(upbeat music) - Hello and welcome to "Prairie Pulse."

Coming up later in the show, we'll hear music from Annabelle Maher.

But first joining me now is the superintendent at the North Dakota State Hospital in Jamestown, Aaron Olson.

Aaron, thanks for joining us today.

- Yeah, thank you.

John.

- As we get started, tell the folks a little bit about yourself and maybe your background and maybe where you're originally from.

- Yeah, over the last 24 years, I've been in operations, infrastructure, and also supply chain management.

And a lot of my roles now in the last 14 years have been more on the healthcare operations side of things, but my focus has been on building culture and really leading people.

- Well, with that said, I understand you started in this role since September, and how have you adjusted to the new position there in Jamestown?

- Yeah, you know, from day one, coming into the State Hospital, it was really nice.

The staff there was really supportive, and it has made my acclimation into the State Hospital really quite easy.

You know, if I hadn't had such great staff to work with, and they do a quality job of providing care for our patients, but they ultimately have made it very easy for me to get into, not only the State Hospital, but also into the community in Jamestown.

- Okay, can you tell us sort of what is the mission and the role of the State Hospital, and yeah, let's start there.

What's the mission?

- Yeah, so it's to provide care, and treatment, and support for those that are looking to really get to that point where they can have that wellness and recovery.

And so the State Hospital really fills a gap that is very important.

And without the State Hospital and it's doing its role that it does, there are a lot of gaps out there right now and services that should be and could be provided and are being worked on.

But ultimately, without the State Hospital doing what it does and and providing that care, we would be at a loss here in North Dakota.

So very happy to be a part of the process of making patients better here.

- And so when was the State Hospital founded and built, I guess?

- Yeah, so 1880, if I was right around that time, I think I have that correct in my history notes, but that was around the time that the State Hospital came into fruition.

And so over the years, there's been a lot of things that have changed, and obviously care has changed as well.

- Yeah, so I understand there may be a new campus expansion that's going on, and can you talk about what that's about, what the cost are, how it's going, and when it'll be finished, kind of the project?

- Yeah, so in last session, the legislators appropriated $12.5 million to really work on a way to come up with a clear plan for a new State Hospital.

And so we've been very diligently working hard on making sure that we're doing that, that's already started.

So when I began my role in September, really, that's when we started having meetings with the architects and others that are a part of making sure that we have a real strong plan put into place.

And then we've included staff and being a part of designing and understanding what needs to be in the design of the new State Hospital.

So we're really looking forward to, you know, once we have this all put together and we've still got some things left to do, that we're gonna have a great plan to be able to provide to legislators next session.

- So why is a new campus needed?

Is it replacing or is it expanding?

Talk.

- Yeah, you know, kind of what I've been thinking about with a lot of this, there's a lot of reasons for it, but I would say maybe the top three that I have in my mind are first, you know, best practices.

When the new or when the State Hospital was built back, when it was originally built, there were best practices at that time.

And obviously moving forward, it's become more and more of a challenge to be able to keep those best practices up with current practices that are going on in healthcare today.

And so it's a constant day-to-day battle for us to really make sure that the State Hospital is meeting the best practices that are needed for.

And so it's really gotten to a point where, you know, we need to look at a new State Hospital to be able to do the things that are necessary for our patients.

The other reason, the second reason would be we have six buildings that we're operating out of right now.

And quite frankly, that's from an operational standpoint, it gets to be a little bit of a hard task to do.

And so really consolidating everybody into one building, afford some efficiencies as well as a better patient care.

- Was there a third one, I think?

- Yeah.

- Yeah.

- The third one.

Yeah.

- Yeah.

- Yeah, so the third reason I would say is that, you know, obviously safety and security.

We wanna make sure that our patients are getting that safety that they need and are secure in our building.

And we wanna, you know, there's a dignity that goes along with coming into the State Hospital and we wanna make sure that we have the safety and security properly matched up with one building versus six.

- Well, I think you were hitting on it 'cause really, you know, so what will a new campus expansion allow you to do that maybe you can't do today or is more difficult to accomplish?

And you're touching right on it.

I mean, yeah, if you've got six different buildings, obviously efficiency, if you're in the same building, just walk down the hall instead of across the street, but are there other things that are gonna really help with this expansion?

- Yeah, absolutely.

So going back to maybe the safety and security side of things.

You know, we, right now, when a patient comes to the State Hospital and they're gonna be, you know, dropped off at our location, that's done outside.

And so there really isn't an area that, you know, provides that dignity and that safety that's necessary there.

The other thing is that they, when they go into our admissions, because we have things kind of, you know, in different spots, we have to kind of work around what we have and allow for the admissions process of the patient coming into the State Hospital to be done.

