Updates from Northwestern Mental Health Center

Crookston, Minnesota – Since the pandemic arrived in our world, we’ve all had to make changes to our daily routines and how we live. Northwestern Mental Health Center is no exception. While COVID-19 has caused some hard days with difficult decisions, it has also helped us to reimagine the way we do our work.

“When we’re pushed outside our comfort zone and forced to think outside the box, that’s when we uncover new ideas and strategies to help us improve the way we support our clients,” says Shauna Reitmeier, Chief Executive Officer at Northwestern Mental Health Center.

Here is an update on the current and upcoming changes happening within NWMHC:

  • We analyzed the use of our physical space and opportunities for some positions to work remotely permanently. This reduced the need for physical office space, and the Board of Directors approved the closure of two locations. 

    • On July 31, we officially closed the Resource Center, formally called the Novel Cup located in Crookston. Community-based staff typically used that location as a drop-in space to meet with clients, which will now occur at the main office on Bruce Street.

    • We are in the process of transitioning our senior management and finance teams from the Bremer Bank building to our main office in Crookston or home offices. We anticipate that transition will be complete at the end of August.

  • As a result of the pandemic, we’ve seen a decrease in service utilization for many of our programs, causing us to make administrative and clinical reductions in staff.

    “Part of this reduction includes the elimination of our neuropsychology program,” explains Reitmeier.

    Current providers or managers will notify all clients affected by these reductions this week. Providers will discuss a transition plan that best supports each client and ensure continuity of care with no delay of mental health care services and support.

  • Our East Grand Forks location is now open. Water damage that occurred mid-April caused the entire building to close. Polk County made our space a priority and helped us to reopen quickly, among the renovations to the rest of the building.

  • We continue to see a majority of our clients via telemedicine or telephonic.  We can accommodate face-to-face appointments for more critical client needs and psychological testing and evaluations. We offer same-day appointments for new clients, so we encourage people who have considered getting additional support to call 218-281-3940 and talk to a provider today.

If you have any questions regarding these updates, we encourage you to email them to [email protected].

If you are experiencing symptoms of stress, if you are in crisis, or if you feel like you want to harm yourself or someone else, please call our 24/7 Support & Crisis Helpline at 800-282-5005 or text MN to 741741 to connect with a trained crisis counselor.

Shauna Reitmeier, CEO

Shauna Reitmeier serves as the Chief Executive Officer at Northwestern Mental Health Center. In addition to her leadership and management responsibilities, she is a Licensed Graduate Social Worker and sees clients at the Crookston clinic location. Shauna holds a Master of Social Work degree from the University of Michigan and a bachelor’s degree in social work from the University of North Dakota.

Help and Hope for Substance Use Disorders

Learning how to cope during particularly stressful events in life—and we all experience them—isn’t one of those instinctual mechanisms our brains came equipped to handle. The flood of racing thoughts, feelings of hopelessness, and emotional ups and down are hard for even the most mentally prepared to deal with. For many, this is when substance use can take over. But there is hope and help.

“We’re here for those struggling with substance use and we utilize a whole person approach,” said Shannon Kronlund, Northwestern Mental Health Center outpatient treatment director. “It’s vital to understanding each individual’s protective and risk factors so we can provide the most effective care and treatment which results in higher success rates.”

NWMHC is a behavioral health center that provides a variety of services, including mental health treatment, crisis response, supportive housing and help with early childhood development. It’s substance use disorder treatment helps individuals ages 10 and older. The team also works with community and statewide partners when more intensive outpatient or inpatient treatments are needed.

The center’s whole person approach, or biopsychosocial approach, to helping those suffering from a substance use disorder involves treating the biological, psychological, and social factors of a person’s life and their complex interactions. This includes considering a person’s brain characteristics, environmental stressors and emotional or physical trauma they’ve endured.

These factors can all play a role in creating mental health issues and hindering how they’re dealt with by the individual. It’s not uncommon for people diagnosed with a mental health disorder to also have a substance use problem. In 2018, The National Alliance on Mental Illness estimated that there were 9.2 million adults in the U.S. suffering from these co-occurring disorders, which professionals all term as dual diagnosis.

“This is one of the reasons recovery does not and should not happen alone,” Denison said. “Our entire team at Northwestern Mental Health Center understands this and is dedicated to treating not just the substance use disorder, but the whole person. For many professionals here, that also means they’re treating substance abuse alongside a mental health issue.”

