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. 

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.

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.’” 

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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A renovation project for an Agate Housing shelter and transitional home that received Minneapolis City Council-passed funding will no longer move forward. 

In September, the council passed a resolution to re-appropriate money from multiple city department surpluses to fund a $1.5 million grant to keep Agate’s 137-bed shelter at 510 S. 8th St. from closing permanently. The building closed in October due to needed renovations and the grant was intended to help Agate possibly reopen its doors. 

On Tuesday, Agate Housing confirmed that it would not be moving forward with planned shelter renovation, according to an email statement from Erik Hansen, the city’s director of community planning and economic development. This means the $1.5 million will no longer be appropriated. 

In an email statement about the situation, Mayor Jacob Frey said: “This result, while unfortunate, is exactly what we communicated to the Council months ago. It underscores the importance of ensuring any use of taxpayer dollars is carefully vetted and goes through a thorough and equitable City process, which the Council refused to do.”

Frey also called Agate “an invaluable partner in our shared work to help people experiencing homelessness.” The city and Agate have partnered to open shelters, provide affordable housing and connect people to services, his statement reads. 

When the council considered the grant, city staff warned the council that such budget decisions have potential consequences. Saray Garnett-Hochuli, deputy city operations officer, sent an email to the council at the time warning that the grant approval was based on a second-quarter projection rather than the year-end budget. Garnett-Hochuli stated that a budget surplus is not recognized until books are closed at year end and all revenues and expenses are recorded. 

The council-passed grant was contingent upon an additional $1.5 million match, which came in September less than a week after the council approved its grant. It’s unclear what will happen to the match. 

Agate has not responded to a request for comment. However, as the council was considering the grant in September, Virginia Brown, vice president of external relations for Agate, told MinnPost — grant or no grant —  that Agate still needed a thorough assessment to know the extent of renovation needed. 

The 100-year-old building includes a 42-bed shelter and 95-bed “low barrier” housing area. An initial assessment by a construction company conducted about a year ago found the building needed between $3 million and $5 million in renovations.

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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.” 

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. 

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 16^th 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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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.”

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.” 

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.” 

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.

The post People Incorporated’s rapid responders reach out to people where they are appeared first on MinnPost.

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: 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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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.

“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.

“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.

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.

The post Serenity Kennel looks to remove barriers for dog owners seeking addiction treatment appeared first on MinnPost.

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.”

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.” 

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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For most of Nancy Manther’s life, there’s been a nearly-constant chatter in her brain focused on food and diet. It was an internal noise that often felt impossible to silence. 

“I was what you would consider ‘normal’ weight,” Manther said, “but somehow, I took in all of these messages about weight and diets from the media, from hearing adults and other kids talk about it. It just became a thing I was always really conscious of.” 

As Manther got older, she began to worry about getting weighed when she went to see her doctor for checkup. “I never wanted to get weighed there,” she said. “The older I got, the more it became an issue. I would not eat before an appointment just to make sure that my weight was as low as possible.” 

Later, Manther began participating in a popular weight-loss program, losing so much weight that she was required to get a doctor’s signature to keep participating. That experience only fueled her desire to keep dieting. “Losing weight was addictive,” she said. “I was good at it.” 

Then, months spent in isolation during the global pandemic caused Manther, 69, to take another look at her lifelong attitudes about food and dieting. “During Covid,” she said, “I thought, ‘If I get sick, I could get really sick,’ because I was so underweight,” she said. And because Manther wasn’t going to work, she explained, “I wasn’t comparing myself to other people. I decided my behavior wasn’t healthy and I needed help.” She enrolled in an outpatient eating disorder treatment program, where she was diagnosed with anorexia. 

The program helped Manther to see the different ways her eating disorder impacted her overall health and well-being, like having elevated blood-pressure readings when she was visiting the doctor and being concerned about the numbers on the scale. Treatment also helped give her the language to explain her eating disorder — as well as the confidence required to ask for what she needed. 

When Covid restrictions eased and Manther was able to go back to the doctor for a checkup, she told clinic staff that she had just completed treatment for anorexia and didn’t want to see her weight. “I stood backwards on the scale,” she said. Clinic staffers were good about accommodating this request, Manther recalled, “except when they gave me the after-visit summary, and my weight and BMI were printed right at the top.” 

