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Prioritizing Mental Health

A Conversation with Sue Abderholden

In this episode, Chanda sits down with Sue Abderholden, the executive director for NAMI Minnesota (National Alliance on Mental Illness). Chanda and Sue have a meaningful discussion about mental health in the workplace, schools, and the criminal justice system. They cover what’s working now and what still needs to happen to put wellness at the forefront of our collective focus and what people can do individually to improve their mental health.

Listen to Our Episode

Souphak Kienitz  00:01

You’re listening to Conversations with Chanda a Minneapolis Foundation podcast that unpacks the community’s grittiest most vexing problems, hosted by Chanda Smith Baker.

Chanda Smith Baker  00:13

I would love it for the listeners if you could just provide, you know, an introduction. Say who you are and say perhaps what you do to just give them context for where we’re going ahead.

Sue Abderholden  00:23

Sure. So, I’m Sue Abderholden, and I’m the Executive Director here at NAMI, Minnesota, the National Alliance on Mental Illness. And we’re a statewide grassroots organization dedicated to improving the lives of children and adults with mental illnesses and their families. By providing education support and advocacy, I have family members, and that’s why this mission is so important to me as well.

Chanda Smith Baker  00:44

Yeah. Sue how long have you been there?

Sue Abderholden  00:46

It’ll be 21 years this fall. So a long time.

Chanda Smith Baker  00:50

It feels to me from my limited point of view on this, this particular issue, that there’s been more attention in a positive way, on issues related to mental health is that been your experience over the 21 years that you’ve been engaged? Formally?

Sue Abderholden  01:10

Absolutely, more people are talking about it, you hear you know, about celebrities, and, you know, famous athletes talking about their struggles with anxiety or depression or PTSD. And I would say, during the last two, some years, during the pandemic, there has been more attention to it than ever before, because people, so many people have been impacted by the pandemic, in terms of anxiety and depression, that more people are talking about it.

Chanda Smith Baker  01:37

Can we just start with anxiety, right? Because I think that along with self-care, right, like you hear like radical self-care, which to me implies that people are not doing well, or trying to make sure that they stay well, right, and that the increased anxiety around whatever it may be getting COVID, I hear people talk about heart rate increase, I hear people talk about short-temperaments in the workplace, we’ve often seen and thought about or I have mental health issues as something that has been diagnosed. But it also feels like there’s a narrative that’s going on around sort of this continuum of mental health and how we care for it. Can you say maybe some things that are maybe trending in the workplace that might be useful?

Sue Abderholden  02:25

Sure. So you know, it’s important to remember mental health is a continuum. So, you have really good mental health, and then you have, you know, diagnosed serious mental illnesses. And then there’s a lot in between. And I think what we’re seeing right now is a lot in between, not necessarily people who need to be formally diagnosed and receive treatment in terms of, you know, medication and therapy, but people who are realizing that their mental health isn’t great. And so, they’re reacting to things, you know, when we’re all stressed out, right? We react sometimes not in the best way, you know, we might be a little snappy, you know, kind of anger, less patience about things. And that’s, I think what we’re seeing in the workplace, people are not patient. People are being crabby. Think about the signs, you see, I mean, whether it’s fast food, or we have a clinic on the first floor, and they’re like, please be kind, please be kind, we’re doing the best that we can. We didn’t have those signs before. We didn’t have signs up reminding people to be nice, right. And so I think that impatience and nerves are frayed. People just are not being kind to each other.

Chanda Smith Baker  03:32

I guess you just made me think about the number of videos that we’ve seen of people acting out on airplanes.

Sue Abderholden  03:36

Yeah, yes. Right. And think of you could do them and all the other places where people are not being kind and where people are being, they’re really overreacting, right to what’s happening in front of them.

Chanda Smith Baker  03:48

I know that I’ve heard this, but from an employer point of view, what are some things that should be considered if we are completely thinking about how to take care of not just the physical health, but the mental health of our employees?

Sue Abderholden  04:04

I think the first thing is to actually be conscious about it. Right? And to kind of recognize it, name it and say, Yeah, we know people are really struggling and, and then to do some things about it. Certainly, promoting good mental health practices. So really talking about things like exercise, having walking meetings, to really promote that to get those endorphins going in people’s brains, right? Having things like sad lights available during the winter, for people who are coming into the office, promoting, you know, mental health days. I mean, we take time off when we’re having running a temperature right or having a bad cough. We need to take time off when our mental health is really, you know, struggling as well. And then the thing that employers never really look at is what are your benefits? Mental Health Parity is still a dream is not a reality. And most employers actually never looked to see what their mental health benefits are. How large is their network? How long do employees have to wait to actually get an appointment with a psychiatrist or a therapist, how narrow is that drug formulary, so people can’t actually access the medications that are going to be the best for them, you know, all of those kinds of things most employers never look at. And if you’re really going to want to promote good mental health in both in the extreme cases, and just in, you know, kind of the prevention part of it, you need to look at the whole thing.