With the whole person approach, professionals like those at NWMHC provide low intensity individual and group treatment for substance use disorders as well as outpatient care for mental health issues. Several of the providers are trained in dual diagnosis treatment. The facility also is equipped with several nurse practitioners who can administer medication assisted therapy, which may help recovery for some.

“People may find that the use of drugs or alcohol provides them a brief relief from the overwhelming feelings they carry around,” Kronlund said. “They may not have another coping skill they find works as ‘effectively’ in the moment and as a result, a pattern of use can be established.”

Those who are struggling may also find that substance use provides a faster result than coping skills that are new or unfamiliar to them, and to get relief quickly, they continue to use substances.

“It’s common for people to turn to substance use as a coping mechanism, whether it’s alcohol, methamphetamines or marijuana,” said Janet Denison, Northwestern Mental Health Center chief clinical officer. “Often during challenging times we may have increased stress and this can test the person’s use of healthier coping skills and their use of supports and connections.”

Treatment not only helps individuals deal with the short-term issues, but it also equips them with the skills for long-term success. Those in recovery also avoid the future health effects of long-term substance use, such as liver damage, vitamin deficiencies, paranoia, stroke and increased cancer risks.

“We focus on helping individuals as well as their families find hope and a path to wellness,” Denison said. “Our staff approaches care from a non-judgmental standpoint, putting the client first.”

In addition to professional help, there are many things people can do to improve their wellbeing and overall outlook on life. These include:

  • Being aware of and communicating feelings
  • Connect with family and friends
  • Knowing what is and is not in a person’s control
  • Eating healthy, well balanced meals
  • Exercise 
  • Getting adequate and quality sleep
  • Keep a positive attitude
  • Making time for hobbies and various interests
  • Relaxation such as deep breathing, meditation, yoga
  • Setting limits to decrease stress and knowing it’s okay to say “No”

If you or someone you know is struggling with substance use, whether it’s  isolating from others, or neglecting work or family obligations, the caring team at Northwestern Mental Health Center is here to help. Call us today at 218-281-3940.

There is help and there is hope.

Shannon Kronlund, MSW, LICSW serves as the Outpatient Treatment Director for Northwestern Mental Health Center. She sees children, adults, and families and specializes in the treatment of trauma, depression, and anxiety.

Janet Denison, MSW, LICSW, LADC serves as the Chief Clinical Officer for Northwestern Mental Health Center. In addition to her administrative role, she sees adult clients with a specialized focus on co-occurring disorders.

National Council for Behavioral Health Announces New Board Members

WASHINGTON, D.C. (July 1, 2020) – The National Council for Behavioral Health is pleased to announce the results of its recent Board elections.

The National Council welcomes our newly elected Directors:

  • Region 1 (CT, MA, ME, NH, RI, VT)
    Tomasz Jankowski, Ph.D., President and CEO, Northeast Kingdom Human Services [VT]
  • Region 2 (NJ, NY, PR, VI)
    Yaberci Perez-Cubillan, LCSW-R, SIFI, Senior Vice President-Behavioral Health & Service Integration, Acacia Network [NY]
  • Region 3 (DC, DE, MD, PA, VA, WV)
    Richard Edley, Ph.D., President and CEO, Rehabilitation and Community Providers Association [PA]
  • Region 5 (IL, IN, MI, MN, OH, WI)
    Shauna Reitmeier, MSW, LGSW, CEO, Northwestern Mental Health Center [MN]
  • Region 6 (AR, LA, NM, OK, TX)
    Lee Johnson, MPA, Deputy Director, Texas Council of Community Centers [TX]
  • Region 8 (AZ, CO, MT, ND, SD, UT, WY)
    Joseph (JC) Carrica III, Ed.D., MA, CAC, CEO, Southeast Health Group [CO]
  • Region 9 (CA, Guam, HI, NV)
    Camille Schraeder, MA, Director of Public Policy, Redwood Community Services [CA]
  • Region 10 (AK, ID, OR, WA)
    Jodi Daly, Ph.D., President/CEO, Comprehensive Healthcare [WA]

The Board elected the following Officers:

  • Second Vice Chair
    Susie Huhn, MA, CEO, Casa de los Niños [AZ]
  • Secretary-Treasurer
    Ed Woods, Board member, LifeWays Community Mental Health [MI]

The Board is composed of elected volunteers from the staff and community boards of National Council member organizations. They are elected by National Council member organizations representing 10 regions covering the entire U.S. The Board of Directors represents the membership and is committed to diversity, leadership and promoting excellence in mental health and addictions treatment.

