Health Archives - MinnPost https://www.minnpost.com/category/health/ Nonprofit, independent journalism. Supported by readers. Mon, 03 Feb 2025 16:36:55 +0000 en-US hourly 1 https://www.minnpost.com/wp-content/uploads/2023/12/favicon-100x100.png?crop=1 Health Archives - MinnPost https://www.minnpost.com/category/health/ 32 32 229148835 Nearly 1 million Minnesotans could be going hungry https://www.minnpost.com/race-health-equity/2025/02/nearly-1-million-minnesotans-could-be-going-hungry/ Mon, 03 Feb 2025 16:36:53 +0000 https://www.minnpost.com/?p=2191559 Make Hunger History summit panel, from left: Lisa Lane, Chief External Affairs Officer, Open Arms of Minnesota; Dr. Nathan Chomilo, medical director of Minnesota’s Medicaid and MinnesotaCares programs; Abby Gold, Health & Nutrition Extension Specialist, UMN Extension/School of Public Health; and Terese Hill, Supervisor of Community Advancement and Food System Strategy, Fairview Health Services.

Organizations that receive federal funding fear what could happen if those dollars are no longer available.

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Make Hunger History summit panel, from left: Lisa Lane, Chief External Affairs Officer, Open Arms of Minnesota; Dr. Nathan Chomilo, medical director of Minnesota’s Medicaid and MinnesotaCares programs; Abby Gold, Health & Nutrition Extension Specialist, UMN Extension/School of Public Health; and Terese Hill, Supervisor of Community Advancement and Food System Strategy, Fairview Health Services.

One in five Minnesota households face food insecurity.

Twenty-six percent of Minnesota households with one or more children under 18 were also food insecure. For households with at least one school-age child from 5 to 17 years old, the percentage of food insecure households jumped to 28%. The results of Second Harvest Heartland’s statewide hunger survey, conducted with help from Wilder Research, were evocative. 

Households of color – defined in the methodology as households where at least one member is  Black, Indigenous or from another community of color – were also disproportionately affected by food insecurity. Karen Spitzfaden, director of consumer insights and digital strategy at Second Harvest Heartland, noted that 40% of Minnesota households of color were food insecure compared to 20% of households overall. Fifty-two percent of Minnesota households with at least one Black member, along with 52% of American Indian and Alaska Native Indigenous households in the state, were also food insecure. 

Food insecurity is where households were unable to get enough food with or without help from the emergency food system. 

Even Minnesotans who were food secure based on survey data have concerns about affordability. Allison O’Toole, chief executive officer of Second Harvest Heartland, said 30% of all Minnesotans are “worried they won’t be able to afford food in the next year.” For households of color in Minnesota, that number is 47%.

Allison O’Toole
Allison O’Toole

“People are living paycheck to paycheck. Grocery prices are about 30% higher than they were in 2019. The same goes for energy prices; the cost of rent (and the cost of) childcare. When you put all those (together), it’s a confluence of events,” added O’Toole. 

Though she noted that federal and philanthropic assistance helped her organization provide Minnesotans with food during the height of the pandemic, food insecurity went back up after those supports sunsetted. By the end of 2023 the Food Group, which tracks visits to food shelves in Minnesota, had recorded around 7.5 million visits according to O’Toole. 

“I’ve heard now that it is 9 million or more (visits in) 2024,” said O’Toole. “What that tells me is the status quo isn’t working.”

In response to the survey, Second Harvest Heartland gathered 300-400 partner organizations at its first Make Hunger History summit on Jan. 31 – an opportunity to promote collaborative solutions. Though Second Harvest Heartland’s mission to get 90% of Minnesota households to food security by 2030 was announced last year, more recent uncertainty around federal funding was a topic of discussion. 

In the midst of federal uncertainty, Gov. Tim Walz emphasized the state’s resilience and willingness to tackle the problem of hunger, noting that Minnesota’s “superpower” is how Minnesotans act collaboratively, building ecosystems of support between federal and state governments, local nonprofits and faith-based organizations. 

“I’ve been using a phrase I heard somewhere, ‘Enthusiasm is common. Endurance is rare,’” said Walz. “I think we possess both of those in Minnesota. We are enthusiastic, but we will not back off.”

Speakers on a panel at the event on the topic of food as medicine also voiced concerns around federal funding. Lisa Lane, chief external affairs officer of Open Arms of Minnesota, which sends nutritionist tailored meals to critically and chronically ill people, said her organization receives federal funding through the Ryan White CARE Act and the Older Americans Act. As this funding may be in jeopardy, Open Arms is looking to philanthropy to help fill in the gap. 

Abby Gold and Terese Hill work for the University of Minnesota and Fairview Health Services, respectively and receive federal funding from the Gus Schumacher Nutrition Incentive Program. One part of this funding allows the organizations to participate in produce programs, where health systems work with farmers to provide freshly grown produce to patients. This service isn’t just about providing food to people who are ill, but about preventing illness. 

“Yes, we want funding for food for people (who) need it,” said Hill. “But also there’s a whole amount of work around prevention and how we can keep people well, rather than treating the illness.” 

“One of the reasons we’re talking about food as medicine is because we have to frame it (that way) so that we get those resources from a medical system that sucks up so much of the oxygen,” added Dr. Nathan Chomilo, medical director of Minnesota’s Medicaid and MinnesotaCare programs. “This is a decision we’ve made as a country. It’s a decision that’s rooted in our health care system being founded in capitalism. There is no real reason that we shouldn’t have created a system where everyone doesn’t need to worry about food.”

Deanna Pistono

Deanna Pistono is MinnPost’s Race & Health Equity fellow. Follow her on Twitter @deannapistono or email her at dpistono@minnpost.com.

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How new funds could broaden the network of BIPOC mental health professionals https://www.minnpost.com/mental-health-addiction/2025/02/how-new-funds-could-broaden-the-network-of-bipoc-mental-health-professionals/ Mon, 03 Feb 2025 12:05:00 +0000 https://www.minnpost.com/?p=2191494 Roots Wellness has expanded its offering to include culturally specific chemical health services, and, in January, it officially moved into its new headquarters, the former Keystone Community Services building at 1916 University Avenue W. in St. Paul.

New state grant is helping the Roots Wellness Center support Black and brown social work interns.

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Roots Wellness has expanded its offering to include culturally specific chemical health services, and, in January, it officially moved into its new headquarters, the former Keystone Community Services building at 1916 University Avenue W. in St. Paul.

Back when Katy Armendariz, founder of Roots Wellness Center, was earning a master’s degree in social work, she nearly worked herself into the ground in order to complete her degree program’s unpaid field internship requirement.

“I did two nine-month unpaid internships — and I also worked three jobs,” Armendariz said. “It was a lot, to say the least.” 

Field internships, or time spent working directly with patients in a clinic or agency under supervision, is a key requirement in all masters in social work training programs (MSW) in Minnesota. To earn an MSW, schools require students to complete a minimum of 500 hours a year in an internship, an experience considered essential in the training of future mental health professionals.  

For MSW students with adequate resources, this requirement may not feel burdensome, but it can present a roadblock for those who are BIPOC, first-generation or low-income students. This complication partially explains why Minnesota has so few licensed mental health professionals of color. 

Katy Armendariz
Katy Armendariz

Armendariz, who built her clinic with the goal of creating a welcoming space where Black and brown people could seek mental health support from professionals with shared life experiences, wants to do whatever she can to support BIPOC graduate students through the process of earning their degrees. 

Her own experience — of having to work multiple jobs to support herself through graduate school — was tough. “I don’t want other people to have to work like I did just so they can complete their schooling,” she said. Too often, the daunting financial reality of having to complete an unpaid internship causes less financially-secure graduate students to drop out or delay completing their degree.  

Some social work internship programs — usually those offered by larger employers — offer funding to support students. But many programs, especially those at smaller agencies like Roots, do not. A few years ago, Armendariz was excited to learn about Minnesota’s Cultural and Ethnic Minority Infrastructure Grant (CEMIG), a program that provides funding to help recruit more BIPOC providers to work in health and substance-use disorder care. 

“The state Legislature approved this funding,” Armendariz explained. “The goal is to increase the ability of Black and brown trainees to become mental health professionals and clinical supervisors.” 

As soon as word got out about CEMIG, Armendariz applied for a grant to help fund potential interns and intern supervisors at Roots Wellness. Her first few applications to the state weren’t approved, but she kept at it.  

Rounding up money to pay BIPOC interns and supervisors is “something that’s been on my mind for a very long time,” Armendariz said. “I’m always looking for funding to help attract and retain interns.” This year, Armendariz applied for a CEMIG grant again. “I told myself, ‘We’re in a great position to apply,’” she said. Armendariz’ confidence turned out to be justified: “We finally got the grant,” she said. 

Paving the way for future therapists

Roots’ CEMIG grant — approximately $200,000 a year for three years — will go a long way to support Armendariz’ goal of helping to expand the number of Black and brown mental health professionals in her practice — and in the state.

“We are able to do a number of things with this grant,” she said. “We can offer diagnostic assessment and therapy services to people who don’t have insurance so that’s not a barrier. We can also pay $1,000 per month for BIPOC interns — with clinical supervision toward licensure provided by a BIPOC clinical supervisor.” 

Another potential roadblock for MSW candidates are the fees associated with state board exams. Roots’ CEMIG grant money will be used to subsidize those costs. “It’s a great equalizer,” Armendariz said of the grant. 

