. Eric Arzubi, of Frontier Psychiatry, partnered with developers of the tool, to help combat these troubling trends. 

Arzubi is the Billings-based partner and proponent of Project YES (Youth Empowerment and Support) Montana, and he’s excited to witness what comes of the professionally developed, evidence-based digital mental health support as it circulates throughout the state.

Some of his colleagues in Montana's mental-health community are also optimistic the tool will have an impact. 

“I think it'd be a really great tool for those who can't get connected to care for whatever reason,” Kori Anderson said. “Whether it's lack of access, especially among rural communities, or for whatever reason they can't get in to see a provider, whether it's insurance or transportation or anything like that."

As RiverStone Health’s prevention health specialist, Anderson is active in suicide prevention work and interacts often with Billings teens.

Getting to the internet — whether it be on a smart phone or library computer — is often easier than getting to see a mental health professional.

And even if they can gain access, “It’s pretty important to give, especially teens or youth, as many tools as possible, because maybe some don't feel comfortable talking to a therapist.”

No appointment, personal information or credit card is needed to gain access to Project YES Montana. Anderson believes those features are especially beneficial for and attractive to teens.

“I really liked how it was all anonymous,” Anderson said. “I feel like a lot of students that I hear from that's a big concern, even in other realms.”

In her time talking with teens, she’s learned it can be a deterrent to seeking help if there’s a chance an adult could be notified. “So, I think that was pretty cool and I think a lot of teens could feel comfortable using it."

Focusing on problems

The tool is available on Montana.projectyesguide.org and includes a variety of interactive — and intentionally nonclinical — modules that focus on specific problems and skills — not diagnosis. The modules are designed to help users do things like improve their mood, rethink their body image, reframe negative thoughts, know their power to change, take steps to their goals, protect their LGBTQ+ pride, handle self-emergencies and stay safe when having dark thoughts.

Emily Aerts gave the new tool a try recently, and after working her way through a few different modules said the tool could be beneficial, especially for teens in crisis who don’t have access to a therapist.

Aerts is a Pediatric Behavioral Health Provider at RiverStone Health who works one-on-one with youth up to 18 years old. She tried to put herself in a teen’s shoes while using the new platform.   

“What I liked about it is, it was very action oriented," she said. "You could go through and pick what you feel like would work for you. You don't have to enter in any of your personal information. It's just kind of like in-the-moment feedback. It's fairly quick and easy to follow and easy to understand. And then at the end, you get like a summary of your action plan.”

She imagined teens using the tool on their phones and could see them taking a screenshot of the advice at the end to refer back to.

“I could see somebody benefiting from it who maybe didn't have access to a therapist and wasn't really familiar with what to do, or where to go, or how to address something,” she said. “It gave really realistic first steps for how to address your thoughts, what actions you can do now to change some of your feelings.”

Even for those who have access to a therapist, she said the tool could be useful for teens “having trouble (reframing thoughts) in the moment,” and to be “able to revisit some of those concepts that you do learn in therapy.”

“It was definitely really good for that: ‘I'm in crisis, and I need to walk through with someone what to do right now,’” she said.

Future of mental health

At the end of the user’s chosen module, Aerts said links are shared to local resources as well as other free pertinent resources online, like breathing exercises on YouTube.

“In my mind, this is the future of mental health — proactive, scalable tools that kids can access on their own terms instead of waiting months for an appointment,” Arzubi said. “If we can give them something that’s evidence‑informed, easy to click into, and actually moves the needle on how they feel, that changes the game.”

Arzubi said 995 Montana teens have used the platform since its launch, and efforts to disseminate the tool are “only just beginning.”

The platform is anonymous, takes about 10 minutes to use and is available to any young person in the state with an internet connection.

A state initiative for a systemic issue

The tool started as simply Project YES. It was developed by scientists at the Lab for Scalable Mental Health in Illinois in 2019 as an initiative to “ensure every young person has access to online services to improve their mental health,” according to the website.

Project YES Montana is the result of a public-private-academic partnership between Montana Department of Public Health and Human Services, Frontier Psychiatry, Montana Pediatrics and the Lab for Scalable Mental Health at Northwestern University.

“Montana is the first state to go live with anything like this,” Arzubi said. “Now other states, I think, are trying to copy this. That's really cool for Montana, because oftentimes, we're last, or close to last.”

Since the beta program’s launch it’s expanded through partnerships with states across the country to expand their mission “to ensure more young people can access mental health support quickly, privately, and barrier-free.”

Modified versions of Project YES have now launched in Montana, Indiana and Texas, tailored for relatability by youth from each state.  

More options

Anderson and Aerts believe having a trusted online tool that is free to use is beneficial to teens, especially since some other sites claim to be free and aren’t. Another free, habit-forming app Aerts said many of her patients use is Finch. It’s designed like a game where the user takes care of a small virtual bird and sends it on adventures by completing real‑life self‑care goals.