“I look forward to working with our new Board members in the months ahead,” Board Chair Jeff Richardson, vice president and chief operating officer of Sheppard Pratt Health System said. “Community behavioral health clinics face incredible challenges. Their experience and enthusiasm will be a wonderful asset to all National Council members as we navigate the road ahead.”

We are grateful to the following individuals for their service as they depart the Board on June 30, 2020: 

  • Vic Armstrong, MSW, Director of the North Carolina Division of Mental Health, Developmental Disabilities, Substance Abuse Services [NC]
  • Kevin Campbell, former CEO, Greater Oregon Behavioral Health [OR]
  • Danette Castle, MPA, Chief Executive Officer, Texas Council of Community Centers [TX]
  • Daniel Darting, Chief Executive Officer, Signal Behavioral Health Network [CO]
  • Alan Hartl, Executive Consultant, Lenape Valley Foundation [PA]
  • John Kastan, Ph.D., Interim CEO, Chief Program Officer, Jewish Board of Family and Children’s Services [NY]
  • Rich Leclerc, MS, MSW, Consultant, Substance Use and Mental Health Leadership Council of Rhode Island [RI]
  • Chris Stoner-Mertz, MSW, CEO, California Alliance of Child & Family Services [CA]

“I want to thank each of our outgoing Board members for the many hours they devoted to the National Council since their election,” Chuck Ingoglia, president and CEO of the National Council said. “I will miss their expertise, determination and professionalism. But I also know I can rely on their guidance even after their departure as our organization continues its important work on behalf of members.”

The newly elected Board members assume their duties on July 1, 2020.


About the National Council for Behavioral Health

The National Council for Behavioral Health is the unifying voice of America’s health care organizations that deliver mental health and addictions treatment and services. Together with our 3,326 member organizations serving over 10 million adults, children and families living with mental illnesses and addictions, the National Council is committed to all Americans having access to comprehensive, high-quality care that affords every opportunity for recovery. The National Council introduced Mental Health First Aid USA and more than 2 million Americans have been trained.

Behavioral health providers concerned about future of telehealth

Written By: Adam Kurtz, Grand Forks Herald | Jun 15th 2020 – 2pm.

Movement to make rapid changes permanent is being pushed forward at the state and federal levels.

Behavioral health providers in North Dakota and Minnesota overcame challenges in making the rapid change to providing services through telehealth, and, while some providers say telehealth is here to stay, they want to see legal changes made to allow it to flourish.

The coronavirus pandemic that erupted in mid-March closed the doors of behavioral health providers in the region, necessitating the switch to telehealth. After a period of struggle, providers made the change and were aided by state-level executive orders which loosened restrictions on the provision of those services. When those orders expire, the gains made in expanding access to mental health services could be undone.

“Telemedicine is the way to give access to people who would never walk in our door,” said Shauna Reitmeier, CEO of Northwestern Mental Health Center, in Crookston. “Continuing these waivers and ensuring that laws change for the long haul is important.”

In particular, a Minnesota executive order signed on April 6, allows out-of-state practitioners to provide telehealth services until the state’s peacetime emergency is terminated, which could be as early as July 13.

Across the river, North Dakota Medicaid issued a temporary COVID-19 telehealth policy on March 25, that allows providers to make use of such platforms as the recently popular, Zoom and Google Hangouts. That policy is set to expire when the national emergency is declared over.

Additionally, an executive order signed on March 20 by Gov. Doug Burgum, requires insurance companies to cover online visits in the same manner as in-person visits. The order doesn’t mandate the same rate of reimbursement to providers, however. Some insurers have lowered what they will pay for a telehealth session by as much as 30%.

“Telehealth is a new service, and the laws have not yet changed as fast as the times and the technology,” wrote Heidi Jensen, co-owner of behavioral service provider Agassiz Associates, in an email to the Herald.

A national movement

At the federal level, there is some momentum in seeing the expanded access to telehealth, brought about by provisions in the Coronavirus Aid, Relief and Economic Security Act, made permanent. The number of Medicare beneficiaries using telehealth services has skyrocketed by 11,718%, over the course of the pandemic. Portions of the CARES Act waived requirements for certain providers, including rural health clinics, to bill Medicare for primary and hospice care. A bipartisan group of 30 senators, including Sen. Kevin Cramer, R-N.D., have signed a letter to Senate Majority Leader Mitch McConnell and Minority Leader Charles Schumer, advocating for the future of telehealth.

“Americans have benefited significantly from this expansion of telehealth and have come to rely on its availability,” the senators wrote in a June 15 letter. “Congress should expand access to telehealth services on a permanent basis so that telehealth remains an option for all Medicare beneficiaries both now and after the pandemic.”