Chanda Smith Baker  05:24

I know, the social sector has sort of a fascination with working very, very hard and taking no vacation. And I’m often saying here, right, like, you have to take vacation, I’ve been intentionally trying to model what that looks like. And I’ve been, you know, the number one offender of, I can’t take a day off, I have meetings to go to, if I take a day off, there’s going to be more when I come back. And so, recognizing that I’m also responsible for taking this time. And I can’t even imagine how much PTO was sitting on the books of nonprofits across the sector. But if you were, you know, to speak to the employee, what would you recommend around that?

Sue Abderholden  06:06

So, I’m the worst offender, I have a really hard time taking time off as well, because I’m, you know, running an agency. But we do need to take that time off, to have our brains not be thinking about work, but something else to be able to dream, right and to think and to do all those kinds of things. And if you’re feeling like it’s really hard to take, you know, two weeks off in a row, then take little pieces, you know, come in late on a morning, take a day off, you’re in there, leave early on a Friday, we can still do those things if the stress of thinking about how many emails we’re going to have in our inbox when we come back is too high. And there are little things that we can do. I mean, I make sure that I take a walk every morning, because I know that that helps my stress levels. And so, you know, if I’m not going to make it in by eight o’clock, that’s okay. My walk is actually more important than coming in at 8 am. So what if I come in at 830? Or nine, right? And so really kind of thinking about what are those things that’s going to be different for every person? What are those things that actually help relieve your stress? And to actually schedule them into your life so that you make sure you do them?

Chanda Smith Baker  07:08

Yeah, so for us adults, it’s a little bit easier. And as I think about our young residents getting ready to go back to school, have you seen improvements of our educational system as it relates to mental health services for students?

Sue Abderholden  07:26

So, the hard part right now, in terms of youth mental health, is that it’s much worse than it was before. So, our young people were really impacted by the pandemic. I mean, we’ve seen developmental delays and little kids because they weren’t with other kids. We’ve seen kids come back to school who have gone through a very traumatic event. And they don’t really have the words to describe what happened to them. We have kids who had food insecurity during this time, and we’ve had children who have lost a caregiver, right, they died by COVID. You know, George Floyd’s murder and the impact on the BIPOC community. So there has been a lot going on. And those kids, most kids are actually doing much more poorly. And so what we’ve seen is the schools definitely see this as a high priority. We have a couple of programs in Minnesota that are very helpful. So we certainly have schools support personnel, whether it’s a school counselor, social worker, nurse, but we also have a program in Minnesota called School Linked Mental Health, where grant money actually goes to a community mental health provider, who then co locates in the school. So they see their child in their own milieu. And the other thing it does is it removes all the barriers for families getting access to mental health care, they don’t have to think about where they don’t have to take off or work to bring their child to a therapist or anything like that. They can just the child can walk down the hallway, and visit a mental health professional. We’re in about 60% of actual school buildings. So that’s pretty good. But usually by December, they’re full. And there are then waiting list. And so knowing that this program works, it’s really incumbent upon the legislature to fully fund this, to make sure that all kids can access mental health care when they need it. Some schools like in Rochester, they’re going to start doing mental health screenings of all kids, you can tell some of the kids who are struggling with their mental health because they’re actually you can see their behaviors, right? They’re kind of acting on the classroom. They’re loud, they’re inattentive, but we miss the kids who are quiet, who because of their anxiety or depression, we can’t really tell right? And so doing those screenings helps us identify all the kids, which isn’t really important because as with any healthcare issue, early identification and treatment yields the best outcomes.

Chanda Smith Baker  09:41

Sue, okay, so there’s a couple of reactions that I have to all students being on screen. So, one is they do that with parent’s permission I assume. And then over-diagnoses of kids of color, specifically African American boys extend to have really taken off, especially with ADD and ADHD. If we move there, then is there any guidance around how to do that equitably? And then how do we ensure that one screen does enough support? Right, like, so if I screen my son and find out, he has some challenges, and then there’s no support services available, where you have this waitlist. Now, as a parent, I’m, I’m sort of in a pickle, right as a parent that would not be able then to provide what I need to provide for my child.


