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When L tells the story of her mom — and how she's stuck in a repetitive cycle of mental health crises and bouts of homelessness — she refers to a thick stack of papers and notes she's accumulated along the way.

L has spent more than a year trying to navigate Montana's mental health system, searching for anyone who could help her mom manage her symptoms and achieve enough stability to get off the streets and into a permanent home.

This story was produced in partnership with KFF Health News.

Her mom, K, is 65 and has been homeless in Missoula, Montana for the last eight years. Because of schizoaffective disorder, she experiences severe mood swings and delusions. Another symptom is anosognosia, which means she doesn't understand that she has a mental health condition, and because of that often refuses treatment.

Her daughter, L, asked NPR to only identify them by their first initials because of the stigma of severe mental illness — and to protect K's ability to get housing.

In late 2025, L uprooted her life in Colorado to move back home to Missoula. Her mission was to help her mom regain mental health services and eventually find a place to live.

Missoula is a mountain town, and a destination for outdoor enthusiasts. But the people who live on its streets, like K, must contend with cold winters and scorching summers.

K's mother was surviving, but she wasn't taking her psychiatric medications. Her symptoms were too disruptive for L to take her into her own home. L, an only child, says she still has trauma from growing up with her mom's mental illness.

"It's pretty painful on cold nights to have to not let somebody in because it will deteriorate your whole mental health and stability," L said, choking up with emotion. Her two dogs hopped up on the couch to comfort her.