A rapid transition

Jensen told the Herald her office purchased a HIPPA-compliant version of Zoom, when it closed its door to in-person services in mid-March. Jensen said it took about two weeks to transition all of Agassiz’s services to telehealth, including psychological, psychiatric and substance abuse evaluations, among others.

It wasn’t easy. Agassiz hired an information technology specialist to help clients transition to the new format. In some cases, clients don’t have access to WiFi, or a device to hook one up to.

The same goes in Crookston, where Northwestern Mental Health made the switch in four days. Reitmeier told the Herald her office worked to provide devices to clients who either didn’t have one, or used up their entire cellphone data plan, during a Zoom consultation. The facility was at a 3% utilization rate for telehealth before the pandemic, now it’s at 61%.

Other challenges included helping clients adjust to seeing a provider on a screen, rather than in person. Some treatments require the use of devices, such as a heart monitor — something that can’t be done through telehealth. Initially, providers saw their number of clients decrease, but many of those people have come back, as the pandemic wears on. According to both Jensen and Reitmeier, the need for treatment is great.

“The number of individuals needing services due to the stressful impact of COVID-19 over time is definitely on the rise,” Jensen said.

On the whole, clients have adapted well to telehealth, especially those who are more comfortable using technology. Some people feel more comfortable talking in their own home, office, or even car. People living in rural areas don’t need to travel to see a provider — a benefit which goes both ways, as providers don’t need to travel to rural hospitals when conducting emergency hospital assessments.

“I think (telehealth) really is going to be dependent on the individual and the treatment that’s being provided, but, overall, yes, it is as effective as in the office,” Reitmeier said, and added that the expanded access to mental health services is threatened by the temporary nature of the executive orders that brought it about.

Reference: Grand Forks Herald

Shauna Reitmeier, CEO

Shauna Reitmeier serves as the Chief Executive Officer at Northwestern Mental Health Center. In addition to her leadership and management responsibilities, she is a Licensed Graduate Social Worker and sees clients at the Crookston clinic location. Shauna holds a Master of Social Work degree from the University of Michigan and a bachelor’s degree in social work from the University of North Dakota.

A Message from NWMHC CEO Shauna Reitmeier

You are welcome here

When reflecting on the past several months and weeks, there is a flood of thoughts, feelings, and emotions so complex, it is hard to put into words or actions. We put strategies and tactics in place to protect ourselves and others from COVID-19. We are grieving milestones met, yet not celebrated. We remain distant from our loved ones, knowing that connection is so vital to mental wellness. Our region lost a valued law enforcement officer, husband, and father in the line of duty. To further compound our circumstances and grief, our state and our nation are experiencing the effects of the killing of George Floyd. Our communities, region, state, and country are hurting. 

When we hurt and the hurt is not healed, we experience trauma and continue to hurt.  When healing doesn’t happen, individuals, communities, or systems continue to hurt themselves and others. Comparing one person’s trauma or hurt to another re-traumatizes and breaks down the ability of an individual, community, or system to be mindful of their role in perpetuating trauma.

The events we are experiencing remind us of the historical trauma plaguing our country, which we are not immune to right here in northwestern Minnesota. That pain is real. To understand recent events, we also need to understand and acknowledge the long history of oppression, supremacy, injustice, and economic disparities within our region, particularly for our Ojibwe and Lakota neighbors, our Mexican and Latinx migrant workers, and anyone on the margins of poverty.  We have also had a challenging agriculture industry for years, with low commodity prices, tariffs, crops left in the fields, and livestock euthanized. All of these instances and experiences create hurt, can create trauma, and with it, fear. 

With all of this loss comes intense emotions. And the responses to these emotions are just as complex as the events themselves. We can mourn the loss of Officer Cody Holte’s life AND the life of Lola Moore. We can be angry about the loss of George Floyd’s life AND mourn the losses within the communities of Minneapolis and St. Paul. We can have compassion for local law enforcement AND advocate for policies and practices that promote justice.

It doesn’t have to be an either-or situation. We can do both.

That is why I want to share our mission: To promote wellness and instill hope.  Within our mission, we strive to be a trauma-informed system of care.

Not only do our qualified staff provide individual treatment to help people heal from trauma, but we also work toward ensuring our policies and procedures promote healing and equity. As a trusted partner throughout northwestern Minnesota, we are allies and advocates for creating spaces for individuals, communities, and systems to talk about their trauma. Trauma that brings with it fear, uncomfortability, and reinforces scarcity of tangible goods, services, and power. The healing that comes from those spaces turns into courage, sharing of knowledge, resources, and influence for the entire northwest region of Minnesota being trauma-informed. 