Sue Abderholden  10:35

So those are all good questions. So, one, I would just remind people that a screen is kind of like a thermometer doesn’t tell you what someone has, it doesn’t even tell you that it might be a bad thing, it just tells you that the temperature is up, you might want to look at this more carefully. That’s really what a screen is, it is not a diagnostic assessment. And I think you’re right, that we have absolutely seen, especially, you know, young African American boys misdiagnosed with ADHD, and also oppositional defiant disorder. And, you know, neither which are, are great in terms of if you’re misdiagnosed, but I think as a parent, I would rather know that my child’s screen positive, so that I can perhaps watch them more closely, at least get them onto a waitlist, rather than that, knowing it all. And, and so I think that’s part of it. The other thing I will say is that we’ve also seen the suicide rate among, you know, young, you know, black teens and young adults go up. And so that’s another reason for us to be concerned to make sure that we are, you know, kind of catching those kids and, you know, finding that they’re struggling, and again, that’s going to be more internal than external. And we want to, we want to save their lives, right, we want to know that they’re struggling so that we can help them. And that’s something new, because usually those suicide rates were lower among that age group and among African Americans. And so that is also something that’s new that we really want to pay great attention to.

Chanda Smith Baker  11:59

Can we talk about that for a second? So I’ve been proximate to two suicides in the last probably 30 days of African Americans? Yeah, it’s been a it’s been a little rough. And I would say, in the last several years, I could probably name eight black men that I know or know through someone that has committed suicide. Growing up, that was not something that I was aware of, it was something that I thought other people did and other communities. And it is becoming, it feels like a crisis. Is it a crisis? Is it something that we should be more broadly paying attention to?

Sue Abderholden  12:45

No, absolutely. It’s a crisis. And we need to really look at all the factors that lead to that, certainly, the pandemic had a huge impact. Right? You know, again, the killing of George Floyd and other black men has a huge impact. I think that, you know, in some ways, because of political things, we’re seeing racism way out in the open, that perhaps was hidden in some situations, right? And so a lot of those young people have gone through, again, a huge traumatic event during the last couple of years. And teenagers don’t necessarily have the tools in their toolbox to deal with those things. And I think we’ve also certainly seen an African American community not to talk about mental illness very much not to talk about depression, the church in one hand, faith communities can be a protective factor, but sometimes they can also limit you from talking about it. And so the more that we can have those conversations, I know, they’ve been working with barbershops, right, black barber shops to really talk about mental health and to talk about depression, which we think is really critical. So, we do need to talk about it. But we also need to make sure that people know what those signs and symptoms are, and then what to do.

Chanda Smith Baker  13:53

Meaning it’s hard to talk to God and pray about it and not to a therapist. Is that sort of the gist of it?

Sue Abderholden  14:00

Yes. But we need to sometimes talk to a therapist, right, we need to know what the resources are in the community. And again, faith plays a huge role in people’s recovery. But it’s sometimes it’s not the only thing.

Chanda Smith Baker  14:12

Can we talk about culturally diverse therapists and workforce? I know that you’ve been working on that, can you sort of talk about why you’re working on it, and then what progress you’ve seen?

Sue Abderholden  14:24

So we’ve seen that the workforce, the mental health workforce in Minnesota is largely white. And so we don’t have a culturally diverse workforce. And I think it is really important for people to be able to see someone who understands their culture and community and it can be hard for someone, someone from the BIPOC community to go to a white therapist and have to explain the impact of racism on their mental health. Whereas if you were to go to another BIPOC therapists, right, they would, they would understand right away. It’s why honestly, I mean, I like to see women physicians, you know, especially OBGYN right I mean, I don’t want to see man, I want to see a woman and so I think that she will understand what I’m going through. And so I think the same is true when we talk about mental health. And so what we’ve seen is we have to figure out how to build that workforce. And a couple of things that we’ve seen is that people are graduating, you know, from graduate school BIPOC, mental health professionals, students, graduates, but they’re not going on to become licensed. And there are barriers there. And a big barrier is they can’t find a supervisor who’s from their culture, and community to do those supervisory hours. And so we did pass legislation creating a program to actually pay for the credits needed for a BIPOC mental health professional, to become a supervisor, so that we can bring more of them into the field and then help more people become licensed. We also expanded the loan forgiveness program, because certainly, you know, financial constraints and high student loans, and all of those kinds of things can be a barrier. So we have that program as well. We created a council that will start meeting this fall to really look at all these issues, and what are the other barriers? What can we do to bring more people into the field from diverse cultures and communities help them kind of get across that finish line, as well. And the other thing that we did is actually require all mental health professionals to get continuing education, becoming more culturally informed and responsive. You know, I think about people like Dr. Willie Garrett, you know, who’s heard of the Black Psychologists and he said, it’s going to take years to bring more black psychologists. And so in the meantime, we need to make sure that the white psychologists really understand more and can respond better. So those are just some of the things that we’ve been working on to create a more culturally diverse workforce,