“We know that teens and youth are going to use their phones,” Anderson said. “I think it never hurts to have more options, especially when you live in places where you have very limited options.”

Aerts views Project YES Montana, Finch and other apps as useful for teens to keep in their toolbox of resources and support, “but we have to have our other tools,” she said.

“We still need to put our phones down and connect with other people,” Aerts said. "Those in-person social connection pieces are so important, and having those other things, especially time off screen, is really important too.”

Peer reviewed

Project YES and its individual single-session modules have been evaluated and published across several major peer-reviewed journals, including "Nature Human Behavior" in 2021, "Journal of Consulting and Clinical Psychology" in 2022 and "Journal of Clinical Child & Adolescent Psychology" in 2023.

According to Project YES’s impact report, led by Lab for Scalable Mental Health founder Dr. Jessica Schleider, the tool has been shown to reduce hopelessness and self-hate and increase a sense of agency among participants, regardless of which module they interacted with. This finding was first noted in the original Project YES trial, and has been replicated in subsequent community trials, adding up to more than 5,500 youths who’ve interacted with the program.

How it started

Project YES Montana grew out of an ask from Montana DPHHS for Frontier Psychiatry “to do something creative, impactful and innovative” with a portion of its funding from the Health Resources and Services Administration. Frontier Psychiatry holds the state contract to manage the Montana Psychiatric Access Line.

The goal was to create something to move the needle on mental health outcomes statewide. 

“I give the state of Montana a lot of credit for letting us do something cool,” Arzubi said. “They came to us and asked us to do something that had never been done before. They wanted us to think creatively, take a real swing at the youth mental health crisis, and use public dollars in a way that could change lives at scale.”

Arzubi needed no encouragement to create something to make a difference for Montana youth’s mental health. 

“It’s part of my oath as a physician to keep trying new things, to move the needle, to make things better,” Arzubi told the Gazette during project development. “Does it make me nervous sometimes to try new things? Sure, but that should not be a reason to keep what’s potentially lifesaving interventions from our community. Otherwise, we’ll keep reading the same headlines over the next 20 years about how mental health in Montana is not very good.”

Arzubi had been following the research of Schleider, and her work with the Lab for Scalable Mental Health, when he was tasked with creating something innovative. He knew exactly who to call. Schleider developed the first renditions of the program that would later be tailored for Montana youth.

Built with Montana youth

A central feature of the Montana rollout of the online platform is that young Montanans helped design it. Young people across the state shaped the final product through a formal co-design process that influenced the language, length and flow of every module on the platform. Schleider acted as principal investigator for the study during modifications and interacted directly with a Montana teen focus group.

The teens provided a variety of feedback.

“I feel good about my participation as I feel it may help other teens in the future if needed,” one participant said.

“There's a lot of stuff for kids or for adults, and I think often teens are left out,” another participant said of the teen-centric online tool.

One Montana teen shared that they appreciated the tone of language used throughout the modules, which speak directly to the user, saying, “I want the words to feel like they’re talking to me, not about me.”

Schleider said early feedback from teens led to a renaming of the clinical “single-session interventions” as “mini courses.” From their feedback, modules were shortened from their original 15 to 20 minutes down to five to 10 minutes, and the entire experience was altered to be anonymous.

“I'd be more likely to do the short activities,” one teen shared. “It would be more immediate support rather than making an appointment and the soonest availability being three months later.”

“I would know if the experience was worth it or valuable to me if I was able to leave the activity feeling like I have a plan I will use the next time,” another teen said. “Being prepared for that will make me feel better.”

Schleider said clinical trials comparing the different module lengths confirmed that the shorter versions delivered the same measurable effects on depression two months later.

“Having activities to do to regulate yourself, and how you're feeling, is also a big thing, because lots of people don't know how to regulate, and so they end up spiraling,” another said.

Attracting views

Project YES has now reached more than 150,000 young people nationwide through clinical trials and partnerships, involving feedback from local youth for each state-specific tool disseminated.

“This in my mind, this is the future of mental health, you've got to be able to do this stuff,” to make an impact “on the overall mental and emotional well-being of the youth of Montana,” Arzubi said.

"Montana's hard,” Anderson said. “We don't have to have this pull-yourself-up-by-your-bootstraps mentality. It’s OK to ask for help.”

One Montana teen Project YES focus group member said they appreciated the connection to local resources at the end of the module, adding, “Local resources are important, too, because it's just another encouragement to reach out to people who can help you.”

Aerts says Project YES Montana mirrors real therapy in one crucial way: it doesn’t assume every teen is ready to change at the same pace. Each module asks them to rate “how ready” they are to do something differently, on a scale of one to 10.

“We can offer all of these resources, we can have all of these tools,” Aerts said, “but mental health is a very personal journey, and you have to decide that you’re ready for it, and you have to decide that you want your life to be different.”

For immediate emotional support, people can also dial 988, the suicide prevention hotline.