This experience prompted Manther to take action. She didn’t think her weight and BMI needed to be on her forms. Emboldened by her recent eating disorder treatment, she was determined to speak out. “I’ve learned so much about diet culture and everything connected to it,” Manther said. “I can’t unsee it. I can’t unlearn it. It makes me angry the way that people, especially women, are made to feel self-conscious about their body size. It’s become my crusade.”

So Manther fired off an email to Sameer Badlani, MD, executive vice president and chief strategy and digital officer at Fairview Health Services, telling him about her experience and requesting that the health system somehow adjust their policies. 

“Is there some way that if a patient either requests to not be weighed or not told the information, could those details be omitted from the printout and/or online chart?” Manther wrote. “It may not seem like a big deal, but to patients struggling with weight stigma, body image issues, disordered eating and eating disorders, it’s a very big deal.”

An ‘amazing’ change 

Badlani took Manther’s request seriously and pulled together teams of M Health Fairview employees to address her concern. The change happened surprisingly quickly: As of July 2024, the health system now offers patients an option to change their online medical MyChart settings to indicate that they do not want to discuss their weight during clinic visits. 

Jillian Lampert, vice president of communications at The Emily Program, a Twin Cities-based eating disorder treatment and recovery program, noticed the change when she was filling out online forms for an upcoming doctor’s appointment on Fairview’s MyChart platform. 

“I just tripped across it,” Lampert said. “I pulled up MyChart, and the first question was, ‘Do you want your weight and BMI included on your after-visit summary?’ I was like, ‘Wow. That’s amazing.’ One of my colleagues also noticed. She asked me, ‘Did you see the thing at Fairview?’ It’s amazing that it happened.” 

Lampert, who is in recovery from an eating disorder, said many program clients say that having their weight taken or recorded at a physician’s office is an especially stressful experience. While she understands there are some situations where measuring a patient’s weight is an important part of a doctor’s diagnosis and treatment, most of the time weight or BMI is not important in patient care. 

Lampert said she thinks the new policy is a win for everyone. 

“To have weight or BMI not be the primary thing that shows up is a win for people. If I go in for an ankle sprain, why do you need to take my weight? It’s often not important. Once, I went to the doctor for an ear infection. The nurse said, ‘Let’s stop here and get your height and weight.’ I couldn’t see why that was important to my care.” 

Stress or concern around having their weight taken and discussed causes some people to avoid going to the doctor, Lampert said. “We hear so often from our patients that they don’t go to the doctor because it is so weight focused, especially people who live in larger bodies. They end up not going anymore because so much of the conversation is about weight. I think this change will actually help more people access primary care.” 

This policy shift doesn’t mean system patients will never have their weight measured and recorded by health care professionals. The new policy gives patients the opportunity to opt out of discussions focused on weight and BMI measurements, explained Kim DeRoche, MD, a family physician and M Health Fairview president and chief of primary care, but there are still some circumstances where a health care provider will need to record or discuss a patient’s weight. 

For health care providers, it’s a balancing act, DeRoche said: “We wanted to be careful to make it clear that we could still collect weight information because it is an important part of many people’s medical care — and we wanted to recognize that the presentation of that information to the patient can be more stressful than it is intended to or needed to be. We wanted to balance the stress to the patient with a data point that can be important to monitor someone’s health.”

This change is an important part of building strong patient-provider relationships, DeRoche said. “In primary care, we want to be able to personalize the care patients receive while still following guidelines in evidence-based care,” she said. She added that, to her, the change feels healthy: “We can enhance the personalization of care because our intention is to be personal in how we interact with patients. Supporting patient mental health is an important part of primary care. It is part of what we do every day.” 

Manther said she is pleased to see that the change she advocated for is now a normal part of the way things get done at her health provider. Not that long ago, when she went online to schedule her yearly checkup, she was pleasantly surprised. “I was filling out information online and a screen come up that asked, ‘Do you want your weight and BMI discussed at your appointment?’” she said. “You could check yes or no. I said to myself, ‘I helped make that happen.’ I was so happy.”

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.

The post How one patient’s email led to change in M Health Fairview’s weight and BMI policy appeared first on MinnPost.

