by Jill Finkelson
A new grant from the Department of Corrections and Lutheran Social Services of North Dakota allows for victims of crime to receive help for PTSD and related mental health issues. HPR arched out to Terri Burns of LSS about the new grant and how it’s working to bridge the gap left by conventional insurance. Working alongside Abound Counseling, the program is available state wide. There are telehealth and language interpretation options to reach out to those who are ESL or live in rural communities.
High Plains Reader: Can you talk a little bit about why you feel we need this grant here in North Dakota and then sort of gap in coverage that we are experiencing?
Terri Burns: Unfortunately, suicide is the second leading cause of death for North Dakotans between ages 10-34, and North Dakotan teenagers are three times more likely to commit suicide than their peers nationwide. With such a rural state, families may have to drive a significant distance to see mental healthcare providers and can often face long wait lists. Of the 53 counties in North Dakota, 48 have been designated as “mental health professional shortage areas” by the ND Center for Rural Health. Only 5 counties (Ward, Grand Forks, Cass, Burleigh and Morton) have sufficient mental health providers for their populations. As a state, we have a pretty strong stoic streak that makes asking for help difficult and leads to people suffering in silence unnecessarily. The cost can be a significant barrier as well; even families with comprehensive health insurance have barriers in the form of high deductibles, copays and coinsurance. Crucially, in a rural state, a significant number of our farming and ranching families are uninsured.
HPR: Reading through, there seems to be a lot covered in this, from bullying to traumatic crime. Can you speak to the sort of things that people experience that are overlooked when we talk about PTSD and its effects?
TB: When the word "victims" is used, particularly as it pertains to PTSD, it is often thought of as big, violent crimes; things like sexual assault, physical abuse and assault, intimate partner violence, large-scale community violence. What isn’t always considered is non-violent crimes; home invasion, for example, is an immensely violating experience that can leave victims suffering from severe anxiety and nightmares. We've found that victims often feel like they need to just "get on with it" because it isn't a violent crime, but they've still experienced a violation of their sense of security, which is a significant trauma. We know that bullying is an unfortunately common thing (particularly in childhood) but can have lasting effects well into adulthood. Being able to expand the definition of “victim” to things, like bullying, that aren’t necessarily crimes means we’re able to help people when the barriers mentioned before may have gotten in the way, and we can set people on the path from “victim” to “survivor” before things reach a crisis point.
HPR: Further, the use of telehealth is mentioned. Has there been success in this outreach to the rural community? It can be difficult to find support for mental health in isolated/rural parts of the state.
TB: We’ve had a lot of success with telehealth- we’re extremely proud of the work we’ve been able to do to make access easier for rural clients. We currently have 26 sites across the state where people can use community buildings (schools, churches, social services agencies) to access telehealth, as well as our in-home telehealth option. This means we are able to minimize barriers for clients such as taking less time off of work, less financial resources going towards gas money to drive to closest therapy location, and less missed appointments due to our wonderful North Dakota winters. We’ve had fantastic reception from communities regarding these sites, and our clients have been happy to have such a flexible option; I hear a lot of gratitude for the option to get therapy from home, particularly in winter.
HPR: Is this part of a broader initiative in the country to reach out and obtain support for people dealing with these kinds of issues?
TB: We are passionate about the idea that mental health care should be accessible, and it should have no more stigma than getting your annual physical. While we know that this currently isn’t the case, we are hopeful that the increasing number of conversations around mental health will get us there. With this additional funding we can address more of the needs of those who have been victims of crimes and attend to the long-ranging consequences to individuals, families and communities stemming from unresolved trauma. There are federal VOCA funds from the US Department of Justice used nationwide for all sorts of victim assistance, which is an incredible resource we are grateful to be part of.
HPR: This sounds like a great opportunity for North Dakota to improve lives and mental health across the state. What would you say to someone who is maybe unsure or reluctant for some reason, even though they are struggling?
TB: You don’t need to do this alone. We understand that therapy can feel like a big step, but it’s the first step towards a better life for you, for your family, and for your community. We’re here for you, wherever you are, whenever you’re ready, even if it’s just to ask us a few questions about our services.
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