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

Coming up later in the show, we'll hear music from the band Poitin.

But first, joining me now, our guest is Dr. Jon Ulven, Psychologist with Sanford Behavioral Health.

Thanks for joining us today, sir.

- Thanks for having me.

- As we get started, tell the folks a little bit about yourself and your background.

- Sure.

As you said, I'm a Psychologist at Sanford Health.

I've been there for, this June will be 20 years.

I'm the Department Chair for our Adult Psychology Group.

I see patients every day of the week.

But I also have a leadership role within our department, and I'm from around here.

I grew up about 25 miles south of here.

I grew up on a farm, went to Concordia College, and then I went away to the University of Kansas and where I got my Doctoral degree and live in the area.

And I've got a wife and two children.

- Well, you're here today to talk about mental health awareness, and May is Mental Health Awareness Month.

Can you talk about this month and its significance?

- Yeah, I actually had to do a little homework on this one.

And it was interesting.

The United States has been recognizing a Mental Health Awareness Month since 1949.

I was really surprised that it went back that far.

And it is largely, as I researched this, it's largely due to a gentleman by the name of Clifford Beers who was, he was someone who received care in an institution for many years.

He had multiple family members, siblings who were in institutions.

And he was a national and international advocate for improving the care of people in institutions and improving our mental health services.

So this month is a month to bring awareness to mental health, but it's also, its original intent was to celebrate recovery from mental health issues.

And I thought that was really interesting to know that it goes back to 1949.

- Well, interesting, it is.

You mentioned your practice.

Tell us about your practice and kind of who and what conditions I guess you treat and deal with.

- Sure, so at Sanford Health, I work in an integrated system.

So what that means is I work with professionals from many different departments who send referrals to our behavioral health clinic, and I work primarily with adults.

I do a lot of treatment of anxiety disorders, depression, trauma.

And then within our organization, I also have been doing, for the past dozen years, I work with clinicians who are showing signs of burnout within our organization.

So we provide professional services for those folks to help them do their work better.

- Have you seen your workload increase over the last few years?

Are you seeing more patients?

- Certainly during the time of Covid and after Covid, we actually had a period of time, it was a shortlived period of time, but we had 2,500 patients on a wait list to get into our clinic at one point after Covid.

It's settled down significantly from there, but we still have a wait list.

And I think the other thing that we're seeing is we're seeing that when our patients come to us, that they tend to be sicker.

And so if they have had preexisting mental health conditions, those conditions are a little bit worse.

Around this time of year, things can get a little bit better.

But on the whole, what we've noticed is just the severity of illness has gone up in this time.

There's also a survey that's done every year by the American Psychological Association.

It's called Stress in America.

And what they've found is that the rate of people diagnosed with a mental illness has gone up about 4% in the last year, and up to about 37% of people surveyed saying that they had a diagnosable condition.

- Well, here's sort of an ignorant, you said a wait list.

I mean, is there an emergency room situation with people that need some services quicker to get in?

- Of course.

So we have a pretty robust social work program within our clinic.

So we are working to help get folks to our partners in the community.

We also do a lot of care for our mental health in our primary care clinics.

And then of course, we have an urgent care as well as our emergency department services.

- Can you talk some about the new virtual behavioral health visits that I think have been effective for patients I understand?

- They have, virtual care, which during Covid , that was really a lot of the approval to do that type of care was given at that time.

And we've run with it.

And that's happening across the country.

Behavioral health in particular is one of the places in healthcare where virtual care seems to be as effective as in-person care.

And what that's done is it's really helped to be a more patient-friendly way for our folks to receive care.

And then we can serve a broader area for people who need the care.

So I see patients well into Minnesota.

For a while I had a patient from the Twin Cities, someone who I started working with here and then had moved.

I also see people all throughout the state of North Dakota too.

- We're starting to hear or maybe always heard counselors are overworked and especially in middle school and high schools dealing of course with the volume of teens with mental health issues.