For most of her life, Andrea Gilats wasn’t the kind of person who bared her soul to the world. In her 30-year career at the University of Minnesota, as founding director of the Split Rock Arts Program and founder and director of Learning Life, Gilats instead focused on providing opportunities for others to engage their creative talents. 

“I had a rewarding career,” Gilats, 79, said. “In many ways, I felt like my work helped to give my life meaning. I was satisfied with that.” 

Later, in her retirement, Gilats discovered another side of herself. With open time to think about her life and the experiences that have shaped it, she was inspired to write the searingly honest “After Effects: A Memoir of Complicated Grief” about the decade she spent in deep grief after the untimely death of her husband Tom Dayton.  

Not long after the book’s publication, Gilats realized she had more to say about her long life, particularly about her personal experiences with aging and how a cultural obsession with youth has the power to harm our mental health. She wanted to reflect on how years of experiences — both painful and pleasurable — have shaped her into the person she is today. Those stories, along with Gilats’ musings on the challenges of aging, appear in her latest memoir, “Radical Endurance: Growing Old in an Age of Longevity” (University of Minnesota Press, 2024).

When I spoke with Gilats last week, she told me, “When you live a long time, you do a lot of different things.” Rather than fade into the background, she said she wants to tell her story, a complicated history that she believes she shares with many of her peers. 

Though some might view the last decades of life as a time for quiet reflection, Gilats sees it differently. She hopes the stories she has chosen to share with the world will inspire others to embrace aging as an opportunity for continued growth. “There’s still so much more to say,” Gilas said. “I hope that talking about my experiences can help others realize that they are not alone.” This interview has been edited for length and clarity.

MinnPost: Did you always know you wanted to write a book about aging? 

Andrea Gilats: When I was working with the University of Minnesota Press on “After Effects,” I already knew I wanted to write this book. I was further spurred on by the pandemic and the fact that it was so, especially, affecting old people. I think that at least 70% of pandemic deaths in the U.S. were people over age 65. Because of my own age, that statistic was inspirational to me. I knew I wanted to write a book that would combine stories from my professional experience and my personal experience of growing older.

MP: In this book you talk about some deeply personal events in your life. Why did you choose to be so open and self-revealing? 

AG: I think that if you don’t talk about things like this it just advances a culture of silence, particularly with women. I wanted to resist that. Honestly, I don’t think I talked about anything that was too personal or intimate. I was measured. But it seems to me especially in memoir that’s the place where one is asked to be oneself. I wanted to talk about how we grow and find ourselves by looking back on our past in our old age. There’s this wonderful quote. It’s on a Post-it on my computer. It says, “When memory comes, knowledge comes, too.” 

MP: One of the personal events you write about is a time you attempted suicide decades ago, when you were a young woman. Can you tell me more about how you felt this story fit in a book about aging? 

AG: I think suicide is always with us, but it is increasingly with us as we age. In the U.S., suicide rates, especially among men, are highest among the oldest people. I was astounded to learn that. I thought, “I need to write about this.” I knew the story of writer Carolyn Heilbrun, [the best-selling author of “Writing A Woman’s Life,” who died by suicide at age 77 in 2003]. That was one of those things that never left me. When I was writing about aging and mental health, I thought, “This is the time to write about her and let her story form a bridge so that I can talk about my own experience.” 

I still wonder if many more of us think about suicide than actually do it. Suicide is there even in old age. Because of Carolyn Heilbrun’s story, I have always wondered, “What was it about old age, about the way we view our worth in old age, that would be so terrible or terrifying that it would make a person like her want to end her own life.” 

MP: Oncologist and bioethicist Eziekiel Emmanuel famously wrote an essay in The Atlantic saying he wanted to die by age 75, that by that age a person had basically outlived their usefulness. At age 79, what do you think about that perspective? 

AG: He’s only 67,  so that’s easy for him to say. I think that he has a really good-sized ego. I was tempted to write about him in my book, actually, because this attitude of his all goes back to ageism. We’re so inculcated with ageist behavior. It has infiltrated our minds. I’m not sure my book can change that too much. At the least, I was hoping to bring to light some of these prejudices that are so pervasive that we are not even aware of them. 

MP: You also write about having an abortion in 1979, before you and your late husband were married. What made you want to share that story in this book? 

