An addiction program was supposed to help nurses. Then one took her own life.

Last December, Billings nurse Amy Young returned to Montana after spending roughly two months in an inpatient addiction treatment center in Georgia. The 50-year-old mother of three was sober and ready to rebuild her life after relapsing with methamphetamine earlier that year, members of her family recall. She had a recovery plan and wanted to turn a new leaf. 

But soon after she arrived in Montana, family members said the state’s Board of Nursing notified Young that it would be suspending her license for at least a year based on her prior relapse. To regain the ability to practice, licensing records show, Young needed to remain in full compliance with the rigorous terms set by the Montana Recovery Program, a program she had been working with since 2023, when the Virginia-based company Maximus, Inc. took over the contract for medical monitoring in Montana. The program is tasked with closely monitoring dozens of health care workers’ sobriety and mental health.

Young’s mother and eldest daughter said the nurse was distraught about her temporary license suspension and her inability to return to a job she loved. They also said the monitoring program, with its many costly and seemingly impossible-to-adhere-to requirements, compounded her distress. 

“She felt like there was little hope of getting beyond it,” Susan Davidson, Young’s mother, said. “I don’t feel like they served her very well. Gosh knows the outcome wasn’t good.”

Young had already been in the Maximus program for more than a year. Under a new agreement, Young could have faced years more of frequent and expensive drug tests, location monitoring and costly group meetings, all while not being able to work in medicine. Participants continue in the program even after they become eligible to work again — sometimes for as long as five years, according to the program’s website.

“She felt like there was little hope of getting beyond it. I don’t feel like they served her very well. Gosh knows the outcome wasn’t good.”

Susan Davidson

Young died by suicide in January, the day after public records show the state nursing board finalized the terms of her suspension. The suicide of a Montana Recovery Program participant has not been previously reported.

Since then, the death has been left out of multiple program reviews, Montana Free Press found. Maximus failed to acknowledge the suicide of a participant in an April public presentation to the state nursing board, according to a review of public meetings and records. The company also has not mentioned a participant’s suicide in standard reports about the program’s operations, which include detailed data about enrollment, discharges and recent relapses. Additionally, the death went unmentioned in an August report about the program written by nonpartisan legislative auditors at the request of state lawmakers.

National researchers interviewed by MTFP offered mixed opinions on whether a specific suicide of someone in an addiction monitoring program should be publicly discussed, noting that cases are highly personal. But they agreed that health care worker deaths are often wrongly downplayed and ignored by state and national regulators, missing valuable lessons that could prevent future tragedies. 

Young’s death also adds to existing questions about the quality of the Maximus’ program, which Montana began contracting with in 2023. The program is designed to serve any one of the more than 60,000 licensed physicians, nurses, pharmacists or dentists whose work is impaired because of addiction or mental illness. State lawmakers are scheduled to question legislative audit staff about their recent report about the program at an upcoming meeting on Friday.

Bruce Robertson, a doctor and a former member of the Montana medical board that licenses doctors, said board members who oversee the Montana Recovery Program should have been notified somehow about a participant’s suicide, even outside of a public forum, “to determine whether additional, confidential investigation should have been undertaken” about how participants are supported within Maximus’ program. 

“It is the responsibility of the participating, professional boards to provide such expertise and advise the [state labor department] which, of course, they cannot do if unaware of a potential problem,” Robertson told MTFP in a September email.

One member of the licensing board for physicians, James Guyer, told MTFP in July that he did not recall seeing any recent information about a suicide within the monitoring program.

“[The Board of Medical Examiners] is not routinely apprised of physician deaths regardless of cause,” Guyer said.

Maximus declined to respond to questions about how it communicated with licensing boards about Young’s death, directing MTFP to the Department of Labor and Industry. 

A spokesperson for the state labor department, Sam Loveridge, told MTFP that Maximus had in January notified a department staffer, who is not a member of any licensing board, about Young’s death. Asked why the suicide of a nurse under a state-mandated monitoring program wasn’t discussed with board members at later public oversight meetings, the labor department said that including information about participant deaths could be inappropriate and disrespectful to family members and other licensees.

“Quarterly reports do not include information related to deaths of participants or those ordered to complete the program. Reports are public documents and inclusion of those statistics, while potentially relevant, could be inflammatory,” Loveridge said.

Chani Nava, Young’s daughter, said the state’s rationale for not publicly discussing her mother’s death with board members didn’t sit well with her.