Northwestern Mental Health Center is committed to being a partner that raises individuals, communities, and systems to thrive at their highest potential. History of trauma informs us, but it does not define us. WE — Northwestern Mental Health Center, our staff, and our community members — can define our region.

Most of all, we commit to making NWMHC a place where every human knows without a doubt, YOU are welcome within our doors.

Shauna Reitmeier, CEO

Shauna Reitmeier serves as the Chief Executive Officer at Northwestern Mental Health Center. In addition to her leadership and management responsibilities, she is a Licensed Graduate Social Worker and sees clients at the Crookston clinic location. Shauna holds a Master of Social Work degree from the University of Michigan and a bachelor’s degree in social work from the University of North Dakota.

Shifting Our Perspective on Mental Health

Woman comforting another

If you’re like most people, you rely on your car to get you to the grocery store, drop off the kids, and do all the day-to-day things that need to happen between Point A and Point B. To ensure our car is dependable and runs smoothly, we know that each component, even the hidden computer system, should be in good working order. The human body is no different; we break a bone, we see an orthopedic doctor; we feel sick, we see a primary care physician. But what do we do when our “computer,” our mental health, breaks down?

For many people, nothing.

“Historically, mental health has been separate from physical health,” said Janet Denison, chief clinical officer at Northwestern Mental Health. “But our minds and the way we think is essential to how we feel. That is why mental health should never be overlooked and should always be included in our total health picture.”

The Total Health Picture

When we experience an injury or are feeling ill, it’s typically obvious when we need to seek professional help. When it comes to struggling mentally, however, the symptoms may be more subtle at first and it’s hard to see our “computer system” being compromised. But that doesn’t make these symptoms any less important to address.

As people struggle with mental issues, it takes them more energy to get through their days. They may have difficulty concentrating, relaxing or feeling joy and satisfaction. Like a car with a broken computer system, when our mental health isn’t well, we simply cannot function at full capacity. Feelings of being overwhelmed, anxiety or depression begin to settle in and even our physical well-being becomes affected  by chronic pain, digestive issues and headaches. If left unchecked, these symptoms of a deeper mental issue can become more serious.

“So many of us struggle with mental health, including ourselves, neighbors, friends and family,” Denison said. “Challenges can be triggered by the loss of a loved one, family struggles or financial issues; the reasons are varied and common.”

In fact, the triggers for mental health issues are so common researchers believe nearly every one of us will experience a mental health crisis or challenge at some point in our lives.

But the issue isn’t when we will experience these challenges, but rather recognizing when we need help to navigate through them.

Many people, when faced with mental struggles, think they can power through. In some scenarios that approach may work with a good night’s sleep or talking to a friend. But when the issue is deeper, just like running on an injured ankle, powering through often causes more damage.

“There will always be losses and challenges we face and when these happen, it truly is okay to not be okay,” Denison said. “Because you’re not alone.”

Getting the Right Help

We live in a time where there are professionals who specialize in treating every type of mental health concern, from depression and PTSD to bipolar and eating disorders. They understand the chemical, emotional and physical challenges a person is facing and are able to be a guide for individuals of any age, helping them navigate through tough times. People not only benefit in the short term, but also gain insights, perspectives and valuable life skills for the long run.

These are skills we didn’t learn growing up. Skills that no one taught us in school, but it’s these lessons in coping that are perhaps the most critical life skills most of us missed out on.

“Mental health is part of your total well-being and when you’re in good all-around health you generally enjoy life more,” Denison said. “You become more optimistic, energized and productive. People also appreciate what they have, are easy to get along with, and generally more generous and altruistic. Their bodies are more relaxed because their emotions are more stable.”

Part of our overall health comes from our genes, but there is a good portion of it that comes from what we can control; our environment and our everyday choices. This is good news because that means there are many ways we can maximize our mental and emotional health every day. Some examples include:

  • A healthy diet
  • Being outdoors
  • Cultivating spirituality
  • Defining your purpose
  • Keeping a supportive network of people who care about you
  • Minimizing or eliminating alcohol
  • Maintaining a healthy weight
  • Moderate exercise
  • Meditation
  • Practicing gratefulness and grace by forgiving yourself and others

When to get help

Anyone can get help anytime, but if they’re uncertain, a good question to ask, is “Are you having more bad days than good days?”