AG: Going back to your question about writing things that are deeply personal, I wanted to tell the story of my abortion because I believe I am not the only one that has that kind of story to tell. It is something in my past that, as I say in the book, especially after my husband passed away, has stayed in my mind. It was permanent. You can’t take it back. And yet I still stand by it. Also, my husband and I made that decision basically out of sadness. We knew it wasn’t practical to have a child at that point in our lives. I thought it was important to tell the story. Then, after I had written that chapter, the Dobbs decision came down. I thought, “Now it’s even more important to talk about it.” 

I know those two things — the suicide attempt and the abortion — are intimate. But they are not unique to me. They are common experiences for so many people. I’m close to 80 years old. In the book, I talk about how the veil between life and death gets thinner and thinner and thinner as one gets older. It is not as opaque as it once was. In order to talk about old age, I needed to talk about all of the things that happen to all of us during our long lives. 

MP: Are there things that particularly concern you about aging? 

AG: My greatest fear, other than losing my mind, is having to live in a nursing home. I think the state of nursing home care is shameful. But I know that may be my reality someday. I thought I needed to voice these fears in this book partly because they are real and I’m not the only one who feels this way. 

In my book, I write not only about the terrible things I’ve read about nursing home care but also about my personal experience with nursing homes. I have family members who have been in good nursing homes, but there are also too many awful nursing homes. I think for most people, the move to a nursing home represents such a diminishment in quality of life that it opens the door to dying. When you look at the statistics about how long people live in nursing homes, the average stay from the time of admission to death is not very long. I don’t attribute that to failing health in the very old. In part, I attribute it to the lack of what I call an engaged life in most nursing homes. 

MP: How would you define an engaged life? And why do you think that is important for the mental health of an aging person? 

AG: Part of what I believe and want to make clear in this book is that for older people, intellectual stimulation is every bit as important for our health and happiness as is caring for our creature needs like food and housing. I think especially in a state like Minnesota, we do a good job of caring for the creature needs of the aging population — but we need to do more to help take care of those emotional and intellectual needs. 

We have people of every age in the building where I live. I have several friends my age who have chosen to live in so-called “senior living communities.” Some of these communities are just wonderful. Residents are still largely independent. It is like living in a condo: You direct your own life, you have freedom of movement. What it gives you is a community, a sense of belonging. But that’s not the case in all senior-living environments.

MP: There is a large portion of your book where you write about your experience living through the Covid pandemic as a person over age 65 with a few chronic illnesses. There were times when you were lonely. Did that experience open your eyes to the loneliness experienced by many older people? 

AG: Persistent loneliness is a serious issue for a lot of seniors. Loneliness has become so rampant that the Surgeon General issued a warning that we have a loneliness epidemic. Loneliness can make you sick and it can kill you. I think that many, many people in old age are living with loneliness. I believe that something like 44% of women over age 75 in the U.S. live alone. Loneliness also affects older men.  

By that age, many people have lost a spouse. They may have been retired from their work for a decade. Those relationships gradually fade the longer you are in retirement. Your children maybe have moved away. 

MP: You have lived on your own for a long time now. Does solitude have a different impact on your mental health now that you have, as you write, crossed the line into old age? 

AG: I have lived alone since my husband died 26 years ago. There is a difference between loneliness and missing someone. For a decade after my husband died, I missed him urgently, profoundly. I don’t think of that as loneliness because I wasn’t missing being with people then. I was missing Tom and our relationship. Later, as I got older, I began to understand what it was like to be lonely. Part of that is a lack of meaning in life. We derive meaning from our relationships. When we lose meaning in our life, we lose our reason for living. 

So many old people are alone in so many ways. When we don’t have contact with others, what happens to our minds? We need to be in relationships, whether that is with another human being, a book, nature. Loneliness for me is that yearning for relationships. That’s what makes it so painful. One expert that I quote in my book calls loneliness a feeling of being distressed.

MP: How do you cope with that feeling of being distressed in your life?  

AG: For me, one way that I combat it is a lesson I learned from the pandemic. We can now communicate online and see each other on our computers. I do a lot of Zoom meetings and get together with people who live in other places. I love online contact. I’m an introvert, so that mode of communication works well for me. And now that I can get out socially I love having lunch with friends. And I don’t know what I would do if I couldn’t read. Reading a wonderful novel or memoir is a wonderful way for me to combat loneliness. 