“I would like an explanation of how that would be somehow inflammatory. I would love for whoever said that to come and sit down and explain that to us because I don’t see the logic there whatsoever,” Nava said. “They should definitely want to know if they have participants that are dying, especially via suicide or overdose. I would say those are kind of the two main things that I would think they would be pretty concerned about.”

The causes of suicides — especially among health care workers — are complex and rarely based on one factor. But experts say that, despite discomfort and stigma around discussing these deaths, investigating suicides among medical professionals is essential to prevent future tragedies.

“We need these individual cases to, sadly, become an impetus for change,” said Judy Davidson, a researcher at The Ohio State University College of Nursing who has studied factors that contribute to nurse suicide.

Nurses and other health care providers have previously raised red flags about the stress and perception of punishment that comes with being part of the Maximus program. Participants monitored by Maximus in Montana and other states have described the company’s program as punitive, invasive and punishingly expensive — a stark contrast from how the former contractor, a Billings nonprofit, operated the program for decades.

Previous reporting by Montana Free Press revealed how enrollees saw the costs of drug and alcohol testing substantially increase since Maximus took the program over, stacking up to hundreds of dollars a month. In August, Lee Newspapers reported that one participant had to pay $294 for a single test that the program required her to complete the same day.

Professional assistance programs for medical licensees vary widely from state to state. Many models emphasize peer support to help providers recover from burnout, addiction and mental health issues. Others offer financial assistance if licensees are struggling to afford program requirements, including drug tests. 

The diversity of programs makes it difficult to track which models are working or falling short when it comes to rehabilitating health care providers. The state-by-state approach also obscures the prevalence of suicides among medical providers who went through a monitoring program. But research shows that the lead-up to Young’s death included several known warning signs for suicide among nurses: job-related pressure, financial burdens, stigma about seeking mental health and addiction treatment and fear about license discipline. 

A national 2021 longitudinal study of more than 200 nurse suicides found that the vast majority of deaths happened among professionals who were out of work or at risk of losing employment, often because of mental health issues or substance use disorders.

In a September policy discussion among leading researchers, Amanda Choflet, the dean of the nursing school at Northwestern University’s Bouvé College of Health Sciences, said one possible reform could be addiction recovery programs that try to ease financial burdens on licensees.

Christopher Wojnar, a Wisconsin-based psychiatric nurse practitioner and policy adviser for health care worker protection, said other reforms could focus on changing how participants perceive and experience monitoring programs. 

“The way monitoring programs are designed right now lead to either overt punishment or punitive undertones, rather than support,” Wojnar said during the panel. “They compound shame, financial hardship and isolation, all of which are well-established suicide risk factors.”

Davidson, Young’s mother, watched many of those themes plague her daughter. She described Young as a resilient person and compassionate nurse. But her license suspension and experience with the monitoring program seemed to carry a heavy toll, Davidson said. 

Financial strain appeared to play a role in Young’s depression. According to one Montana nurse who recently graduated from Maximus’ program, standard costs included a $125 monthly program fee and up to $100 for a single drug or alcohol test, which could be required multiple times a month. The nurse requested anonymity to protect her professional reputation.

Davidson and Nava said that, before her death, Young was spiraling about the surge in new costs, and worrying about the prospect of missing mortgage payments if she wasn’t able to find work that paid her as much as her previous nursing job.

“She was just obsessively talking and thinking all the time about how scared she was of just her financial situation and her life situation with not being able to work,” Nava recalled.

If she had received more help, Nava suggested, the health care system in Montana would have benefited from her return to the labor force.

“I think one of the things that allowed her to be such an amazing nurse was the depth of empathy that she was capable of,” Nava said, crying. “The people in this world that have the most empathy are the ones who have had to go through really tough experiences themselves.”

In the months after her death, other nurses who worked with Young remembered her as a kind provider who supported her colleagues and patients. One former coworker even designed a T-shirt and logo with an inspiring message of hope and Young’s initials on the back, encouraging other nurses to buy one.

“Maybe someone will see the shirt/hoodie and change their mind,” one former coworker said.

The text is on the front, printed over the wearer’s heart: “You matter.”

This story was updated on Sept. 18, 2025, to correct estimated costs about the Montana Recovery Program made by a prior participant.

This article was updated on Sept. 19 to correct the month in which a report about the Montana Recovery Program was published.

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