“If you or a loved one is unable to get out of a funk, which usually means the bad days outnumber the good days, it’s a good time to seek help,” Denison said. “There are so many resources available, including online assessments as well as in-person and virtual visits with a professional. There really is no reason to struggle.”

Where to get help

Individuals interested in talking with someone about their mental health can call Northwestern Mental Health Center’s caring team at 218-281-3940. They’ll ask a few clarifying questions and then schedule an appointment with the right provider, either virtually or in-person. The organization serves six Minnesota counties, including Kittson, Mahnomen, Marshall, Norman, Polk and Red Lake. Their team also offers school-based services in Pennington County.

People can also discuss their mental health concerns with their primary care provider, who can make referrals and recommendations based on needs.

In our lives, we may own many vehicles, but in this lifetime we will only own one body. It’s important to take care of every component of it. Celebrate what works well and seek out assistance when you need to support to feel better. Because mental health is just as important as our physical well-being.

If you are feeling distressed, anxious, or if you are experiencing a mental health crisis, please call our 24/7 Support & Crisis Helpline at 800-282-5005.

Janet Denison

Janet Denison, MSW, LICSW, LADC serves as the Chief Clinical Officer for Northwestern Mental Health Center. In addition to her administrative role, she sees adult clients with a specialized focus on co-occurring disorders.

Healing after a Life Disturbing Event

Article: Healing After A LIfe Disturbing Event

Written by Chris Green, MSW, LICSW

Throughout history, people have experienced life disturbing events, both personally and as a community. The way we talk about these events and their impact has changed significantly over generations. Society is beginning to recognize the importance of this discussion as we seek to find meaningful and helpful ways to address this type of pain in our communities. It is becoming more common to hear people talk about trauma and its impact. It’s become even more significant as we navigate the current global pandemic that has created difficulty and hardship for so many. While we are witnessing the impact of the virus itself, we are yet to realize the subsequent impacts of poverty, isolation, and loss. This moment we are in now provides a valuable opportunity to continue the conversation to address personal healing and support prevention efforts.

The ways that people deal with a life disturbing event in order to survive is amazing. One of the most important jobs that our brain has is to get us into the next day. Trauma responses are adaptive and meant to protect and sustain life. These self-protecting responses are smart solutions in the moment.

However, they can be costly over time. This cost shows up once the moment has passed, and the brain continues to use the same method of dealing with past stress and danger in situations where it is not helpful. This becomes maladaptive or unhealthy behavior that creates difficulty in other areas of life.

Most people will experience a full range of emotions after a life disturbing event and recover. But for some, symptoms will persist past the time of recovery. Posttraumatic stress disorder (PTSD) is a condition that may develop after someone experiences a scary, terrifying, or dangerous event. An estimated 7-8 percent of the population will have PTSD at some point in their lives. PTSD creates significant difficulties in many areas of life, including home, work, school, and relationships. When these difficulties persist 30 days past the event and impacts a person’s ability to function well in their life we begin to consider a diagnosis of PTSD.

PTSD may cause people to experience a decreased interest in their hobbies and activities, feel detached from themselves and others, and difficulty feeling happiness or love. Life disturbing events also affect our nervous system causing us to feel jumpy, restless, on edge, always on guard or looking for danger, or irritable. It can also cause us to participate in risky behaviors, have difficulty with sleep, or difficulty concentrating or focusing. *

People with PTSD have among the highest rates of healthcare service use. PTSD can present with a range of physical symptoms, the cause of which may be overlooked or misdiagnosed as having resulted from past trauma.

PTSD can cause ongoing, unwanted distressing thoughts or memories of the life disturbing event. Some people will have dreams or intense, prolonged distress when reminded of the trauma. Simple cues or objects can evoke responses as if the event is happening all over again. In the moment, our brain has a hard time deciding between a real threat and one that looks/sounds/feels real. In truth, this is okay. It is more important for our brain to take the side of protection than to be open to a threat.  And we can see why this would cause issues in our life. If our brain is in self-protection mode it may react in a way that is not helpful in the moment when a threat is not actually present. People with PTSD may find themselves reacting strongly in situations where it is not necessary, leading to further stress in relationships and other areas of life. Some people plan their lives and make decisions as if the trauma is still taking place. This thought process creates and sustains a loop that can lead to further difficulties and trauma. Research shows that those with trauma are at a much higher rate for re-traumatization. *

It makes sense that when we have a significant life disturbing event that we would want to avoid thinking about it or being reminded of it. Individuals with trauma go to great lengths to avoid people, places, and things that remind them of a traumatic experience. They also find themselves staying extra busy or distracted to avoid thoughts or memories of the event. *