While the CEMIG money is only enough to sponsor four interns (“If we want to add another intern,” Armendariz said, “we would have to take from the uninsured grant pot or from the licensure pot”), it is an important start: “It will go a long way to making it possible for students to complete their MSWs. And it will help create a new crop of BIPOC therapists and clinical supervisors.” 

Programs like the CEMIG grant are key to supporting the education of today’s social work students, said Sharyn DeZelar, St. Catherine University MSW program director and assistant professor of social work. Compared to college students of the past, who usually had the time and resources needed to devote to a full-time education, DeZelar said the “profile of today’s college student is much more someone who needs to work, who has caregiving responsibilities and, with the rising costs of a college education, has many more barriers to completing their degree.” 

Add to that the complications baked into being  a student of color or someone who comes from a lower-income or first-generation college background, and, DeZelar continued, “the financial strain is just compounded.” The CEMIG grant gives clinics like Roots the opportunity to support students through internship placements so they don’t have to work full time while they are completing their degree. “They can really focus on their studies and get the most out of it. They can have a much more engaged experience because their basic needs are being met,” she said.

Sharyn DeZelar
Sharyn DeZelar

DeZelar said that St. Catherine has placed several of their MSW students in internships at Roots. The internship requirement of a social work degree has presented a roadblock to some of her students; knowing that Roots will now have funding to support interns is good news. 

“Having these grants can be a big attraction,” DeZelar said. “There are a lot of people who would like to do this kind of mental health work but they think, ‘I don’t have in my capacity to do all this free labor.’ Now, if they know they are going to get a stipend or a supplement, maybe they will feel they can go to grad school. It will attract a more diverse pool of students.”

Eli Wood, St. Catherine MSW field director, said that being able to pay interns will help Roots attract students who otherwise may feel like they have to select paid internship positions at larger agencies. He said that many of his program’s students agree with Roots’ mission and would like to support it, but because of their own financial situation, they may make their final decision based on the available funding. 

“A lot of our students tend to prioritize placements that are paid,” Wood said. “My concern is that if students are just focused on getting paid for the placement, they may pick one that doesn’t actually align with the work they want to engage with in their careers.” Because CEMIG funding can free up space and time that otherwise would have to be occupied by an extra job, he added, “These grants help students say, ‘I can now really prioritize my learning.’” 

Eli Wood
Eli Wood

Student social work interns are actually an important part of Minnesota’s mental health workforce, DeZelar said. Just like medical interns or residents, social work interns treat patients and provide important feedback and insight to their colleagues. It doesn’t seem fair to her that their work so often goes unpaid. 

“[Interns] should be paid because they are providing services,” DeZelar said. Because a lack of funding makes it harder for students from historically disadvantaged backgrounds to complete this degree requirement, she explained. “It’s a social justice issue,” she said. “In the medical field we pay resident doctors. So why in the mental health field are we expecting all this free labor from our students?”

The importance of shared experience

Diversifying Minnesota’s mental health workforce is essential to providing high-quality care for the state’s increasingly diverse population, Armendariz said. Being able to work with a mental health professional who looks like you or whose life mirrors your own makes seeking mental health care feel less intimidating. Schools and mental health care organizations like her own should do whatever they can to level the playing field, so that more people of color will be able to enter the profession.

“Research shows that people prefer working with someone they believe represents them and their experiences with systemic oppression,” Armendariz said. “Representation matters.” On the training end, it also matters that BIPOC student interns are able to work with clinical supervisors who understand their unique point of view or way of interacting with the world: “Too often, there are clinical supervisors who have a Black or brown intern who may say something like, ‘Are you sure?’ or ‘That seems overly sensitive.’ We need to work with people who get us.” 

For BIPOC patients, the feeling of somehow being on the outside of a white, American ideal can feel particularly disheartening, Armendariz said. During this particular moment in history, mental health care is essential to working through feelings of displacement, anger or fear. 

“These political times are incredibly scary,” she said. “We have culturally responsive therapists. People don’t always have access to that.” 

DeZelar said she and her colleagues at St. Catherine understand the importance of diversifying the mental health workforce. “There is a big call to get more BIPOC folks into the field so that the providers look more like the people they are serving and have that lived experience,” she said. “That’s what Roots and Katy are all about. It’s also what we’re about. That’s why we as a program like to partner with them.” 

The CEMIG grant is another feather in the cap for Armendariz and Roots. The organization has seen steady growth in the number of patients it serves and the providers it employs. Since its founding in 2013, Roots has expanded its offering to include culturally specific chemical health services, and, in January, it officially moved into its new headquarters, the former Keystone Community Services building at 1916 University Avenue W. in St. Paul. 

“It’s super exciting,” Armendariz said of the  move. “We closed on the building in December 2023 and spent a year getting ready.” Her vision is to one day turn the building into a community hub focused on Black and brown wellness.

Armendariz said she wants the new space to feel welcoming and safe, an island of mental wellness in what can sometimes feel like a rocky sea. “I would like this to be a place of help, where people can come and say, ‘I need help. I don’t know where to start,’” she said. “I want this to be the place where they know that help is there.”

Andy Steiner

Andy Steiner is a Twin Cities-based writer and editor. Before becoming a full-time freelancer, she worked as senior editor at Utne Reader and editor of the Minnesota Women’s Press. Email her at asteiner@minnpost.com.

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Conference offers hope, advocacy and tools for parents and caregivers of youth with mental health issues https://www.minnpost.com/mental-health-addiction/2025/01/conference-offers-hope-advocacy-and-tools-for-parents-and-caregivers-of-youth-with-mental-health-issues/ Mon, 27 Jan 2025 17:11:31 +0000 https://www.minnpost.com/?p=2190971 Super Saturday

This year’s free conference, ‘Super Saturday: Family Roadtrip to Mental Health,’ will be held Feb. 8.

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Super Saturday

Years ago, when Greta Kjos’ daughter was deep in a mental health crisis, Kjos knew she needed help in the form of support from other parents and professionals who understood childhood mental illness and how to navigate the systems that could help her daughter recover. 

But the problem was it felt nearly impossible to leave the house. 

“I have a daughter who has had significant mental illness,” Kjos said. “I’ve been through the wringer. It can be really hard to take even a half day and go somewhere, even if it is a place filled with people who can help you.” 

During the most intense part of her daughter’s mental health crisis, Kjos felt homebound. 

“I needed to be with her all the time,” she said. “I couldn’t leave her alone even for a day.” 

Greta Kjos
Greta Kjos

For Kjos, now director of children’s programs at NAMI Minnesota, this need to stay by her daughter’s side meant it was harder to build the connections that today feed her work and activism. When she finally learned about NAMI Minnesota and the range of programs the nonprofit offers for parents of children with mental illness, Kjos eventually made her way to a support group.  

“It took me a long time to get there,” she said of the group. “Once I finally went, I cried because I didn’t have to explain myself or my daughter. There was no judgement. These people knew what was going on. These are veteran parents of this kind of situation so you’re not alone. Other people get it.  It was an amazing experience.” 

Kjos understands her early experience wasn’t unique. She’s now met many parents of children with serious mental illness who have struggled to build connections because caring for their children demanded so much of their time. That reality is why this year organizers decided to hold Super Saturday, NAMI’s annual conference for parents and caregivers, completely online. This year’s free conference, named “Super Saturday: Family Roadtrip to Mental Health,” featuring educational sessions, a mock support group and a resource fair, will be held Feb. 8 from 9 a.m. – 1:30 p.m.

In the past, Super Saturday conferences have been held in-person. For two years during the pandemic, the event was moved online, but in 2024 it went back to the original face-to-face format. Participants, specifically parents, told organizers that they appreciated the convenience of a virtual conference, so this year it was shifted back online. 

Kjos understands where parents are coming from. It took a long time after her daughter’s first mental health crisis for her to feel ready to venture out into the world. If there had been remote support options at the time, she would’ve been all over them. 

“The bar was too high for me to go somewhere in person,” Kjos said. 

Beyond the need to be at her daughter’s side at all times, she also felt a sense of discrimination and stigma around mental illness, so at first she wanted to keep her head down: “It was easier for me to enter into this whole space a little more anonymously. Not everybody’s ready to do the in-person thing right away.”

 And there are the more mundane barriers that get in the way of in-person events, Kjos added. 

“There are all kinds of issues with transportation and schedules. We are doing much more online these days based on feedback we’re getting from parents. It turns out it is much easier for them to meet this way.” 

Designed for parents and professionals

The Super Saturday event is designed for parents, caregivers and professionals who work with young people, explained Kabao Yang, NAMI Minnesota multicultural program coordinator. 

“We’ve always had a solid mix of participants,” she said. 

Kabao Yang
Kabao Yang

In another nod to participant preferences, the conference was shifted from a full day of events to a half day, she added: “We know Saturdays are valuable for folks. We want to make (sure) this is something that can work for them.”

This year’s shifts to a virtual, half-day conference have been popular, Yang said. 

“Typically we get about 100 registrants,” according to Yang. “This year, with more robust marketing and earlier planning, we’ve (had) more than 200 registrants at this point. We’re very excited.” 

Participants can sign up for a range of classes, including a session on mental health crisis planning that will talk about ways parents and caregivers can prepare to safely react to and care for a young person experiencing acute mental illness. 

A class like this is important, Kjos said, because it is hard to think straight when you are in the midst of a mental health crisis. 

“You don’t want to be figuring out how to help your kid when things are so disturbing,” said Kjos. “You want to be able to have this figured out ahead of time.” 

There are also two classes offered for professionals, both offering continuing education credits. One is called “Families as Partners.” 