The other thing I do every day without fail is take a walk. I think physical engagement is so important. I live on the river. During the pandemic, I was able to get outdoors and walk along the river. For me, even if I was walking alone, that was a great way to keep loneliness at bay. My family has also become very important to me as I age. I make sure to keep my family connections close and strong. If I’m feeling down, I’ll call my sister.

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.

The post In ‘Radical Endurance,’ author Andrea Gilats looks clear-eyed at the mental health impact of aging appeared first on MinnPost.

For 20 years, Clara’s House, a behavioral health program based in St. Cloud, has been a place of respite for children ages 5-18 who struggle with mental health concerns. In recent years, the CentraCare-run facility, a partial-hospitalization program — with intensive, day-long therapy combined with school instruction to keep young participants on track academically — has been fielding an increasing number of requests from parents and care providers searching for mental health care for toddlers and preschool-age children. 

Barbara Skodje-Mack, CentraCare director of child and adolescent behavioral health, chalked some of this increase up to a growing cultural awareness and treatment of mental illness in even the very youngest children. “We have integrated behavioral health therapists in our primary care settings now,” she said.

When a parent brings their child to the pediatrician for a routine visit, Skodje-Mack explained, young patients are regularly screened for mental health concerns. This approach is uncovering mental health issues in young children, she added: “We are seeing greater demand for early-intervention services, which is great. Just like any other medical condition, the sooner we can spot a mental health issue and provide therapy, the better the outcome for the parent and the child.” 

While the growing presence of behavioral health providers in pediatric clinics leads to more mental health diagnoses in children, a more accepting attitude about mental illness and its impact also plays a role in the growing interest in programs like Clara’s House, Skodje-Mack said.

“Our society is recognizing and talking about mental health and trauma and taking care of our mental wellness much more than we did in the past. We are also paying attention to and understanding early brain development, how significant traumatic experiences can be in the first five years of life and how those experiences build core brain development. This shift increases interest in our services.” 

In response to this growing need, Clara’s House administrators made plans to expand their offerings to include mental health services for children as young as 3 years old. The CentraCare foundation raised the funds needed to add a 5,785 square-foot early-childhood unit to the program’s existing building. The addition includes space for two group rooms, psychiatry services, psychological testing and art and recreational therapy, as well as occupational and family therapy. Construction is nearly complete, with a grand opening scheduled for Jan. 27. 

While there are already a variety of agencies in the state that provide mental health services to children ages 0-5, Skojde-Mack said Clara’s House will be “the first in the Midwest to have a partial hospitalization program for these earliest ages.” 

Jeffrey Reed, a psychotherapist who has worked at Clara’s House for eight years, said early intervention is key to the successful treatment of mental illness in children. 

“The earlier we are able to intervene the better,” Reed said. “At these young ages, critical brain development and attachment are happening. If we can get to mental health issues sooner, we’re more likely to be able to help family systems understand the significance of these issues and change their path.”

In the years leading up to the early childhood expansion, Clara’s House has been enrolling what Reed describes as “some very fresh 5-year-olds” or “kids at the very tail end of what we generally accept here.” Even though these participants seem young, Reed said he and many of his colleagues wish they would’ve been able to intervene even sooner. “We can see we’ve waited too long, that many of these issues have been going on for some time,” he said. 

Much of this has to do with limited availability of mental health care options for young children. “Parents were waiting a long time to get this kind of intensive care,” he said.   

Though staff could see that they needed support, Reed said some of those fresh 5-year-olds struggled to find a place in programming designed for older children. “They have been hard to manage,” Reed said. “It felt like our program wasn’t equipped with the right space and the right interventions for them.” The new early-childhood addition is designed to better meet the developmental needs of these young participants, he said: “The way the program will work with the right equipment and interventions for their age group will be excellent.” 

What brings kids in 

What kinds of behavioral issues inspire parents and pediatricians to seek mental health care for very young children? To the untrained eye, some issues may appear to fall under the category of “normal” toddler or pre-school behavior, Skodje-Mack said, but are actually more intense and difficult for parents and other caregivers to address. 