And we have to move that patient around in order to do that.

So really we, if we, you know, with this new State Hospital, we'll have a garage that will, an ambulance or anybody coming to the State Hospital, the vehicle can drive into, they'll be able to drop off the patient inside of that garage.

And again, not with everybody watching, so that dignity is taken care of from that standpoint, but ultimately then they'll be able to be brought into the State Hospital.

They'll go through admissions, which is gonna be right there, and we can have that patient properly brought into the State Hospital in a safe and secure manner.

- Will some parts of the old facility, the existing facility now, be utilized or not?

- Yeah, so there's been a lot of, you know, undetermined things yet, but DOCR is interested in the location.

You know, we're doing a great job right now of just cleaning up the campus.

So we've demolished some buildings that needed to be demolished.

We've also got some more buildings that need to be demolished.

So we're kind of taking care of some of the locations that aren't usable or maybe they've met their useful life.

But at that point, once the new State Hospital's in place, it'll be a nice spot for DOCR if they decide to move forward with what they wanna do in the building locations that are there.

- So how many people work at the State Hospital?

- So we have right around 360 staff there and, you know, a majority of those are patient care.

And then we also have those that are doing some critical operations as well as, you know, doing the maintenance of the campus.

And so there's a lot of folks doing a really good job to make sure that we have a beautiful campus for folks to come on, and as well as one that we can have patients get the care that they need.

- Yeah, so what is the role of the superintendent, your job?

So what is your role?

And I mean, how do you fit into this grand scheme of things?

- Yeah, so that's a great question.

So when I was appointed into this role, one of the things that I understood that I would need to have in place is, and that we would be working through, would be a co-leadership.

And I was fortunate enough to have Dr. Yabut, who is the medical director at the State Hospital.

He and I work together in this co-leadership.

And so I am the operations side of what needs to be done at the State Hospital.

And he does the patient care and the medical side of it.

So it's really a good balance and a strong team that we have together.

And again, I feel very fortunate to have a great co-leader to work with.

- Yeah, well, real quick, your previous jobs and experiences, how have they prepared you for this position?

- You know, I would say it's because of the people at the State Hospital.

You know, I've had a lot of roles where I've gotten to know a lot of people in different ways.

And, you know, the staff at the State Hospital really does an outstanding job.

So for me, I've learned that if that's the case and they know how to do the care, I step back.

I make sure the obstacles are out of their way so they can do their job, but ultimately they're really good at their job.

So I just wanna make sure that I'm taking care of them and they can take care of the patients.

- Well, thank you for joining us today.

In fact, up next we have Dr. Yabut, the medical director.

He'll be with us in just a moment.

Thanks for joining us.

- Yeah, thank you, John.

I appreciate it.

- Yeah.

(upbeat music) - We're back now with Dr. Ed Yabut, the medical director of the North Dakota State Hospital in Jamestown.

Dr. Yabut, thanks for joining us today.

- Thank you for having me here.

It's a pleasure.

- As we get started, as we did, tell us a little bit about yourself and your background.

- Yeah, my name is Dr. Ed Yabut.

I was graduated from medical school in 1991.

I came here straight from medical school.

I completed my residency in New York Medical College in the State of New York.

I serve an underserved area for a period of about four years.

And that was done in West Virginia, Kentucky area.

I came to the state in 2002.

I have been with the department for the last 22 years.

- Yeah, so what's your role as medical director of the State Hospital?

- So as medical director, I supervise all the clinical and medical services that are delivered at the State Hospital, which include your laboratory services, pharmacy services, services rendered by radiology, specialty services, like a dental clinic, a podiatry clinic, and the medical services overall.

But I'm also a clinical psychiatrist, so I provide care for patients as well.

- So how many patients are at the hospital?

- So I can just give you an example for what has happened for the last couple of months.

We are over capacity.

We have 125 certified medical beds certified by Medicare.

But what we can serve right now is for a total of 81, which is what can be supported by our workforce.

- But you have 125.

- Certified beds.

Yes.

- Wow, so a question of your, might wonder is, what kind of patients are at the State Hospital and what kinds of processes need to happen to have someone admitted or is it even committed to a facility like this?

- Yes, so we serve a number of specialties at the State Hospital.

So we provide acute care at the hospital so people can come to us in an acute manner because of the acuteness of their illness.

We provide psychosocial rehabilitation to aid people in their recovery.

And so these individuals will stay at the hospital for a longer period of time.

We also serve a number of individuals who are sent to us by court for assessment so that they can aid in their legal defense, for example.

If they're suffering from a mental illness, they're required to get treatment from the State Hospital.

We also have a geriatric population, people who are suffering from a major neurocognitive disorder and needing hospitalization to manage their complex psychiatric and medical needs.