“This teaches professionals how to help families get what they need to help their children with mental illness,” Kjos said. 

In addition to the classes, Super Saturday also offers a legislative-advocacy session. One of NAMI Minnesota’s goals is to influence legislation at the state capitol that supports the needs of people with mental illness. The session emphasizes the importance of parents and other advocates speaking out on their loved ones’ behalf. NAMI’s legislative advocate will talk about ways that families can help make changes in the legislative process. 

“Families will learn about how they can bring their story to help make legislative change,” Kjos said. 

Another important conference offering is a mock support group. Designed for individuals who, like Kjos, felt unsure about talking to others about their experience with mental illness, the group will give participants a taste of what a support group looks and feels like. It’s an easy, commitment-free way to try it out. 

This year, in an effort to be more inclusive, conference organizers are offering two classes in Spanish. One is on special education services. 

“That can be difficult to figure out,” Yang said. “If your child needs services in their school, there are so many different terms to understand, like an IEP or a 504. This class is designed to help parents understand those terms.” 

Yang said she has long wanted to create more robust offerings for Spanish-speaking participants. She and her colleagues asked Spanish-speaking parents what subjects most interested them and then tried to develop classes in those categories. One thing they learned was that most parents preferred the virtual option. 

“Having this conference virtual is going to be the most accessible for Spanish-speaking folks,” Yang said.   

There will be a virtual resource fair of NAMI Minnesota’s offerings for parents and caregivers. Participants will have a chance to learn about all of the groups sponsored by the nonprofit and what they have to offer, Kjos said. Instead of the separate booths featured at the in-person fairs of the past, individual groups will have their own breakout rooms, where conference participants can join and talk to organizers and other participants. It’s a way for people to meet each other and learn about opportunities for support and renewal.

“We really wanted to create those opportunities that are really intentional but less structured,” Yang said. “We wanted to create an opportunity to get our heads together and talk.” 

Out from under

In the depths of her daughter’s first mental health crisis, Kjos felt like she’d never find her way out. 

“In the beginning it is really hard,” she said. “You try to fix things and all of the sudden there’s another crisis.” 

At one point, her daughter began talking about suicide. 

“I had no idea what to do,” Kjos said. She had never heard of NAMI, so instead, she recalled, “I fumbled. I called my pediatrician. I struggled to find her a therapist. I felt urgency but I didn’t know what to do. Do I take her to the ER? It’s terrifying.” 

Eventually, Kjos’ daughter was hospitalized. Even after that, Kjos said it was four or five months before a therapist asked if she’d ever heard of NAMI. Kjos hadn’t, but she soon got involved. 

“Had I known about NAMI ahead of time, I would have talked to a peer specialist who would’ve walked me through what to do,” she said.

Determined not to be knocked to the ground the next time her daughter was in crisis, Kjos signed up for mental health crisis-planning classes. She also learned about NAMI’s Parent Warmline, a free phone resource open from 9 a.m. to 9 p.m. where parents can call and talk to other parents who’ve cared for children with mental illness. 

“It’s staffed by parents who have been through it,” Kjos said. “They’ll spend an hour or more on a call with a parent who is in first-time crisis. They are an amazing resource.” 

This year, the keynote speaker is Addyson Moore, a member of NAMI Minnesota’s “Ending the Silence” high school outreach program. Moore, who has been hospitalized more than 30 times for mental illness, will tell conference attendees about her own journey to recovery. 

“She faced a lot of barriers with mental illness,” Yang said. “She is inspiring to parents and caregivers. It can be powerful to see and hear from her that it can and does get better.” 

Conference organizers say they want participants to leave the event on an up note, building key connections that will help them navigate the journey of supporting a young person with mental illness. 

“The hope is that folks will be feeling hopeful by the end of the day,” Yang said. “And that they have the energy that they need to channel somewhere positive.”

In other upcoming events, NAMI Ramsey County is sponsoring a screening of the documentary, “Into the Light: Meaningful Recovery from Psychosis.” The hour-long film discusses ways to achieve meaningful recovery from serious mental illness through education, medication and connection-building and features interviews with patients, parents, medical advocates and health care professionals. The event is free and will take place at 6 p.m. on Feb. 23 at Harding High School, 1540 16th St., E. St. Paul.

Andy Steiner

Andy Steiner is a Twin Cities-based writer and editor. Before becoming a full-time freelancer, she worked as senior editor at Utne Reader and editor of the Minnesota Women’s Press. Email her at asteiner@minnpost.com.

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U of M researchers find continued loss of OB clinics in Minnesota, across the country https://www.minnpost.com/greater-minnesota/2025/01/u-of-m-researchers-find-continued-loss-of-ob-clinics-in-minnesota-across-the-country/ Wed, 22 Jan 2025 12:10:00 +0000 https://www.minnpost.com/?p=2190526 By 2030, the country is expected to have a shortage of OB-GYNs, with demand exceeding the supply by over 5,000 full-time employees, according to the Department of Human Services.

Workforce shortages and the financial challenges of operating OB units were cited as the main reasons for closures.

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By 2030, the country is expected to have a shortage of OB-GYNs, with demand exceeding the supply by over 5,000 full-time employees, according to the Department of Human Services.

University of Minnesota researchers have found that obstetrics units continue to close in rural counties in Minnesota and across the country. 

Minnesota has seen its fair share of obstetric (OB) unit closures, such as the Mayo Clinic Health System in New Prague, which closed its unit in early 2024, and Essentia Health-Fosston, which also closed in 2024. 

Mayo Clinic Health System in Fairmont reported its OB unit will close in March due to staffing shortages and other issues, including, according to a statement from the health system, “decreasing patient volumes and birth rates, and an increase in the number of patients with complex needs who need higher levels of care.”

The University of Minnesota Rural Health Research Center wanted to quantify the losses and gains of obstetric care at rural and urban short-term acute care hospitals between 2010 and 2022.

Mayo Clinic Health System in New Prague closed its OB unit in early 2024.
Mayo Clinic Health System in New Prague closed its OB unit in early 2024. Credit: Mayo Clinic Health System

“It’s hard, actually, to track obstetric unit closures on a national scale because there is no national database of obstetric unit closures or obstetric unit access across communities,” said Julia Interrante, a research fellow and statistical lead for the University of Minnesota’s Rural Health Research Center. 

The center’s prior research found that access to maternity care in rural counties continues to decline, with 49% of rural counties having had hospital-based obstetrics in 2010, a figure that fell to 41.2% in 2022. 

Interrante said 537 hospitals across the country lost obstetric units between 2010 and 2022. “Rural communities were definitely overrepresented among those losses,” Interrante said.

Essentia Health-Fosston closed in 2024.
Essentia Health-Fosston closed in 2024. Credit: Essentia Health

In 2010, 43.1% of rural hospitals and 29.7% of urban hospitals did not offer obstetric care. The research found that each subsequent year, there was a net loss of obstetric services at U.S. hospitals. While 138 hospitals gained obstetrics in these years, 112 of those were in urban hospitals, but only 26 were in rural hospitals. 

The researchers came up with an algorithm that uses data from the American Hospital Association Annual Survey and the Centers for Medicare & Medicaid Services to identify obstetric unit closures. They check for inconsistencies and validate the information based on new reports, phone calls and hospital websites. 

In 2021, about 14% of Minnesota women had no birthing hospital within 30 minutes, according to a report from the non-profit March of Dimes. Women in the counties with the highest travel times could travel up to 49.2 miles and 55 minutes on average to reach their nearest birthing hospital.

Mayo Clinic Health System in Fairmont reported its OB unit will close in March of this year due to staffing shortages.
Mayo Clinic Health System in Fairmont reported its OB unit will close in March of this year due to staffing shortages. Credit: Mayo Clinic Health System

Studies have found that further distances to receive maternity care increase the risk of maternal morbidity and adverse infant outcomes, such as stillbirth and NICU admission. 

The center’s researchers have also conducted case studies on hospitals that have successfully kept their OB units to highlight potential things that struggling hospitals could do. 

Success stories

In western Wisconsin, one effort involved making services more attractive to potential patients, in turn drawing patients who would’ve otherwise gone to a different hospital. 

Through phone interviews and emails in 2020 with Western Wisconsin Health clinicians and leadership, the researchers learned about the hospital’s various maternity services often not available in rural communities. Because of this, the hospital was able to draw in a large number of clients from surrounding areas and across the Minnesota border.  

“There were some hospitals that provided a greater array of options for birthing to help even try to recruit patients to give birth there, even pulling some patients from urban centers if they were in a rural community but not that far from an urban one. Providing things like vaginal birth after Cesarean (section), water birth, access to midwives, things like that,” Interrante said. 

Resources are needed to offer services like that, and enough staff, too. She said other instances of units staying open have involved someone in leadership who really feels passionate about birthing access. 

Challenges to staying open 

The center’s other work has examined the decisions behind closures by talking with rural hospital administrators. 

Workforce shortages and the financial challenges of operating the unit were the main reasons for closures. Staff must be available at all times, for instance, fixed costs like malpractice insurance can also add strain. 

It can be challenging in rural areas that have two or three people attending to births — especially when one of them is on vacation or retires. “That’s also a big strain on that one or two individuals to be available 24/7, when you don’t really have much backup, ”  Interrante said.

By 2030, the country is expected to have a shortage of OB-GYNs, with demand exceeding the supply by over 5,000 full-time employees, according to the Department of Human Services. 

The system that pays for maternity care services is really a volume-based revenue system, she said. 