“Sometimes, we will have situations where the parents are reporting their child isn’t sleeping well, is refusing to eat, is having frequent and intense tantrums,” Skodje-Mack said. In many children, she added, “Tantrums are normal, but these would be intense tantrums or negative behaviors that are interfering with daily activities. Some kids are being told they can’t come back to childcare settings due to their behaviors and uncontrolled emotions.” 

Reed said he and his Clara’s House colleagues see a range of behavioral concerns, including “hitting, kicking, elopement, biting, being destructive in terms of throwing objects around the room and damaging property.” Some young children even exhibit suicidal statements and self-injurious behavior. Sometimes the youngest children exhibit the most intense symptoms, he added. “We’ve got our hands full with some of those younger students,” he said. 

Behavioral health symptoms in young children often are a reaction to early traumas they have witnessed in their households, Skodje-Mack said. Other times, the behaviors may be a symptom of a larger developmental concern. “We are able to do early psychological testing to assess whether there are learning needs or neurodiversity needs,” she said. 

Exhibiting intense, negative behaviors may be a young child’s only way of expressing their emotions around formative negative experiences, Reed said. “When a young person has experienced scary life events repeatedly, it causes a hypersensitivity to stress. Maybe something small, like having to transition from one setting to another, creates a very large amount of hyperarousal for a child.” 

Typical diagnoses for Clara’s House participants include, Reed said, ADHD, autism spectrum disorder, disruptive mood dysregulation disorder, depression and anxiety disorders. Because young children lack the vocabulary to clearly explain how they are feeling, their mental health symptoms may present in ways that feel confusing to adults, Skodje-Mack said. 

“Sometimes people think of these symptoms as behavior outbursts or tantrums,” she said. “If we look a little deeper we might see that the root of that anxiety might be about the family system and the dynamics in their home.”  

While many Clara’s House participants come from intact middle-class families, Reed said that others come from households that are experiencing financial upheaval and personal struggles. In those cases, adult stressors can trickle down to the youngest family members. 

“We see a lot of single parents that are struggling emotionally and financially,” Reed said. “They lack support. In my experience of being a child therapist, one of the largest underpinning reasons for these kids to be struggling is a struggle in the family system.” 

In acknowledgement of the key role parents and other caregivers play in supporting the mental health of children, Clara’s House requires parents to attend regular therapy sessions with their children. “There are family sessions both with the child and without the child,” Skodje-Mack said. The child-free sessions focus on “providing parenting skills education and advice for raising young children in an emotionally healthy manner. These are skills that have a long-lasting impact.” 

A place of respite

Clara’s House programming is intense and tightly scheduled, Skodje-Mack said. Children come to the program every weekday for as long as six weeks, and children in the early childhood program may participate for as long as 12 weeks: “They don’t stay overnight. They go home to their families, but it is much more intensive than seeing a therapist once a week.” For older children, school classes are included, as well as a variety of therapy modalities, including individual therapy, group therapy, recreational therapy and family therapy. 

The self-contained facility was designed to put young participants at ease. “We have a really great space that feels comfortable,” Skodje-Mack said. “It doesn’t feel like a hospital.” In the new early-childhood wing, she explained, “We have two group rooms that are set up for kids to be in. They look like a childcare setting. The therapy isn’t like therapy for adults. It is engaging and play-based.” 

Clara’s House is small by design, and the early-childhood program will be no different, Skodje- Mack said. “We are planning to have five to six kids in each group room for a total of 12 as a cohort,” she said.

Reed said Clara’s House’s personal, focused approach to therapy helps young participants achieve their mental health goals in a relatively short period of time. “The [older] kids are here in place of school,” he said. “You get to connect with them on so much more of a deeper level. That’s what’s neat about the work: We really get to know our patients. We really make an impact on them in a positive way.” 

While an intense, multiweek program focused on mental health may sound exhausting, Reed said most children who spend time at Clara’s House find the experience relaxing and freeing — a safe, hopeful space where they can process their feelings and emotions without judgment.  

“It’s a breath of fresh air,” he said. “When they are with us, these kids feel like they are on a bit of a vacation. I don’t mean to say we shower them with prizes and luxury, but we do shower them with praise. We give them a lot of reinforcement, reassurance and validation. By the end, they seldom want to leave. They just love it here.”

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.

The post An early intervention for kids with mental health needs appeared first on MinnPost.