Introducing the Behavioral Health Bridge

Podcast: Partnership with UND promotes behavioral health treatment and access

Introducing the Behavioral Health Bridge

Episode Transcript

Courtney Collen (Host): Hello and welcome. You are listening to the Health and Wellness Podcast brought to you by Sanford Health. I’m your host Courtney Collen with Sanford Health News. This series begins new conversations and continues the important ones, all designed to keep you well, physically and mentally featuring our Sanford Health experts. Joining me now is Stephen Wonderlich, MD. He is the vice president of research at Sanford Health in Fargo, North Dakota.

Dr. Wonderlich, thanks so much for joining me. When we talk about the number of people struggling through this pandemic, it’s greater than we think, isn’t it?

Dr. Stephen Wonderlich (Guest): Yeah, it’s really surprising in many ways. Recently done some reviewing of both scientific publications and also just some newspaper pieces around the country. Call lines around the country for mental health concerns are increasing at levels between 500 and 900%. So the demand, the need for just information and help is growing dramatically.

Host: Tell us about the Behavioral Health Bridge and specifically your role in creating this program.

Dr. Wonderlich: Sure. The behavioral health bridge is a collaboration between Sanford health and the University of North Dakota. And at, at the University of North Dakota, it’s the department of psychiatry at the college of nursing and the center for rural health. And those four entities came together. Because Dr. Andy McClain, whose role is principal investigator on this project with me, he and I were talking back in April about what we anticipated would be the mental health side of this pandemic. Looking back at the SARS epidemic in 2003, and looking at natural disasters like hurricanes, tornadoes, floods. We always understand that there’s going to be a mental health side after the actual disaster or pandemic in this case even begins to resolve. And so at that time, there wasn’t much, that was really focused on the mental health side. We found webpages and links and the government was starting to put information out. So he and I had started thinking about the need for it, especially up in a rural state like North Dakota. And so we created a team of about 13 of us who simply started basically writing a small book, which we then turned into a webpage. And the webpage now exists. We launched it on September 8th and it’s geared toward helping people understand how a pandemic like this might influence their mental health and why what they should be looking for and what they can do about it.

Host: This is a pretty big need right now, why did you end up partnering with a university of North Dakota for this effort?

Dr. Wonderlich: The University of North Dakota was certainly well-suited on the center for rural health is an excellent collaborator with us. The department of psychiatry is a great fit, the college of nursing. So we had all these clinical entities working together with Sanford health and that sort of synergy, if you will just fit. Plus I spent 30 years at the university and before I came to Sanford, so I know a lot of these people and it just was an excellent way for us to get it launched.

Find a provider: Behavioral health at Sanford

Host: So as I understand this program is being rolled out in phases. Talk about what each phase is and what is being offered to a patient who needs that support.

Dr. Wonderlich: Sure. The first phase is what we created from April until about July of 2020. And this was this team of 13 or 14 people working on this fairly regularly at the time. And we created a series of modules and the modules address a variety of things about the pandemic itself, about the behavioral risks that come with a pandemic, for example, job loss financial challenges quarantee all the things that changed, including, you know, for all of us, the things that we normally do, you go to the gym, you go to the store, you go to the restaurant, that’s all changed in many ways for many people. So all of that environmental change and personal change increases the risk for a variety of different mental health problems. And then the bridge, we try and help people to see how that could add up and then what they should look for. They should look for things like depression, anxiety, post-traumatic, stress disorder, drinking, drug use, domestic concerns in terms of relationships and all of these things. We lay out in the behavioral health bridge. So they can start to think about how this pandemic might affect them beyond the virus.

Host: So what’s next with future rollouts, what’s next as you continue building this behavioral health bridge program?

Dr. Wonderlich: Well, the first phase is really about this core educational component and that’s up and running in phase two. We’re building in several new things. First of all my Sanford nurse has joined us to provide 24 hour, seven day a week, call contact care in case somebody comes to the webpage and has a serious problem or a question or doesn’t know what to do or where to turn. And so we’re working with the nurses to help us cover. We also fantastic. Yeah, we wanted a voice to be part of the page. Additionally we’ve added, we will add in phase two, a series of mental health screening tools. So let’s say a person goes onto the webpage and they’re concerned that their depression level is increasing. We’ll have a series of screeners for depression, anxiety, post traumatic stress disorder drug use various kinds so that people can take the screening tool and it’ll tell them, Hey, look, your, your level of depression is increasing or your level of depression is in a moderate range.

You might want to talk to somebody or your level of depression is really quite severe. We strongly encourage you to contact your primary care provider or a mental health professional. So those tools will be in there. And then we also are launching something that I don’t know what it’s going to be called when it finally launches, but right now we’re calling, calling it the clinician corner. And we’ve got mental health professionals from all over the state who have agreed to be interviewed for the bridge and the results of their interview about pandemic related mental health issues are going into the, the webpage itself into the bridge and the, the the editor of our webpage Dr. Gail Williams Curver is conducting these interviews and then translating it into useful information for the public. So that’s phase two.

Host: Is there a phase three?

Dr. Wonderlich: Phase three for me is the real deal. This is where we want to use this webpage as a place where people can go when they need help. And it’ll extend well beyond the pandemic. It will be a place where people who have mental health concerns in North Dakota in the Northern Plains can reach out and have a go-to place. But what we want to do is we want to try and utilize telehealth in phase three, so that a person can come to the webpage, learn, take screening tools, maybe talk to a nurse, and then ultimately through the webpage, get access to a mental health professional by telehealth, which helps them in terms of confidentiality, privacy, and also helps with the great distances that people have to travel across North Dakota to try and get mental health care. So phase three is about trying to implement tele-health a statewide basis so that we can get to people who need us.