“By that fact, it really does disadvantage rural lower birth-volume hospitals who, again, if they don’t have enough births to cover those fixed costs, their hospitals losing money on that service line, which can make it really challenging,” Interrante said.

Editor’s note: This story has been updated to include a Mayo Clinic Health System statement on the closure of its Fairmont clinic.

Ava Kian

Ava Kian

Ava Kian is MinnPost’s Greater Minnesota reporter. Follow her on Twitter @kian_ava or email her at akian@minnpost.com.

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People Incorporated’s rapid responders reach out to people where they are https://www.minnpost.com/mental-health-addiction/2025/01/people-incorporateds-rapid-responders-reach-out-to-people-where-they-are/ Tue, 21 Jan 2025 12:00:00 +0000 https://www.minnpost.com/?p=2190358 A member of a People Incorporated ARC Outreach Team, right, working with an encampment resident.

An expansion of services has allowed the health provider to embed itself in the communities where mental health and addiction support is most needed.

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A member of a People Incorporated ARC Outreach Team, right, working with an encampment resident.

On a typical day, Amber Ruth, a licensed social worker and mental health professional at People Incorporated, Minnesota’s largest community based mental health provider, is out and about — at homeless encampments, in drop-in shelters and at public libraries — helping to connect people with the services they need to treat their mental health and substance use issues.  

On a recent Tuesday morning, when Ruth was working her regular weekly drop-in hours at St. Paul’s Rondo Community Library, she completed a mental health assessment for a woman in crisis and helped her get signed up for an intensive residential treatment services (IRTS) bed run by People Incorporated. “I was able to work with our central access team to find her a place,” she said. “She was picked up from the library and brought into IRTS within an hour-and-a-half.” 

This rapid response to community needs is made possible by the recent expansion of People Incorporated’s Access and Recovery Center (ARC) services, which now include substance use and outpatient mental health support. This expansion, which brings Ruth and other mental health care workers out of the office and into the community to provide essential services where they are needed, represents a significant step in delivering compassionate, integrated care to underserved people in the Twin Cities, said Veronika E. Mix, People Incorporated vice president of community engagement.  

“What makes this program different from how we used to do our work is that we are really now based in the community,” Mix said. She said Ruth and her colleagues are embedded in the community, going out and meeting people who may feel uncomfortable asking for help or don’t know where to get it: “We’re going to the right places, to those locations, those shelters. When we come around, people on the street know us. They say, ‘People Incorporated is here.’ They know we can help.”

Amber Ruth
Amber Ruth

Previously, Ruth, a 20-year People Incorporated employee, worked as part of the St. Paul Police Department’s Community Outreach and Stabilization (COAST) unit.  When the department disbanded the unit in September 2024, People Incorporated, with the encouragement of staff like Kristin Sierra, senior licensed program manager, decided to expand its services and continue that programming with Ruth in the same role.  

“She’d found a niche with the unsheltered population, going into the encampments with our outreach team because there are so many barriers that people face with not having a phone, not having transportation,” Sierra said of Ruth. “People know her and trust her. It only made sense to continue that role with as little disruption as possible.” 

The Twin Cities’ unsheltered population continues to grow, Sierra said, and many members of that community struggle with untreated addiction and mental illness. Having an experienced, accessible mental health professional like Ruth — someone who knows the state social service system inside and out — is key to keeping vulnerable members of the community as safe and healthy as possible. That’s why Sierra and her People Incorporated colleagues advocated for the ARC expansion. 

Mix said this expansion will cost People Incorporated around $100,000 a year. “We  do get referrals and payments from insurance,” she explained, “but also it is our mission to serve those individuals who are uninsured as well as those individuals who are living in poverty to help them get access to insurance and other things that would support their mental health. This carries a cost.” 

Ruth’s workdays are varied. “I work primarily with unsheltered folks,” she said. “I’ve been able to build quite a few relationships with community organizations in the city. I try to keep those relationships healthy so they know to reach out to me if they interact with a person who is struggling and needs help.” She has established hours in central gathering points where people can seek her out. As she said: “I have open drop-in hours throughout the week at libraries, shelters, camps — wherever clients are in need. People are aware of my hours. Often they come to me.” 

Ruth’s professional training and experience means that when she meets with a person in crisis she is qualified to conduct a same-day comprehensive evaluation, an essential step that’s key to making people eligible to receive state-sponsored mental health and addiction services. 

“When a person is interested in these kinds of services, we catch them right then and get them referred into our system of care,” Sierra said. “Amber also meets with folks to help them apply for other benefits — or just fill in any gaps they have in services. She can help them get the care they really need.”

‘We have to help in the community’ 

The COAST program was developed to help build connections between the police department and community members with the help of mental health professionals like Ruth, who worked with the department as a People Incorporated employee. Department leaders say the decision to shut down the unit last fall was part of a larger plan to expand those services in the city. A new department program, called Familiar Faces, launched in December 2024, was designed to go beyond the assessment process, but People Incorporated staff felt that community need was great enough to support continuing Ruth’s work. They advocated with agency leadership to make that happen. 

“Kristin and her team,” Mix recalled, “said ’We have to get help in the community. We have to be out there.’” While the nonprofit already has an outreach team that connects with community members, Ruth’s expertise is essential to actually getting the work done, she said: “Having licensed individuals like Amber Ruth available to do assessments right there, to do those clinical things for folks that are in need, is just essential to our work.”  

Sierra can’t emphasize enough the importance of the assessment process. In order to be eligible for services like residential addiction treatment, mental health counseling or many kinds of housing support, a licensed professional needs to spend time with an individual and assess their mental and physical health as well as other needs. Ruth’s deep experience means that she knows how to talk with people, how to do those assessments and how to move forward quickly to access support. 

“If we meet someone whose mental health is more symptomatic and they clearly need more support, we can get them into our crisis beds or Intensive Residential Treatment services very quickly,” Sierra said. “This can happen either the same day or the next day.”

Sierra said Ruth completes somewhere between 30-40 assessments a month. While that number may seem high, there are many more people out there, on the streets, at the library, in shelters, who desperately need assistance. “There is much greater need, but Amber is only one person,” she said. “It is a lot.” 

Kristin Sierra
Kristin Sierra

The assessment skills that Ruth brings boosts People Incorporated’s ability to make significant change in their clients’ lives, Mix said. “Same-day assessment is so key for an individual to really allow us to ask those questions and identify, ‘What are your needs?’ and helps us to understand how we can help them.” Perhaps a client needs to participate in one of People Incorporated’s crisis programs. Or intensive residential treatment. Or long-term housing or case management. 

“The biggest difference with what Kristin and the team have done with expanding this to the community is being on the street, being right there and making themselves available to meet the needs of those individuals,” Mix said. 

While People Incorporated has traditionally focused its efforts on St. Paul, it’s expanding its reach to Minneapolis. “We are just finding out who our community partners are there and building up referrals,” Sierra said. In Minneapolis, People Incorporated workers are, Sierra explained, “riding the trains, meeting with individuals and doing mental-health evaluations right on the trains. We’re also offering more support or handing out our cards.” 

Veronika Mix
Veronika Mix

While this expansion comes at a cost, Mix said it didn’t take long for Sierra and her colleagues to convince her and other members of People Incorporated’s senior leadership team that the investment was needed. 

“We had to do something,” she said. “We couldn’t just continue to see so many individuals who are struggling. At People Incorporated, we specialize in helping people with substance abuse. How do we meet the needs of individuals who need crisis help? We have to be in the community. Once we get that assessment done, we can get them into our programs immediately so we can identify their long-term journey.” 

The benefit of connection

Ruth’s decades of experience and deep connections make her indispensable, Sierra said. “Amber is everywhere in the community. She’s pretty well known in St. Paul. If people meet someone who needs an assessment or an evaluation, they know they can call Amber.”

Being part of the community for so long helps build deeper connections with people whose bad experiences with authority figures breeds a strong sense of distrust, Ruth said. She understands that it takes time to prove her motivation, that she’s in it to help people in need, not to control their lives. Being out and accessible is an essential part of getting that message across. “I am mobile,” Ruth said. “I go to the consumer where they are most comfortable. We meet where they are to help fill those voids and build that trust.”  

Being a constant presence in places where people struggling with mental illness, addiction and homelessness congregate makes it easier for those people to feel like they can trust her, Ruth said. But it takes time. Just the other day, she was able to help connect a client with essential support programs. “It took them three years to get comfortable with me, but when they were ready, they knew where they could find me at the right moment.” 

And once the wheels get set in motion, change can happen quickly.  

Take the person who met with a People Incorporated Access and Recovery staff member on a recent Wednesday. “They are unsheltered, have a severe and persistent mental Illness, are not on medications, have recently lost their job and are just facing a lot of barriers with getting to therapy or medication management,” Sierra said. When the client agreed to do a 90-day program with People Incorporated’s intensive residential treatment service, she explained, “I was able to message our central access contact center, ask if there were any beds open. They were able to locate a bed at one of our Minneapolis facilities and that person got admitted the next day.”

Being in the right place at the right time takes commitment, Mix said, but it’s a commitment that staff at People Incorporated are willing to make. To them, she said, the effort required to meet clients in their preferred environment is worth it; when the opportunity to help arises, they want to be there. 

“It’s about meeting people where they are, not waiting for them to call our contact center or even walk into the library,” Mix said. “It’s about riding on those trains, riding on the buses, being present in those gathering spots so individuals can really have access to us. A huge barrier for individuals wanting help is access, not knowing where to go, so we go to them.”