- So what does a family go through if they feel or if a family member needs to be admitted to the State Hospital?

- I can only imagine what families go through where they have an individual or a loved one who is suffering from an acute episode of a psychiatric illness.

Usually they will call 911, and they'll be directed to a crisis service that are provided by the regional human service centers.

Or at times, they will even call the State Hospital.

The State Hospital will direct them to an appropriate line of service provided for by the community.

- So is the goal to get patients back into society or is it different from patient to patient?

- It really varies from one patient to another, but our general goal, really, for individuals is to be incorporated and reintegrated back in the community so they can participate as rightful citizens out in the community, free from being encumbered with acute symptoms of their illness, receiving wraparound services, receiving care in the community, and not suffering from homelessness, and offer stability.

- So is there an average length of stay at the State Hospital again or does that vary?

- It's a very good question.

It'll vary from one specialty to another.

For an acute care unit, for example, the average length of stay is 20 days.

For our geriatric unit, because they have more complex medical and psychiatric needs, the average length of stay will probably be about 90 to 120 days.

For a psychosocial rehabilitation or recovery, it can vary from about three to four months.

And the forensic ones or the court-ordered assessments, the average length of stay is about 90 days.

- Okay, most people have probably never been inside a facility like this in person.

Is there still a perception out there, do you think, that they used to see, like decades ago, portrayed in even a movie like "One Flew Over the Cuckoo's Nest," is that what it's like or what can you talk about the facility?

- Yeah, I think the stigma persists, still persists about the State Hospital because of the way it's portrayed in popular culture, be it in the movies or even in your regular TV shows.

This is something that we've been trying to correct at the State Hospital.

You'll be amazed at the perception that medical students have about the State Hospital.

They think individuals are gonna be violent and they'll be scary, only to leave the State Hospital with a whole different idea of what behavioral health is nowadays compared to how it existed probably decades back.

- Of course, we had Aaron Olson on earlier that talked about, so what is the real goal when you're treating a patient?

What is that goal?

- So the real goal is to address their acute presentation, manage them with medications, and then provide services that will help them in their recovery, And this includes rehabilitation.

and it comes in all sorts of ways, vocational rehabilitation, participation in groups, educating them about their illness so that they can manage their illness out in the community and be independent, really, eventually.

- You know, you talked about, you know, court cases that have to have evaluation, I guess, and geriatric care.

So what is, is there an average age of a patient that's there or anything?

Or is it just all ages?

Are there young people at the State Hospital?

- Yes, not young.

Not young below 18.

So we can admit individuals from 18 and above.

So your geriatric population, the geriatric population is usually defined by the age 65.

But believe it or not, we have younger patients probably in their 40s or 50s who are also suffering from a major neurocognitive disorder.

- So can you talk about how it feels when you or your staff can really help someone get better, recover?

And do you have those success stories, I guess you'd call 'em, so to speak, do you?

- Yes, it's very fulfilling.

You know, we'll get letters or even cards from family members or even from patients, and I've collected them over the years, and I share them with the staff.

And they're really very happy when people are able to succeed in the community and follow up with treatment when they get released from the State Hospital.

- When people come to the hospital and seek help or they're told to get help through you is, do you say that it's medication that does it, and then do they stay on medication when they leave the hospital?

Is that the way it's usually treated?

- Yeah, so it's our hope that they will stay on medications, and again, it will vary from one individual to another.

Most of them will stay on medications.

Fortunately we have newer medications now through a different delivery system, can be given once a month as a long-acting injectable for example.

And for a lot of patients, you know, we try to educate them that this might be an option for them if they don't like taking medications on a daily basis.

- Yeah.

Okay.

So what is the one thing people may not know about the State Hospital that maybe you could tell 'em?

Or maybe there's a couple, but is there one thing you could tell people?

- Yes, at the State Hospital, even though we are in a small community, we really strive for excellence in provision of care, even in a small community.

So we try to really get to the bottom of what they're suffering from, get the right diagnosis, and get the right treatment.

- So, you know, there's the State Hospital in Jamestown is for North Dakota, but does every state have a state hospital?

- Not every state, but most states do.

- [John] So most states do.

- The way they function in deliveries, and the delivery of service may vary from one state hospital to another, but most states do.

- Okay.

Well, if people are interested in getting more information or finding out more, is there someone they can call or a place they can go?

- Yes, they can either contact me or superintendent also at 701-253-3650 or 701-253-3964, or they can go to the website.

- Okay.

- The DHHS website, and then North Dakota State Hospital will be there.

- Okay, well, thank you so much for joining us today.

- Thank you very much for having me.

- Okay.

Stay tuned for more.

(upbeat music) Annabelle Maher is a singer-songwriter from Fargo who draws inspiration for her songs from her own real-life experiences.

