The suspect accused of fatally shooting four people at a Montana bar, who remains at large, struggled with mental health issues but was denied services from agencies that were supposed to help, according to his niece.

A manhunt is intensifying for the gunman who allegedly killed a bartender and three patrons at a bar in southwestern Montana, authorities said.

Anaconda is about 75 miles (120 kilometres) southeast of Missoula in a valley hemmed in by mountains. A town of about 9,000 people, it was founded by copper barons who profited off nearby mines in the late 1800s. A smelter stack that’s no longer operational looms over the valley.