Andy Steiner

Andy Steiner is a Twin Cities-based writer and editor. Before becoming a full-time freelancer, she worked as senior editor at Utne Reader and editor of the Minnesota Women’s Press. Email her at asteiner@minnpost.com.

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Study finds deep-brain stimulation shifts people out of negative ‘cycles’ of mental illness https://www.minnpost.com/mental-health-addiction/2025/01/study-finds-deep-brain-stimulation-shifts-people-out-of-negative-cycles-of-mental-illness/ Mon, 13 Jan 2025 12:10:00 +0000 https://www.minnpost.com/?p=2189818 A new study has found that deep brain stimulation, a surgical procedure that uses electrical impulses to treat neurological disorders, can enhance psychological flexibility in people with depression, anxiety or obsessive-compulsive disorder.

A Q-and-A with Alik Widge, a lead author of the University of Minnesota report.

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A new study has found that deep brain stimulation, a surgical procedure that uses electrical impulses to treat neurological disorders, can enhance psychological flexibility in people with depression, anxiety or obsessive-compulsive disorder.

While a flexible body may be helpful for physical health, a flexible brain — or the ability to break out of cycles of negative thoughts, behaviors and actions — is key to mental health. 

A new study conducted by a team of researchers from the University of Minnesota Medical School’s Department of Psychiatry and Behavioral Sciences and published in the journal “Science Translational Medicine” has found that deep brain stimulation (DBS), a surgical procedure that uses electrical impulses to treat neurological disorders, can enhance psychological flexibility in people with depression, anxiety or obsessive-compulsive disorder (OCD). This enhanced mental flexibility was shown to help people move away from behavioral cycles that have left them feeling “stuck” in their mental illnesses.

Frustrated by relatively slow progress in the development of new psychiatric treatments for mental illness, the University of Minnesota team decided to take a new approach to their research. Instead of beginning development of this treatment in the traditional way — through animal trials — they instead started by treating human subjects with depression, OCD and anxiety with DBS and then interviewing them about the treatment’s impact on their symptoms. 

After study subjects reported that DBS treatment helped them break free of the limiting cycles of their mental illnesses, researchers launched a clinical trial in rodents in which rats who had learned to complete a task for a reward in a specific way were given DBS-like stimulation and then required to find a different way to complete that task. The research team found they were able to replicate the human results in rodents, that the rats that had been treated with DBS showed mental flexibility and an ability to adapt to new behavioral requirements. 

Recently, I spoke with Alik Widge, associate professor of psychiatry and behavioral sciences and one of the study’s lead authors. He told me that his team’s results — aided by the innovative way it conducted its research — demonstrate DBS’ great potential as a treatment for significant mental illness. “This could help change the way we treat mental illness,” he said. But, he added, mainstream use of the practice is still far off on the horizon. “The field is still grinding through and will be for some time to figure out how to make this work.” 

This interview has been edited for length and clarity.

MinnPost: I’m intrigued that you started this research with humans and then replicated your results in rodents. Isn’t that the reverse of the usual order?  

Alik Widge
Dr. Alik Widge

Alik Widge: My lab does human and rodent research. We do this with the idea that we have these treatments that have very complex brain effects, but we don’t know exactly how they work and it is very difficult to study those mechanisms in humans. That’s true, whether it is drugs, brain stimulation, any of it, because the tools we have to measure humans in terms of behavior and brain activity are not what we can do in animal models. You can make an animal do something over and over and over again. But you can’t do that with a human because they will get bored and walk away. Humans also have a negative reaction when you ask, “How will you feel if we put a bunch of wires in your brain?” whereas animals don’t get to say that. 

MP: So animals aren’t as difficult to deal with as humans?

AW: If you want to study stroke, you can give an animal a stroke. If you want to study cancer, you can give an animal cancer. But that only goes so far. If you want to study anxiety, you can ask a rat, “How are you feeling?” They will answer, “Squeak.” 

MP: That doesn’t sound very helpful.  

AW: What we’ve been wrestling with for decades is, “How do we build an animal model that we can use in people to modulate the disease process?” Unless you have an animal model that lines up with what you’ve been doing in humans, that model is scientifically useless. It is very limited, unless you can prove your animal model lines up with something that happens in humans. 

That’s what led to this study. Nearly 10 years ago now, I started thinking about the question of, “What if we flipped that script a little bit? What if we found a treatment that is replicable in people and build an animal model where that same intervention does the same thing? What if you find something that lines up and you could use it for a platform or a toehold to do really good science and modeling?” 

This is where we centered on the model that we call “cognitive flexibility.” I found data that shows that when you do DBS in people, one of the things it does is improve their cognitive flexibility. It helps people shift away from the mindset that they are “stuck” in their mental illness into one that is more adaptive. 

MP: How does making the brain of a person with, say, depression or OCD more flexible help them to recover from their mental illness? 

AW: There is a whole pile of [mental health] disorders where people say, “I’m stuck. I don’t want to do this thing but I seem to always end up doing it in the moment.” What we discovered in the initial human papers is if you do DBS in the right way you can get people unstuck so they can break free from this cycle. It’s kind of like a circuit override. 

MP: How did your patients describe the experience of being unstuck? 

AW: I gave a dean’s lecture about a month ago that was meant to be accessible to the general public. It included a video where patients talk about their experience of having their cognitive function enhanced and becoming more flexible. They say things like, “Whatever was weighing me down just can’t get to me.” Another patient says, “Now, the OCD is behind the door. It is pounding on it and trying to get to me, but it is on the other side of the door.” 

MP: With depression, for instance, is it the feeling of being stuck like when a person is so depressed they can’t get out of bed? 

AW: In depression, the classic loop I describe is what Aaron Beck talked about when he was developing cognitive behavioral therapy: You wake up and you feel miserable. You have an option: You could do something. You could go to the coffee shop. You could apply for a job. You could message your friends. You know you could do something, but depression is a cancer waiting to perpetuate itself. It is a parasite. 

Depression tells you that things aren’t going to turn out well, so why should you bother doing anything? You are stuck. You spend the day stuck in that loop, and then you look at the clock and say, “I had so many things I wanted to do today. I didn’t do them. I am a useless piece of humanity.” The next day, you wake up feeling much worse. That cycle is one of the classic perpetuators of depression and anxiety. 

MP: And the circuit override caused by DBS can help patients step out of that cyle? 

AW: The idea is that if you can just do something a little bit outside of that pattern, if you can get just a little bit outside of the path, even if you fill out the job application and don’t hit submit, maybe tomorrow you will hit submit. You’ll never get there until you start. The classic proverb is, “The journey of a thousand miles begins with one step.” All you have to do is take one step. If you take one step, you start tomorrow one step closer to your goal.

With DBS, we can make it easier to take one small step. That was something we saw in people. The question then was, “Could we do it in an animal model?” 

MP: Do rats change their behavior patterns after they experience DBS-like treatment? 

AW: Yes. Rats in our study learn to adapt to the demands. If we change the demands that are on them, they adapt their behavior. We’ve been able to show that DBS makes humans’ brains more adaptable. We were able to show that we could use similar technology to make rats adapt in the same way.

After doing about a year and a half of math, we were able to say, “These are the computation processes that happen when a rat gets better at doing this task.” The cool thing is, we said, “OK. What if we went back to our old human data and ask, ‘Does that model accurately fit and predict what happens in humans?’” The answer is yes. 

We have evidence of human cognitive enhancement. We managed to make the same cognitive enhancement happen in rats. In the rats, we identified a mechanism. Then we went back to the human data and showed that the rat data explained what happens in humans. It is a truly translational model. It goes back and forth between humans and animals. 

MP: Is this “humans-first” approach part of what makes your study stand out? 

AW: Doing this type of reverse translational human-to-animal approach to build a model is really rare. I don’t think it’s ever been done before. That’s why I think it’s so powerful because now something lines up. Now we have a platform for therapeutics discovery because we understand what we need to do to the brain. This is why that paper ended up in a big, fancy journal.

MP: Do you think this approach will catch on? How do you think a reliance on animal trials limits advancement in psychiatric treatment? 

AW: Many of us in the field, we believe that’s one of the biggest problems in psychiatry. So many drugs look promising in animal studies. They succeed in phase one and phase two studies, then fail in phase three studies. Psychiatry is a valley of death for drug development. Developing new drugs has been hard because scientists start with the animals, do some stuff, see value, then advance the work to humans and see it is not a reliable indicator of effectiveness in humans. 

This is a new approach. It was first talked about 10 years ago as a means of study. It is one thing to say theoretically, “We should start with the human brain and then build animal models.” It is another thing to actually say, “This is how we are going to do this.” Clearly, there are still a lot of details that need to be worked out. 

MP: Is one of the goals of this approach to research being able to develop treatments that target areas of the brain to treat specific mental illnesses? Right now, the psychiatric treatments available don’t seem to have that kind of specificity. 

AW: In cancer treatment, there are more options. Doctors can genotype your tumor to identify if it is sensitive to one of these new categories of drugs. Then they will target your treatment to that type of tumor, and you will have way less nausea, less hair falling out. If you are unlucky, you might have a mutation of a tumor that doesn’t respond to these new drugs, and doctors are still going to have to carpet bomb you with chemo — but that’s where all the new cancer drugs are heading. 

The approach we used in this study is a gateway to being able to do similar things in psychiatry, to be able to say, “I know exactly what I need to do to change your brain to make you healthier. I’m going to adjust your treatments until I see that I have caused that change.” 