She learned to play guitar at a young age and regularly performs throughout the region.

Her passion is recording in Nashville and is scheduled to release new music this year.

(upbeat guitar music) ♪ Bet you're driving around town in a new clean truck ♪ ♪ And finally changed tires from that time we got stuck ♪ ♪ Bet you knew girls ♪ ♪ Who love feet kicked up on the dash ♪ ♪ You got her right where you want her ♪ ♪ Yeah, she thinks it'll last, huh ♪ ♪ Well, you can keep on playing ♪ ♪ Because he is coming down the road ♪ ♪ He bought me flowers last week ♪ ♪ Said he is bringing me home ♪ ♪ And you can keep on chasing ♪ ♪ What you never gonna find ♪ ♪ Because I finally found something ♪ ♪ I'm proud to call mine ♪ ♪ A little healthy competition ♪ ♪ We both know I'm winning already ♪ ♪ I wish you the best ♪ ♪ But I'm petty ♪ ♪ And my heart's still heavy ♪ ♪ And I'm doing fine ♪ ♪ I'm just a little bit unsteady ♪ ♪ I'm wearing his clothes ♪ ♪ Mine is pretty much gone ♪ ♪ Finally let down my guard ♪ ♪ For all the things you did wrong ♪ ♪ Go ahead and move on ♪ ♪ I just don't want to see ♪ ♪ Hope you're jealous 'cause I'm selfish ♪ ♪ But happy as can be ♪ ♪ Oh, you can keep on playing ♪ ♪ Because he's coming down the road ♪ ♪ He bought me flowers last week ♪ ♪ Said he is bringing me home ♪ ♪ And you can keep on chasing ♪ ♪ What you never gonna find ♪ ♪ 'Cause I finally found something ♪ ♪ I'm proud to call mine ♪ ♪ A little healthy competition ♪ ♪ That we both know I'm winning already ♪ ♪ I wish you the best ♪ ♪ But I'm petty ♪ ♪ And my heart's still heavy ♪ ♪ And I'm doing fine ♪ ♪ I'm just a little bit unsteady ♪ ♪ I don't care anymore ♪ ♪ You're doing great, I'm sure ♪ ♪ And I've been trying to be macho ♪ ♪ But I'm petty ♪ (upbeat guitar music) ♪ Yeah, I'm petty ♪ ♪ And my heart's still heavy ♪ ♪ And I'm doing fine ♪ ♪ I'm just a little bit unsteady ♪ (upbeat guitar music) ♪ He'll be five minutes early when he comes to pick me up ♪ ♪ He'll open the door ♪ ♪ And I'll jump into his cleaned-out truck ♪ ♪ He never makes a promise and he knows my favorite thing ♪ ♪ My dad kind of likes him and Mom is his biggest fan ♪ ♪ But I wanna get butterflies ♪ ♪ When he says my name ♪ ♪ He's a perfect picture ♪ ♪ But he don't fit in my frame ♪ ♪ And all over the town, I can hear 'em now ♪ ♪ Saying I'm the girl to blame ♪ ♪ For leaving him without a hand to hold ♪ ♪ And a broken heart of gold ♪ ♪ A broken heart of gold ♪ ♪ He can make me laugh, wish he can make me cry ♪ ♪ I've been trying to catch him ♪ ♪ In some kind of bold-faced lie ♪ ♪ If he was a cheater ♪ ♪ I could just break it off clean ♪ ♪ But goodbye angel eyes are all I see ♪ ♪ Because I wanna get butterflies ♪ ♪ When he says my name ♪ ♪ He's a perfect picture ♪ ♪ But he don't fit in my frame ♪ ♪ And all over town I can hear 'em now ♪ ♪ Saying I'm the girl to blame ♪ ♪ For leaving him without a hand to hold ♪ ♪ And a broken heart of gold ♪ ♪ A broken heart of gold ♪ ♪ I can hear his engine running ♪ ♪ He's coming up the drive ♪ ♪ One thing's worse than love gone wrong ♪ ♪ "Cause love is almost dry ♪ ♪ But I wanna get butterflies ♪ ♪ When he says my name ♪ ♪ He's a perfect picture ♪ ♪ But he don't fit in my frame ♪ ♪ And all over town I can hear 'em now ♪ ♪ Saying I'm the girl to blame ♪ ♪ For leaving him without a hand to hold ♪ ♪ And a broken heart of gold ♪ ♪ A broken heart of gold ♪ ♪ He'll be five minutes early when he comes to pick me up ♪ - Well, that's all we have on "Prairie Pulse" this week.

And as always, thanks for watching.

(upbeat music) - [Announcer] Funded by the North Dakota Council on the Arts and by the members of Prairie Public.