The trauma experience affects the way we think about ourselves and the world. It impacts our memory and our body sensations. People who have experienced trauma may have a hard time remembering aspects of the event. They may blame themselves or others unfairly for the trauma. Or they may start to think of themselves and others in a different way, such as ‘I am bad,’ ‘the world is dangerous and unsafe,’ or ‘I can’t trust others.’*

It is important to note that not everyone that experiences a life disturbing event will develop PTSD. It is the individual’s experience of the event, not the event itself, that is indicative of PTSD. Many factors influence why one person may develop PTSD in response to a life disturbing event, while another will not. One of the main factors to consider is the idea of agency, or the ability to influence or control what is currently happening to you. Those with less agency, or ability to do something about their situation, have a higher likelihood of developing trauma. As you can imagine, feeling stuck or unable to help yourself or others is terrifying, helpless, and scary. Other factors that may play a role are genetic predisposition to mental health concerns, current environmental supports, sex/gender, previous trauma, and resources.

We know that what is not integrated, or healed, gets repeated. Trauma causes fragmentation. Disorder. Good trauma work provides structure and seeks to integrate, or heal, the traumatic experience so that one can find mastery and agency in life again.

We know that trauma changes the physiology of the brain, including your alarm system’s response to danger, an increase in stress hormones, and your ability to distinguish between real and perceived threats. Why is this important? All too often, the stigma in our society sees mental health as something that someone ‘just needs to get over,’ ‘it’s all in your head,’ or a personal flaw. That couldn’t be further from the truth. These beliefs are not only unhelpful, but they are also hurtful. In reality, wellness and wellbeing is a complex interplay of many systems of interrelated parts. 

It is important to be clear that people who develop or experience trauma or any other mental health concern are not flawed. People do the best they can with what they have at each moment. We are individuals formed and shaped in the context of our genes, the skills of our parents and their parents, vocation, financial flexibility, and temperament. The key to focus on is the repair after the rupture. To use our past and present experience as an opportunity to learn and grow into our best selves. Meet yourself with kindness today, wherever you are, knowing that what you have been through will provide the space and opportunity to grow even stronger.

* These symptoms are discussed in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorder (DSM-5).

If you or someone you know is struggling, distressed, or experiencing a mental health crisis, please call our 24/7 Support & Crisis HelpLine at 800-282-5005 or text MN to 741 741. 
Chris Green, MSW, LICSW

Chris Green is a Mental Health Professional the Manager of Trauma-Informed Care at Northwestern Mental Health Center. Chris see clients ages seven years and older with a special focus on adolescents and young adults. He is certified in Trauma-Focused Cognitive Behavior Therapy (TF-CBT), and he is EMDRIA Certified in EMDR. Chris sees clients in our Crookston clinic location or via telemedicine. 

NWMHC Receives Award of Excellence

Northwestern Mental Health Center (NWMHC) has been recognized for its invaluable contributions to the behavioral health care field by The National Council for Behavioral Health.

“We reserve our Awards of Excellence for those with distinguished achievements in behavioral health care, and I’m incredibly proud to give this award to Northwestern Mental Health Center,” National Council for Behavioral Health President and CEO Chuck Ingoglia said.

The National Council Innovation Award is given to those who increasingly think “outside of the box” in search of creative solutions to challenges faced by staff, patients, families, and communities. This award recognizes the innovations and unparalleled achievements of National Council members. NWMHC is one of seven organizations that received the National Council’s Award of Excellence this year.

“Receiving this award signifies that NWMHC is creating a space where people in their most vulnerable moments feel like they can get what they need to thrive. This culture is rooted in the commitment and dedication of our entire team, all of whom are willing to jump in and deliver new services and structure new processes so our clients can receive the best possible care,” says Shauna Reitmeier, CEO at NWMHC.

Read Shauna’s spotlight interview: Moving Behavioral Health Care Mountains in Rural Minnesota.

About the National Council for Behavioral Health
The National Council for Behavioral Health is the unifying voice of America’s health care organizations that deliver mental health and addictions treatment and services. Together with our 3,326 member organizations serving over 10 million adults, children and families living with mental illnesses and addictions, the National Council is committed to all Americans having access to comprehensive, high-quality care that affords every opportunity for recovery. The National Council introduced Mental Health First Aid USA and more than 2 million Americans have been trained.