If you go to a doctor right now and say, “I’ve got depression,” they will say, “Why don’t you try this drug? I’ve tried this with a lot of my patients. It works pretty often.” If a patient asks, “How does this SSRI treat my depression?” a doctor might say, “We don’t really know.” With DBS, I can say to a patient, “Because you told me that a lot of your problem is you are getting stuck in this negative pattern, I know a way to get you unstuck.” 

MP: If this research continues, it feels like you’re one step closer to one day being able to say, “I’ve taken a scan of your brain. Here is your depression. This is the way I will treat it.” That makes mental illness somehow seem more identifiable and understandable to others. What’s next?

AW: A colleague at Stanford has developed a brain scan that can tell if someone has a deficit in cognitive systems that she can treat. We are working together to pair these things with my research. We want to do a trial of my brain stimulation for people who are positive for her biomarker. 

It is a big, bold claim. We haven’t been able to get the money for this trial yet. If we do get the money, we will eventually have the ability to say, “I brain-scanned you. You have this problem. I know the specific treatment for this problem. I’m going to give it to you, just like I would if you had cancer.”

Andy Steiner

Andy Steiner is a Twin Cities-based writer and editor. Before becoming a full-time freelancer, she worked as senior editor at Utne Reader and editor of the Minnesota Women’s Press. Email her at asteiner@minnpost.com.

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Staff-strapped nursing homes look to new Americans for help https://www.minnpost.com/greater-minnesota/2025/01/staff-strapped-nursing-homes-look-to-new-americans-for-help/ Thu, 09 Jan 2025 16:26:53 +0000 https://www.minnpost.com/?p=2189667 International RN Binita Poudel, right, works with residents of the New Brighton Benedictine Living Community.

A third of the nursing assistants working in Minnesota are immigrants, some of them recruited by senior facilities.

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International RN Binita Poudel, right, works with residents of the New Brighton Benedictine Living Community.

Minnesota is facing a workforce shortage in its aging services, with estimates showing about 17,000 openings statewide for licensed practical nurses, registered nurses, direct care staff and dietary staff, according to a 2024 survey conducted by the Long-Term Care Imperative, a partnership of two senior care associations. 

That’s roughly 20% of the workforce, said Anna Mowry, the director of workforce solutions for LeadingAge Minnesota, a nonprofit that supports more than 1,100 senior care organizations in the state.  

The staffing challenges limit access to care and have resulted in the closure of some nursing homes and assisted living facilities, she said. 

To fill some empty positions, the industry has recruited nurses from other countries to live and work in Minnesota on employment-based visas. According to a 2023 Lightcast report, nearly one in three nursing assistants and nearly 14% of Minnesota’s overall healthcare workers in 2021 were immigrants.  

Dire need in rural communities

Since 2005, the number of beds in rural licensed nursing facilities in Minnesota has declined between 30% and 100%, depending on the region, according to a report by the Center for Rural Policy and Development. The report found counties in the northwest and southwest regions are expected to experience peak demand for nursing facilities significantly sooner than the rest of Minnesota. 

As of February 2024, Minnesota had 33% fewer nursing facility beds than it did in 2005, with the most severe drops occurring in rural Minnesota, where entirely rural counties have 41% fewer nursing facility beds than they did in 2005. Entirely urban counties had 29% fewer nursing facility beds, according to the Center for Rural Policy and Development, a think-tank based in Mankato.

The decline is in all regions — and those in the nursing care industry say people from other countries could help with the staffing shortage. 

“We are not going to see the numbers in terms of birth rate and the workforce population that is domestic be able to solve the problem of the baby boomers getting older and having enough staff to address the needs,” said Kathleen Murray, director of Organizational Learning and Development at Benedictine. 

Benedictine is an example of a nursing home operator that has helped sponsor immigrants to come to the U.S. to boost its workforce. Murray said the organization has brought 158 RNs and nurses’ aids to facilities in North Dakota, Minnesota, Wisconsin, Missouri and Illinois. Over 100 others are currently going through the immigration process. 

Mowry said people in these roles need support when entering the country and beginning their jobs. 

Supporting new Americans 

In 2023, the state Department of Human Services received about $28 million in grant funding from the Legislature to improve the recruitment and retention of immigrants and refugees working in the state’s assisted living communities and other long-term care environments. LeadingAge Minnesota, for example, secured just under a million dollars for that work. Funds were distributed to another 23 organizations, too. 

Mowry said LeadingAge Minnesota will use some of that funding to translate its nursing assistant curriculum into three languages that are commonly spoken by newer immigrants. 

“We need to double down on supporting the new Americans already here in our state who want to have these job opportunities, and who either don’t maybe know they exist or don’t know how to find the certification to become a CNA,” Mowry said. 

These efforts are designed to help people already in the country get into direct-care careers. Efforts to bring nurses and other direct-care workers to Minnesota have been ongoing and have included recruiting nurses from the Philippines, Mowry said. But there have been challenges in supporting those new nurses. 

Last year, a group of people in the nursing care industry, including Mowry and Murray, traveled to Nairobi, Kenya, alongside state Rep. Mohamud Noor to explore partnership opportunities in East Africa to help establish pipelines for nurses to work in the United States under employment-based visas. 

During that trip, Mowry said they celebrated the opening of a second testing center for nurses, which would create more access for nurses to take the exam that’s required for them to work in certain countries. 

LeadingAge’s members sponsor Kenyan students and provide scholarships to nurses abroad. Some even make job offers to candidates who are just waiting on immigration papers, Mowry said. 

Wait times can often be several years, according to Murray. Sapana Dhakal, a registered nurse at a Benedictine Living Community nursing home in Owatonna, interviewed for the position while living in Australia in 2021 but just got to the United States in 2024. 

Dhakal, who is originally from Nepal, and worked as a nurse in Australia for a couple of years, said finding work in the U.S. was much easier than in Australia, where she said more people were applying for the same jobs. 

Since 2016, Benedictine has placed 89 international RNs in Minnesota. In the town of Ada in northwestern Minnesota, for example, two of the four full-time RNs working for Benedictine are international RNs. 

“The need is just so great that if we cover the immigration costs to bring a nurse here … if we can get an RN in a rural community that will work for three years, that will pay for itself in terms of us not having to bring in an external agency that will be a lot of higher cost,” Murray said.

Editor’s note: This story has been updated to clarify that the survey mentioned in the opening paragraph was conducted by the Long-Term Care Imperative and to correct Kathleen Murray’s title.

Ava Kian

Ava Kian

Ava Kian is MinnPost’s Greater Minnesota reporter. Follow her on Twitter @kian_ava or email her at akian@minnpost.com.

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Serenity Kennel looks to remove barriers for dog owners seeking addiction treatment https://www.minnpost.com/mental-health-addiction/2024/12/serenity-kennel-looks-to-remove-barriers-for-dog-owners-seeking-addiction-treatment/ Mon, 23 Dec 2024 12:15:00 +0000 https://www.minnpost.com/?p=2188703 Evan Jandl’s dog Maggie

“I didn’t even entertain the idea of going to an inpatient treatment program because I cared so much about my dogs,” one of the proposed kennel’s founders said.

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Evan Jandl’s dog Maggie

At the lowest point in his addiction journey, Evan Jandl said the only living beings who “didn’t look at me with disgust” were his two beloved dogs, Buck and Maggie. Jandl was so connected to his dogs that, even though he realized he desperately needed residential treatment, he couldn’t imagine sending the pups to live somewhere else for the months he’d likely be away. 

“I’ve been in and out of AA for three years,” Jandl said. “I really needed help. Still, I didn’t even entertain the idea of going to an inpatient treatment program because I cared so much about my dogs. I didn’t want to let them go — and I couldn’t think of a place that could take them.”

Then the decision was made for him when Jandl was arrested for driving under the influence.  

“I got another DWI,” he said. “I ended up in jail. Somebody had to take my dogs. I knew I was going to go somewhere bad. There was no positive outcome that would’ve come because I wasn’t willing to let go of the dogs.” 

Then, at the last minute, the owner of a kennel where Jandl had boarded his dogs in the past agreed to take Buck and Maggie for the 30 days he’d be in treatment. It was a lucky break, he said, but he knew he’d likely need more: When his 30-day treatment was complete, Jandl moved into a sober home, extending his time away from his dogs for six more months. 

Determined to get her son help, Jandl’s mother called the kennel owner and pleaded his case.

Evan Jandl’s dog Buck
Evan Jandl’s dog Buck Credit: Supplied

“She agreed to keep them for another six months so I could do the whole time in the sober home,” Jandl said. As the arrangement fell into place, the kennel owner’s generosity felt miraculous: “The only reason everything happened was because she was the angel that said yes.” 

Knowing he had a safe place for his dogs to stay made all the difference in the world. “I wouldn’t have gone to treatment had I not had somebody I trusted that was able to take them,” Jandl said. “Being able to focus on my recovery and not worry about my dogs changed my life.” 

A much-needed resource

While he was in residential treatment at The Retreat, an alcohol and drug recovery program based in Wayzata, Jandl met Frank Schmidt in his men’s recovery group. Schmidt also had a much-loved dog — Mia, a mixed-breed who has lived with him for three years. “They say she’s a Jack Russell Beagle mix,” Schmidt said fondly of Mia. “I just call her beautiful.”