Chanda Smith Baker  16:36

If we go back to the students for a minute. So, one issue that has always bothered me quite a bit is the suspension disparity that happens in schools. And I imagine a lot of that you sort of described, the students that are acting out in classroom tend to be the ones that are struggling the most. And then the response is often suspension without those students getting support. And you know, that that compounds, and then those students often are ending up tracking. We’ve talked a lot about the school-to-prison pipeline, so we probably don’t need to completely revisit that. But that’s exactly what is happening. And so are there any policies that actually protect these students and young people from, from being suspended when actually what they need as a therapist and teachers and support staff to care for them differently?

Sue Abderholden  17:24

So, there’s a couple of things that we’ve worked on to try to address that. One is that we were actually the first state in the country to require teachers to have continuing education and early warning signs of mental illness and children to understand that what they’re seeing in terms of behaviors may actually be symptoms. And so they it isn’t something to be punished, but to be treated and supported. And so I think that was a big step. Certainly not the only step we need to take, but it was a big step. Um, the other thing that happens is if the child has been suspended, if the child has been suspended for quite a few days, they’re supposed to do a screening, they’re supposed to talk about the children’s and the child’s mental health to see if there’s some other underlying reasons for what they’re seeing. I think the most important part, though, is to not allow children in K through three to be suspended. There is just no reason to do that. And there’s been a bill introduced that the legislature had hearings, every almost every year for the last, I don’t know, five or six years, to not allow that to happen. Because what does a kindergartener first cart first grader learn by being suspended? Nothing, right?

Chanda Smith Baker  18:31

We know that it’s mad, that I mean, they started creating a negative narrative.

Sue Abderholden  18:35

Exactly. And we know, if you keep suspending a child, by the third grade, they become disengaged from school as to their parents. And so then you really kind of see that, you know, school to prison pipeline, and kids not doing well, kids aren’t learning. And so then they’re acting out. And that’s why third grade is so important. Because if you’re not actually, you know, reading for content to third grade, you’re going to, you’re going to erupt in the classroom, because you don’t want to look stupid, right? You’re gonna want to say I want to get out of this classroom, so no one knows that I can’t read. And so so that becomes an issue too. So. So what the bill would have done is say you can’t do it. And you really need to look into what’s happening, you know, bring the family in. If we need to do a screening. It could be anxiety in the classroom, right? It could be, it could be depression, it could be trauma, it could be just a whole ton of things. And so let’s do social-emotional learning in those early grades to really help kids be able to express themselves in in an appropriate way and help them they just don’t have the tools in their toolbox to be able to deal with the stressors of what’s going on in their life.

Chanda Smith Baker  19:41

So now I’ve thought about two of the superintendents that sort of got ousted on policy around no suspension, right Bernardina Johnson and Valeria in St. Paul, that took a hard stance on suspensions and it became a pretty political and then you’ve got teachers coming in and the unions coming in saying hold on The teachers are having to manage classrooms and behaviors and they can’t manage them. And so suspension becomes the tool to manage classroom. So became politicized very quickly. And so is that still where the sticking point is?

Sue Abderholden  20:13

It is a little bit and I will say Bernardina was an a huge advocate for schooling to mental health and making sure that kids have access to mental health care. And for social emotional learning. She was an incredible leader in that area. But she’s right. What do you learn, especially for little kids? What do you learn by being suspended? Nothing, you learn nothing, you don’t learn new behaviors, I mean, punishment and low kids just doesn’t work. So we need to help, you know, we need to help them, right, we need to teach them some of those social emotional skills so that they can do better. And even in older grades, you know, we know restorative justice circles, we know those things actually more impactful than suspension. The most ridiculous thing is when kids are truant, that we then suspend them. I can’t even understand why you would do that. So there’s a lot, there’s a lot that needs to happen there. And I understand when teachers are, you know, trying to keep the classroom settled, and you know, some child disrupts it. But we don’t solve the issue long term, and we don’t help them learn if we simply suspend them.