Can you comment on that and kind of the cause of that maybe?

- Sure, I referenced that Stress in America survey, and what they found was that late teens, young adults, that's the highest stressed group in the country in this past year.

In fact, one of the questions was for them to rate on average how stressed they are on a daily basis.

And 62% of the folks in that group said that they would rate their stress levels at nine to 10 at baseline.

So we have, it seems to be more stress for certainly the young adult age group and then extending to children, some other statistics that have come across from the National Alliance on Mental Illness estimated about 6,000 youths in North Dakota have depression, about 57,000 in Minnesota.

So we are seeing more folks who need the assistance.

The other thing that's come out of that survey I referenced is that there's a cultural shift in that young adults and teens are much more willing to say "I have a mental health condition and I need help for it."

So there's greater awareness among those groups of folks, and they're more likely to ask for help, which is a really good thing.

But I think we have this combination of our world's a bit more stressed and then we also have people who are more willing to get help.

- Well there, you're talking about it so yeah.

Why are we seeing more teens using the mental health care system and what's going on in your viewpoint?

I mean, just society in general has changed obviously over the last 30 years.

- Yeah, I mean, there's a lot of folks are looking into this, researching this, offering their suggestions about why this is.

But I mentioned earlier that we just seem to be less connected with other human beings and connected in genuine ways of like a nurturing, healthy relationship with another person.

People are more likely to report that they're lonely and they're less likely to say that I have a supportive person in my life.

And we know that there are actual health risks that go along with loneliness.

Loneliness can shorten our lifespan and significantly shorten our enjoyment of life.

And I think that, so while we have a lot of our children and teens who are on their phones and they might be interacting with all sorts of people, what we don't know for sure is to what extent is that, how equitable is that to a relationship with a friend?

Like we used to think about it, someone on the playground, someone that I would look forward to seeing in school, which they still have some of that too.

But there's a change in the way that we're interacting with people.

And I think that it appears to be correlating with that increased loneliness and disconnect, and humans just don't do very well when we're disconnected.

- So is there a shortage of mental health services in North Dakota and Minnesota and maybe especially in the rural areas?

- Yeah, there certainly is.

So I recently came across, it was a map of North Dakota with all of the counties.

Outside of Grand Forks County, Burleigh County, and Cass County in North Dakota, every other county is listed as a shortage area for mental health.

So we have just the more densely populated areas around cities seem to have enough, but they're also doing the care for a lot of surrounding areas too.

So we do need more mental health professionals, - Is self-diagnosis among people or patients potentially dangerous?

And what would be your advice along these lines?

- Sure, it's an interesting thing, but self-diagnosis, there's more and more information out there about what does a mental health condition look like?

And TikTok is a very, I think, a good example of this where you'll have people who will post videos and they'll offer what symptoms are supposed to look like, and here's how you know.

I think one of the things that is a challenge for folks is that when it comes to like symptoms of anxiety, symptoms of depression, we all will have symptoms of that.

So have you felt down for a good portion of the day?

Have you felt anxious and worried?

Have you felt overwhelmed by anxiety?

We all have symptoms, but I think what is important when it comes to diagnosis is that it's really about how are you functioning in your life.

And so I think that when folks post, you know, here are the symptoms of depression, what's often missing is how well are you able to carry out the demands of your life?

And that's one of the things that we really look for.

It's one of the diagnostic criteria that we pay a lot of attention to in mental health.

And we try to normalize with folks some of this day-to-day variability that we have in symptoms.

And instead look for times when you have both a lot of symptoms, but you're not able to function in relationships at work, your self-care in the way that you normally would because of those symptoms.

- As an employer, what should employers be aware of and offer in terms of mental health services for employees?

- Sure, that's I think one of the things that maybe one of the silver linings that came out of Covid is recognizing how stressful our work lives can be, and especially in healthcare.