NWMHC Clinic in East Grand Forks Temporarily Closed

On April 4, 2020, Northwestern Mental Health Center was notified of water within our East Grand Forks clinic location due to leakage from the roof. Clinic operations at that location have been suspended pending damage assessment and completion of necessary repairs to the space. 

“Although the closure of our East Grand Forks office is inconvenient, the availability of telemedicine allows continuity of care for our clients while assuring everyone is safe during this critical time,” says Tammy Hickel Zola, CFO at Northwestern Mental Health Center. “Polk County is working diligently with various partners to assure first and foremost the office is clear of any potential contamination, and secondly to allow operations to resume as quickly as possible.”

Clients impacted by this closure have been contacted and alternative arrangements made to allow continuity of service while the office is closed. For those who wish to schedule an appointment with one of our East Grand Forks providers, please contact our main office at 218-281-3940. If you have questions or concerns related to this temporary closure, please email [email protected].

Building Resilient Communities Through Self-Care

For the last three weeks, we start each day thinking, “Today things are going to stabilize. Today we’ll hit a plateau.” But for the past month, regular updates from Governor Walz, new reports from the CDC, and revised guidance from our state and local public health agencies have kept us on our toes. If we’ve learned anything so far, it’s how resilient we are. Our employees, clients, partners, and communities have stepped up.

We’ve watched heartfelt videos from school teachers and staff, pouring out their love for our children. Parents are hosting virtual birthday parties to keep families connected. Employees are extending more grace and patience to their co-workers. Drive through any neighborhood, and you’re bound to see paper hearts on the windows of at least one home or business. These are examples of how we’re adjusting to this new world, finding our new norm while we cope with the effects of COVID-19.

In the coming weeks and months, your mental health will become even more important. Functioning in this physically isolated environment like this is not easy for most people. If you aren’t practicing and modeling self-care and wellness, you may start seeing some challenges at home and with those in your household.

Our message to you today: We are here to help you build resiliency and prepare for what lies ahead. Whatever your situation looks like right now, we have resources and options to support you.

“You don’t have to be in crisis or have suicidal thoughts to use our crisis line. It’s normal to feel some additional anxiety and stress during a global pandemic,” says CEO of Northwestern Mental Health Center, Shauna Reitmeier. “Call our mobile crisis team before you reach a breaking point. Our team is trained to assist in these situations.”

Typically, our Mobile Crisis Response Team (MCRT) receives four to five calls each day. Roughly 60 percent of the calls originate in Polk county. The other 40 percent comes from Mahnomen, Norman, Red Lake, Marshall, Kittson, Pennington, and Roseau counties. While we saw a slight drop in calls the third week of March, calls have been steady.

“About 15 percent of calls between March 16 and April 8 were related to anxiety and worries due to COVID-19,” says Christie Wisk, Mental Health Practitioner on our MCRT.

Since March 23, we’ve been supporting crisis callers through telemedicine when possible. Before that, our MCRT was activated and met with individuals face-to-face for approximately half of the calls. The other half were resolved over the phone. In the last two weeks, we’ve used telemedicine to resolve 70 percent of our crisis calls.

“This is a win-win. It’s safer for callers and our employees. Seeing someone through telemedicine feels more connected and warmer than just talking on the phone. We can see the individual, read body cues, and evaluate the environment around them,” says Wisk. “And if the situation requires face-to-face interaction, we’re still going to go. But we’re taking extra precautions in those instances now, to keep everyone healthy.”

With so many uncertainties, NWMHC providers like Wisk hope to see more people reach out in April and May. Overall, we’ve modified the delivery of all our services.  Most of our providers now offer therapy, case management, and rehabilitation services from their homes using technology. And individuals can receive NWMHC services from anywhere using a phone, smartphone, or computer. 

But there’s concern that as time goes on, people will need more support. We’ve put processes in place to connect with current clients, and we have openings for new clients. We’re exploring ways to reach those who may not have access to technology to connect through telemedicine. Or people who don’t have a safe place to request and receive mental and chemical health care services. We’re also discussing how we can best support first responders, teachers, and those experiencing financial hardships due to COVID-19.

“Support from federal, state, and local governments has been critical in the last few weeks. It’s clear no one wants a mental health crisis to follow this pandemic,” says Reitmeier. “As funding and programs roll out and open doors, people should expect to see more opportunities for receiving mental health care in their communities.”

Northwestern Mental Health Center is a pathfinder and innovator in the mental health care industry, not just in Minnesota, but nationally. We will continue to advocate for the people we serve and do everything we can to build resilient families and communities. We are in this together. And we will make it through this together.