Host: Yeah, it sounds like convenience is a really key component in all of this, isn’t it?

Dr. Wonderlich: It is. And, and like I said earlier, 91% of the counties in North Dakota are mental health shortage areas. So nine times out of 10, if you’ve got a mental health issue, it’s very unlikely. You’re going to have many professionals around you to help you. And so the question is, how do we get the professionals to the people?

Host: Why is this so important? Not only in a rural state, but, but overall, like, what was your, you know, your goal behind creating something like this,

Dr. Wonderlich: There’s sort of the short term goal and the longer term goal, the short-term goal is to help people through what we think is going to be potentially a pretty dark winter. This is going to be a tough time. I mean, we all know right now, why irises are, are spiraling up and it’s going to have influences the weather’s going to change. You’re not going to be able to go sit on patios and have a dinner outside. Things are going to change in terms of the employment market. There’s just going to be a lot of stress as we move through the winter, especially up here with the weather, which is stressful in and of itself. And so we want to be available, especially right now in the next six months. And then the longer term goal is going beyond the pandemic. So whenever we get through this pandemic, if we can build an infrastructure that lasts that persists, that helps Mark Dakota figure out how to do mental health care more broadly with greater ease and accessibility for me, that’s, that’s the agenda. That’s the long-term goal.

Host: Yeah. Awesome. How proud are you to see this come together and really meet the need of so many people in such a challenging time?

Dr. Wonderlich: This is great. And there’s been a group of us that worked on this, but I can’t tell you, these folks are brilliant. They’re savvy. And thankfully for me, they’re technologically sophisticated because I’m not. And, and so I’ve got a team of people working with us that is just great. We’re happy to get something put together. We’re happy to get it out.

Host: Wonderful. Now, if someone is struggling from the effects of this pandemic, and as we mentioned, there’s a lot of people out there who are, how would you encourage them to seek the help that they need? And more importantly, where would they start? So walk us through the process, if you would,

Dr. Wonderlich: If I’m a farmer in Hillsboro, North Dakota, and I’m noticing that I’m I’m feeling not right. And I think it might have something to do with the pandemic or stress that I’m under. Step number one would be go to this page, read a little bit, click on a few things. There’s videos in there. There’s there’s examples in there of what people might be going through that just help put it into context. So go there and learn just by looking at the different modules. And by the way, we have one module that’s about mental health care for healthcare professionals. So if you’re a healthcare professional, if you’re a nurse and Dickinson, go there and look at that module, just get an idea of what’s going on, how they might think about it. Perhaps then take one of the screening tools, just get, get an idea of where you’re at in terms of your depression level, your anxiety level. Start to think about what that means. And the tools will tell you, you know, you might want to think about talking to somebody about this, then there’s going to be a few different options. If it’s an urgent situation, like if somebody’s questioning whether or not life is worth living, there’s going to be some suicide lines that you can call right away, both locally and nationally to get immediate help. There’s also a national treatment locator. That’s sponsored by the substance abuse and mental health services administration. That’s in there. And I tested this, worked beautifully. You’d put in your zip code or your house address and up pops, a bundle of mental health providers in close proximity to you. So at least it would help people think this is where I could go to get some help. Also the my Sanford nurse, if you’re on there and you’re not sure what to do. You have any questions or you’re in an urgent situation, you can reach out to these nurses, they’re there and we’re talking to them, they’re talking to us and they’re just a great place to reach out to. So right now that would be how I would proceed in terms of trying to find some help. And hopefully when we get to phase three, there’s going to be another step. And that is somehow you just push a button on the webpage and hopefully we can set it up so that you get an appointment with a mental health provider by tele-health.

Host: I’m so glad that you mentioned healthcare professionals. This is an opportunity for anybody, is that right?

Dr. Wonderlich: It really is. And I spent some time last April, may, June meeting with healthcare professionals in the region here talking about the stress they’re under, and we all know about it. We’ve seen it on the news, but I heard about it too firsthand in our region. These guys are up against it. They’re doing great jobs. They’re doing the best they can, but it’s been a challenging, challenging world for a lot of them.

Host: Is there anything else you want our communities to know about this opportunity and really taking advantage of, of staying on top of your mental health?

Dr. Wonderlich: What I would say to the public is we’re all tracking, you know, rates of positivity rates. We’re, we’re tracking all sorts of things about the virus, which makes perfect sense that we should be doing that. And we should be taking all the public health steps that everybody’s telling us to take, to minimize our risk. I think we should also be aware though, that there is another piece to this and that, and that is not just our viral health, but our mental health. And it applies to me as well as you and everybody else. There is a stress, there is a burden of living in this world right now that we’re not used to. And I would just encourage people to think about that, to be aware, to try and learn, to try and examine themselves. And if they examine themselves and they find something that just is not them, it’s not right. And it persists. I encourage them to reach out and get some help.

Host: Dr. Wonderlich, it’s always a good opportunity to talk about mental health and really shine a light on awareness to eliminate that stigma that surrounds mental health and learn of course, learn more about what Sanford is doing to support our communities through this pandemic. It was wonderful to learn more about this bridge program, and we thank you for your time and your insight and all that you do. This was another episode of the Health and Wellness podcast series by Sanford Health. I’m Courtney Collen. Thanks for being here.

The National Suicide Hotline phone number is 1-800-273-TALK.

You can also text the crisis text line ‘HOME’ to 741-741.

The Behavioral Health Bridge is made possible by generous donors to the Sanford Health Foundation. Funds raised stay local to support unique programs, provide education and help purchase life-saving equipment and technology. The University of North Dakota also supports this project to cover time of faculty, staff and web development.

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Posted In Behavioral Health, Family Medicine, Fargo, Here for all. Here for good., Leadership in Health Care, Physicians and APPs, Virtual Care