And so I think this is why perhaps Mental Health Awareness Month is just a really good idea for us to take a pause to put more information out to employees about what do mental health conditions look like within the company that's putting this information out, what are the resources?

We have internal EAP resources, employee assistance program services.

We also have separate services that we offer for our clinicians who are showing signs of burnout.

And we've been working hard to have a lot of initiatives around wellness.

One of the things that we've been doing at Sanford is a program called Be Heard.

And it is it where essentially what we do is we teach our employees how to recognize when people are stressed, when people don't seem to be coping well.

And we walk through how do you interact with them, encourage them to get help, and then how do you guide them to services?

So having that type of mechanism for employers so that... What I think about is if you could take almost any employee, pull them aside and say, "If you were struggling with your mental health, where would you get care?

How would you get help?"

And to work for an organization where all of your employees could adequately answer that question.

- What about advice you might give parents whose teen or child might be suffering or experiencing those symptoms?

- Sure, again, I think it is important that what we're looking for is of course we have day-to-day fluctuations in our mood and in symptoms that we have.

But when you start to notice a pattern where your son or daughter is just not the person that they are usually, they've significantly changed from what their baseline is.

I think it's important for parents to be able to have open dialogue with their children, to check in with them, to recognize that this is a more stressful time and how are we gonna, as a family, learn how to cope with stress.

When they have concerns, we have a couple of really good options on the whole for folks.

There are increasingly well-trained people within the school system to help them, certainly to help them initially and some to provide care within the school system.

We also do, within our primary care clinics, our pediatric clinics throughout the community, both at Sanford and outside of Sanford, we have a lot more ability to help people with mental health concerns in those places too.

So I recommend people to approach their school, for the school counselor to start, but also know that they can also go to their pediatrician.

- What are you and Sanford doing maybe to kind of mark this month, as you say, getting more information out?

- Yeah, so something that we've been doing for a long time is our Wellness Wednesdays.

So it's a Wednesday out of the month that we have a certain activity that's focused on wellness.

For this particular month, one of our folks at Sanford have put together, it's a mental health wellness calendar every day of the month with a challenge for folks to try to do some things differently.

So to try going out for a walk today and see how that goes.

Try calling an old friend today.

So trying to encourage people to do things that contribute to their wellness.

We are also doing a lot with just putting out information about how they can access the employee assistance program.

We're doing a lot within our departments to try to encourage, even in our annual check-ins with our employees.

I've been working on them in our department where we ask our folks consistently now much more.

So how are you doing?

How are you coping with stress?

How's your wellness?

We do things, at Sanford, we have a paid volunteering day.

So you get a chance to go and volunteer for a place of your choosing.

And so we really try, we do things like potluck events.

We had a specific event last last week that we did to celebrate multiculturalism.

So we're trying to bring people together and create an atmosphere where we can look out for each other better.

- Well, we're running out of time, but do you find people still nervous about admitting they have a problem in seeking help?

And where can they go to find out more information?

- Sure, yes, of course.

Still there's some stigma that's out there.

I think the really good news is it's getting better.

People are much more aware of mental illnesses and mental health.

They're much more willing to talk with each other about it.

And like I was saying about children and adolescents, a great place to start for us is with your primary care clinics.

We have some really good mechanisms to help people there.

- Okay, well we thank you so much, and we wish you the best.

(bright music) Poitin is a group of talented musicians exploring the correlations between Irish and Metis Red River traditional music, including ballads and dance tunes accompanied by Irish instrumentation.

(bright folk music) (bright folk music continues) (bright folk music continues) (bright folk music continues) (bright folk music continues) (bright folk music continues) (bright folk music continues) (bright folk music continues) (bright folk music ends) (upbeat folk music) (upbeat folk music continues) (upbeat folk music continues) (upbeat folk music continues) (upbeat folk music continues) (upbeat folk music continues) (upbeat folk music continues) Well, that's all we have this week on "Prairie Pulse."

And as always, thanks for watching.

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