Schmidt found a friend who was willing to care for Mia during the 30 days he was in residential treatment. When Jandl told him about his struggle to secure long-term lodging for Buck and Maggie and how much their extended stay at the kennel would cost (he’s now slowly paying the kennel owner back with regular deductions from his paycheck), the two put their heads together, hatching a plan to one day create a new kind of pet-boarding facility, a safe place where dogs could go while their owners spent time in residential addiction treatment programs. There clearly seemed to be a need.   

Jandl and Schmidt decided that the facility of their dreams would be called Serenity Kennel, a dog-boarding program designed to meet the unique needs of pet owners in recovery, with low-cost and sometimes free or subsidized boarding rates. While some recovery-friendly pet fostering programs already exist in Minnesota, the friends knew they wanted Serenity Kennel to be different.

Frank Schmidt’s dog Mia
Frank Schmidt’s dog Mia Credit: Supplied

“The end goal is to have it be an actual physical kennel,” Schmidt said. “We want to have a place where people can bring their dogs immediately if they have a crisis.” Securing a foster home for a pet can take time, he explained. He and Jandl want to open a kennel that could accommodate more emergency situations and longer stays. 

“I think the main thing is how fast we can get these dogs into care,” Jandl said. “For a lot of people, that window to make the decision to go to treatment and actually going there can close really quickly. You could have a terrible night and think: ‘Im going to do this.’ Then, all of the sudden, a week goes by, and you’re still trying to find a place for your dogs.” 

Schmidt agrees. For some owners, finding a kennel that could take their dog at a moment’s notice would make all the difference in the world. 

“From personal experience,” he said, “any barriers you face you can find excuses not to get into treatment. I don’t want to have any barriers for people. I want to be able to say, ‘Yes. We can take your dog here. Go take care of yourself and get right. Once you get out of treatment, you’ll be a better pet owner.’”

Jandl and Schmidt also know how helpful it would be to board dogs at a place where the people in charge understand what it means to be in recovery — or are maybe even part of the recovery community themselves.

“In this day and age there is still some stigma around people who have chemical dependency issues,” Schmidt said. Because of their own personal experiences, he continued, he and Jandl feel they are, “uniquely positioned to help people, because we’ve been through it and we know not only the physical issues and pain but also the mental pain that goes with recovery. We’ve been down that road, so I think we can tell a good story that will help soothe people and take away that barrier.”

Now 10 months sober, Jandl and Schmidt have been talking about Serenity Kennel to anyone who’s willing listen. So far, they say, the response has been overwhelmingly positive. On the advice of a mentor, they met with Larry Castriotta, a fellow Retreat graduate and retired business owner, who joined the effort as a Serenity Kennel board member. With Castriotta’s help, they completed the 501(c)(3) process, registering the organization as a nonprofit. This designation makes Serenity Kennel eligible to receive tax-exempt donations.

Evan Jandl and Frank Schmidt with Gauge, center, at the 2024 Walk for Recovery.
Evan Jandl and Frank Schmidt with Gauge, center, at the 2024 Walk for Recovery. Credit: Supplied

Travis Winship, founder and executive director of the Pink Cloud Foundation and Pink Cloud Pets, has met with Jandl and Schmidt. He believes that the program is needed and hopes that other donors will come forward to support their effort. “Serenity Kennel will be a welcome partner and asset to our community,” he said. 

With an aim of drumming up financial support for the project, Castriotta began reaching out to friends in his recovery network, and he said he was “blown away” by their response. “The more we talked to people about this, particularly people who were running rehab centers, they’re saying this is a big need. They’re having people put off going into treatment because of their pets.”

Donors are needed, the team says, because establishing and running this kind of program won’t be a low-cost proposition. Because they aim to be able to offer scholarship support to pet owners in recovery who can’t afford boarding fees, Castriotta explained that they will need to establish an endowment of around $30,000. Then there’s the cost of acquiring a physical kennel space, and all the other things that go with running a business. 

“We are probably talking about half a million dollars or more,” Castriotta said, explaining that he’s set up meetings with potential donors he thinks might be willing to be “angel investors.”  “My first ask is going to be for $25,000, That’s going to be for stuff like legal fees, accounting. Then operating costs will be another $50,000.” 

Though these numbers seem high, Castriotta feels confident that he, Jandl and Schmidt will be able to pull the needed funds together. “I think once we’ve proven the concept it will be easy to raise the money,” he said. “I think money’s going to be OK. The AA fellowship is an amazing, amazing force. We’re going to fully tap into it to make this thing work and get it up and running and start helping people.”

More than a kennel

Jandl and Schmidt say they want Serenity Kennel to be more than just a dog-boarding facility. They’d also like it to be a place where members of the recovery community can spend time, working volunteer shifts cleaning, walking or feeding dogs, and maybe even attending recovery meetings. 

“We’d like to host monthly or weekly meetings,” Schmidt said. “Maybe people could bring their dogs and even place them in the kennel during the meetings.” 

Another way Serenity Kennel could make money would be if, alongside the nonprofit arm, organizers could establish a for-profit program where people could send their dogs for regular care. 

“We’ll run it like a regular kennel and all profits from that will go into the nonprofit side,“ Castriotta said. “We think the AA community will support that. People who are sober now, if they are going to go on vacation, they’d just as soon send their dogs to us.” 

Because it can be hard to find longer-term pet care when owners are in residential treatment and sober living programs, the Serenity Kennel team also dreams of building connections between treatment centers and places where people could board their pets. It could take the form of a database, with names and contact information for kennels and pet-foster programs.

“What would be really interesting to do is helping treatment centers have information on their site so they can help you place your dog while you are in treatment,” Schmidt said. “If a center could say, ‘We could help you place your dog so you could come in right away,’ that would make a big difference in getting them into treatment. It would be a huge help for everybody all the way around.” 

Castriotta, Jandl and Schmidt said they would like to have Serenity Kennel up and running by early 2025. Though that seems like a stretch, they continue to feel optimistic. The need is there, and they think that the financial resources are, too. 

“We think of it like the movie ‘Field of Dreams,’” Schmidt said. If they build it, “People will come. There’s just so much support out there in the community. It is just tapping into the right people and foundations and corporations and angels that want to help with this.” 

Jandl knows first-hand how much knowing that his dogs were being cared for helped him in his long recovery journey. On the Wednesday before Thanksgiving, Buck and Maggie were able to come home to live with him again. 

Being reunited with his dogs has been, Jandl said, “phenomenal. My springer does not leave my side. I’ll never need a leash for him again. My other one as well was right back with me.” Though he didn’t see his pups for months, he said, “It was good for me to focus on my recovery and know that they were OK. Now that I’m in a situation where I can have them back full time, they jumped right into it. We all feel great being back together again.”

Serenity Kennel organizers have set up a GoFundMe page to support the project.

Andy Steiner

Andy Steiner is a Twin Cities-based writer and editor. Before becoming a full-time freelancer, she worked as senior editor at Utne Reader and editor of the Minnesota Women’s Press. Email her at asteiner@minnpost.com.

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What’s behind rising autism rates: A broader definition of autism and better screening https://www.minnpost.com/health/2024/12/whats-behind-rising-autism-rates-a-broader-definition-of-autism-and-better-screening/ Mon, 23 Dec 2024 12:05:00 +0000 https://www.minnpost.com/?p=2188654 President-elect Donald Trump speaking during a news conference at Mar-a-Lago, on Dec. 16, 2024.

With improved screening and autism services, diagnosis is increasingly happening at younger ages.

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President-elect Donald Trump speaking during a news conference at Mar-a-Lago, on Dec. 16, 2024.

President-elect Donald Trump seemed to entertain the discredited theory that vaccines cause autism as he answered questions from journalists at a press conference last week at his Mar-a-Lago club.

Trump said Robert F. Kennedy Jr., his choice to lead the Department of Health and Human Services who has been an anti-vaccine advocate, would look into the reasons for rising autism rates.

Trump, seeming to respond to Senate Republican leader Mitch McConnell’s defense of the polio vaccine, called himself “a big believer in it.”

“You’re not going to lose the polio vaccine,” Trump said.

A look at autism rates and why they are rising:

What is autism?

Autism is a developmental disability caused by differences in the brain. There are many possible symptoms, many of which overlap with other diagnoses. They can include delays in language and learning, social and emotional withdrawal, and an unusual need for routine. Scientists believe genetics can play a role.

What is the rate of autism among U.S. children?

Among all U.S. 8-year-olds, 1 in 36 had autism in 2020. That’s according to the most recent estimate from the Centers for Disease Control and Prevention. That’s up from 1 in 44 two years earlier.

Why is the rate of autism rising?

There are no blood or biological tests for autism. It’s identified by making judgments about a child’s behavior.

For decades, the diagnosis was given only to kids with severe problems communicating or socializing and those with unusual, repetitive behaviors. But around 30 years ago, the term became shorthand for a group of milder, related conditions known as ″autism spectrum disorders.”

“Most of the increase in recent decades is in relatively mildly affected children and adults, so maybe in the past we wouldn’t have called it autism,” explained Maureen Durkin, professor of population health sciences at the University of Wisconsin-Madison.

With improved screening and autism services, diagnosis is increasingly happening at younger ages. And there’s been more awareness and advocacy for Black and Hispanic families too, leading to an increase in autism diagnosed among those groups.

Does autism have anything to do with vaccines?

No. Scientists have ruled out a link between vaccines and autism, a theory that stemmed from falsified information in a 1998 paper that was later retracted by the medical journal that published it.

Repeated scientific studies in the U.S. and abroad have found no evidence that vaccines in general or those with thimerosal cause autism. That preservative has been removed from routine childhood immunizations; while it remains in some flu vaccines, there are thimerosal-free versions.

The American Academy of Pediatrics calls vaccines “one of the most significant medical innovations of our time.”

What did Mitch McConnell say about vaccines?

McConnell, who had polio as a child, said any of Trump’s nominees seeking Senate confirmation should “steer clear” of efforts to discredit the polio vaccine.

“Efforts to undermine public confidence in proven cures are not just uninformed — they’re dangerous,” McConnell said in a statement Friday. “Anyone seeking the Senate’s consent to serve in the incoming Administration would do well to steer clear of even the appearance of association with such efforts.”

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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‘Creativity Camp’ helps teens pull themselves out of the muck of depression https://www.minnpost.com/mental-health-addiction/2024/12/creativity-camp-helps-teens-pull-themselves-out-of-the-muck-of-depression/ Mon, 16 Dec 2024 12:10:00 +0000 https://www.minnpost.com/?p=2188163 Artwork created by Creativity Camp participants collectively called “Self Portrait: Begin with Pieces.” A statement from the U of M: “Each puzzle piece captures a visual representation of the adolescent artist's life story. Through reflection of things they love, memorable moments that shaped them, and the darkness that feels heavy inside of them, each artist arranged the puzzle pieces to create their self portrait.”

Program created by two U of M professors uses art as a complement to traditional therapy.

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Artwork created by Creativity Camp participants collectively called “Self Portrait: Begin with Pieces.” A statement from the U of M: “Each puzzle piece captures a visual representation of the adolescent artist's life story. Through reflection of things they love, memorable moments that shaped them, and the darkness that feels heavy inside of them, each artist arranged the puzzle pieces to create their self portrait.”

Adolescents with serious depression can feel stuck in their symptoms and ways of thinking, making it harder for them to recover from their mental illness. A series of two-week-long summer “Creativity Camps” developed by two University of Minnesota professors has provided a new treatment approach for adolescents with depression, helping them to get unstuck by encouraging participants’ creativity. The results are impressive, the camp’s creators said, with many participants showing significant, lasting reduction in their depression symptoms. 

Kathryn Cullen, professor at the University of Minnesota Medical School’s Department of Psychiatry and Behavioral Sciences and an M Health Fairview child and adolescent psychiatrist, developed the camp along with Yuko Taniguchi, assistant professor of medicine and arts at the University of Minnesota Rochester’s Center for Learning and Innovation. The half-day intensive outpatient program (IOP) camps, which offered six sessions in the summers of 2022 and 2023 for adolescents who had been diagnosed with depression, were largely held at the University of Minnesota’s Masonic Institute for the Developing Brain

With her long history of working with adolescents, Cullen said she has treated many young patients who have hit roadblocks, trapped by their depression and unable to make progress. 

“I’ve been working with young people for many years, helping them, prescribing medications for them, recommending therapy, researching new types of treatments,” she said. “It was hard to see those kids who just weren’t improving. I was looking for a new approach that could help these patients move forward.”

Kathryn Cullen
Kathryn Cullen

Many of the Creativity Camp participants have tried treatments that have not been fully effective. “We are always in need of great treatments for adolescents with treatment-resistant depression,“ Cullen said. “I have the experience of working with young people who have tried many treatments but get more hopeless and withdrawn and stuck in their own world.”  

Taniguchi’s deep interest in art — her unique dual professorship was created in recognition of her groundbreaking work using art and creativity to aid the healing process — helped her to see the possibilities of harnessing creativity to aid young people struggling with their mental health. 

“Kids with depression can be stuck in really rigid thinking,” she said. “They are determined to see the world as black and white. Their negativity is intense. Creative thinking, on the other hand, is flexible. It can be infused through inspiration by holding them accountable to become artists.”  

Cullen and Taniguchi liked the idea of presenting an option that, for participants, felt significantly different from classic treatment modalities. The idea of a camp where young people were encouraged to tap into their creative sides, where they spent focused time working on art, felt like a good option.   

“There’s more appeal to a camp than a therapy group,” Cullen said. After she and Taniguchi talked about possible approaches, she said, “We really got excited about the idea of doing a creativity camp.” 

Yuko Taniguchi
Yuko Taniguchi

The camp’s focus on art and creativity is more than camouflage, Taniguchi said. It’s also a new way of looking at the world. “What if we were saying to a young person, ‘What you are doing is practicing to be an artist?’ That approach is much more interesting than saying, ‘You are working on your mental health.’ What if being an artist is the priority and feeling better is a consequence? That’s a foundation of our practice.” 

The team was eventually awarded comprehensive funding through a Minnesota Futures Grant from the University of Minnesota to support the project, Cullen said. “Our grant was to not just do a camp and study its impact on mental health but to also study the brains of participants and how thinking creatively impacted them.”

During the camps, researchers measured participants’ quantitative and qualitative responses to creative work, through functional MRI scans to measure brain activity and in-depth interviews (also conducted with parents and other caregivers) that analyzed participants’ depression levels before, during and after their time at the camp.  

As the camps wrapped up, the research team analyzed the data. The first resulting paper, published in the journal Child Psychiatry and Human Development, Cullen said, “reports on the improvement in depression symptoms from both summers. We found that, for participants, there was a significant improvement in depression symptoms after participating in the camp. They also showed improvement in different measurements of well-being.” While there is still room for more research, she added, “The results were quite encouraging.”

Building from an idea

Cullen met Taniguchi in 2018, after her department chair suggested they collaborate.. 

“I was working on creating an after-school mental health program for teenagers that was at the level of an IOP program,” Cullen said. “Somehow my department chair had met Yuko and learned about this program that she was doing with adolescents at the Mayo Clinic. We met, got to talking and I learned about her approach.” 

They eventually got involved in a program called Arts and Health sponsored by the University of Minnesota Medical School and the Weisman Art Museum that connects artists and researchers

The Arts and Health program encourages participants to take time to imagine the possible fruits of their collaboration, Taniguchi explained: “They say, ‘Have a conversation for a year and see what you come up with.’”.  

One of the many ways the two professors connected was around the idea of art as a potential way to pull young people out of depression.  

“When I first met Yuko,” Cullen said, “I told her that the one thing that seemed to get kids with depression out of their shell was when I would talk to them about their artwork or music. It gave them a little spark.” That realization felt promising, she continued: “We needed something that would tap into that a little more and help young people express themselves and be creative.” 

The idea of turning this promising realization into a summer camp was spurred on by Abimbola Asojo, distinguished global professor at the University’s College of Design. “She had been doing these camps every year to encourage kids from underrepresented groups to go into design fields,” Cullen said. “She’d brought in mainly BIPOC kids to the U to do these design-focused camps. She said, ‘Why don’t you do a camp? We’ve been doing these camps. They’re really successful and a fun entry point.’” 

During Creativity Camp sessions, staff made a point of telling the young participants that the creative work they were doing was important, that they were artists worthy of respect. “We take the camp participants very seriously,” Taniguchi said. “They are there to create art every day. We recruited professional artists to mentor them and work closely with them during the camps.” 

The focus of the camps was on accepting the young participants for who they are, and encouraging their creativity in whatever form it took, Cullen said. “The activities are geared towards getting kids to tap into their imagination, to express themselves differently, be weird, be free of judgment about what they create. There are no right answers, no right way to express yourself. It is just what you make.”

At the end of the camps, participants’ creations were exhibited at the Weisman Art Museum. The public exhibition was important, Taniguchi said. “We treated them like the serious artists they are.” 

‘Kids need things like this’

Going in, Cullen and Taniguchi felt confident  their research would show that Creativity Camp would have a positive effect on participants’ mental health. As they analyzed their results, Cullen said the positive outcome “wasn’t surprising, because it sort of fit our expectations. We’d done this kind of work in our programs before, and Yuko had already been doing something similar with kids at Mayo for years.” The difference was the ability to collect hard data about the camp’s impact through MRI scans. “We wanted to collect data that would show others in a definitive way. We were happy that we were able to show it statistically and convincingly, but I wouldn’t say we were surprised.” 

To further back up their research,  Cullen and Taniguchi conducted a similar study with a group of undergraduate students at the University of Minnesota. “We found similar improvement in mental health and depression and an increased well-being,” Cullen said. They also conducted another study on young adults in Japan: “We were able to show that students’ well-being improved there, too.” 

The research team conducted six-month follow-up interviews with Creativity Camp participants and their parents. While all respondents stated that participants continued to experience fewer depression symptoms than before the camps, the teens reported that their depression symptoms had increased in the six months after completing the camp but were still better than the baseline measurements. Parents tended to note that improvement in the teens’ depression symptoms was sustained.

Thanks to all of this checking and rechecking, Cullen and Taniguchi feel like they have developed a robust intervention that could be helpful in treating depression in teens. 

“We’re pretty sure it works,” Cullen said. “I think it’s helping young people tap into something that they don’t really get the chance to do, and to think about themselves in a different way and really enjoy spending time with other people. It is a very meaningful, enjoyable experience that we’re thinking may be one of the key ingredients to their symptom improvement.” 

In the end, the key seems to be finding something that breaks depressed teens out of the cycle of depression, Cullen said: “Kids need experiences that get them out of their stuck ways of thinking and give them an opportunity to reflect and connect with others and find a new way of seeing the world that’s different from the rut that they’ve settled into.”

Andy Steiner

Andy Steiner is a Twin Cities-based writer and editor. Before becoming a full-time freelancer, she worked as senior editor at Utne Reader and editor of the Minnesota Women’s Press. Email her at asteiner@minnpost.com.

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