Chanda Smith Baker  21:20

Is there any policy efforts that are underway in this particular area that would be important for listeners to know,

Sue Abderholden  21:29

I think the I think the important thing is one, again, not allowing suspensions in K through three in terms of that bill, but also funding social-emotional learning, we do really need to do that. And especially now kids have not really been in school in the kind of normal way or, you know, since over the pandemic, and so we need to really help them kind of learn those skills.

Chanda Smith Baker  21:51

I was just gonna say, can you just say, what social and emotional learning is? So I remember my response when I first heard that, right, and so to me, it’s embedded in the idea of what school should be doing. And so are we finding something that fundamentally, right, I mean, I think if R.T. was here with me, now, he would like, tell me to be quiet, because he’s such a fan of social-emotional learning. And I’m not suggesting that I’m not. But it feels like it’s sort of par for the course. But what how do you see that? Like, what are you funding, when you’re funding social and emotional learning?

Sue Abderholden  22:26

Well, there’s actually evidence-based practices and curricula that exist, to be able to teach kids those things. You know, some schools are also adding things like mindfulness, you know, learning how to quiet your brain yourself, when we need to learn that as adults, right? When our anxiety starts growing up, and our stress level starts going up. And we use the apps like Calm and Headspace to kind of help us calm down, we do deep breathing and elevators right to calm down before we leave, or come to work. And kids need to learn those two. And they have found that mindfulness and yoga really help young people a lot, helps people who experienced trauma, learning to really name your feelings, you know, as a young child also really helps. So instead of just, you know, hitting something or throwing something, you start using your words, right? Those are things that we say all the time with, with our kids. And so again, there are evidence-based practices that we can use in the schools, which is why we need the extra money. It’s just not a teacher trying to do it on top of everything else. But we have someone who’s trained to deliver those kinds of programs who can come in and work with the kids.

Chanda Smith Baker  23:30

I got it. So what we’re talking about is expanding the curriculum to include wellness practices, social-emotional practices, and then having someone on site that can then support that throughout the school building is what we’re talking about. Exactly. Okay. Yeah, I get that. So, the other space that mental health has been heavily discussed, as in the criminal justice system, and call responder models. And I for one absolutely agree. My concern here is that, that we don’t have the mental health infrastructure for the call responder model, like do you think that that we have the infrastructure to respond instead of police at this moment? Or what do you think is needed in order for that to be effective?

Sue Abderholden  24:26

So for more than a decade, we have actually funded mobile mental health crisis teams for all 87 counties. Most people are totally unaware that those exist. Now. You know, it’s going to be different in northwestern Minnesota when you’re covering, you know, huge distances versus Hennepin County or Ramsey, for example, but we have them and there are actually when they’re funded through the state, it’s a little over $20 million. There are qualifications for the providers, there’s data that they have to keep. There’s HIPPA requirements because you’re dealing with Health care. And they have shown that it’s very cost-effective because they do prevent hospitalizations, they do prevent people from going into jail. And they do address people’s mental health concerns. The biggest problem initially was that there were actually 40 phone numbers. And so no one knew like who to call. And then we pass Travis’s law saying that 911 operators have to send out a mobile mental health crisis team where appropriate, and now we have 988, which also can connect people as well, to the mobile crisis teams, what’s become more confusing, honestly, is that now we have cities, and sometimes counties who are adding their own teams. So you might have a city that’s adding actually a co-responder model where a mental health professional is going out with a police officer, the officer makes sure that the scene is safe, and then that person does it work. But people don’t actually always know the difference between that CO responder model, and the county mental health crisis team. Because the crisis team can actually provide stabilization services for you know, 10 to 30 days after that crisis occurs. And then you have some cities were just funding their own, and then people really aren’t sure who they call. And at times, for example, in Minneapolis, we’ve had the Hennepin County cope team, we’ve had the city team and the police all show up at the same time. And so that collaboration needs to start taking place. So, people, you know, again, are working together on this,

Chanda Smith Baker  26:21

Where does Canopy fit in there? That’s not cope, right?

Sue Abderholden  26:24

It’s not cope. Nope. So it’s a city-funded team. So they just respond to crisis calls within the city. And what they provide is still a little different than what coke provides. And cope, you can call their number directly as well. And we’ve had calls from people who are confused as to who they should call and we have people who are still worried about calling 911 afraid that the police will be sent out instead of the canopy team or instead of cope.

Chanda Smith Baker  26:50

So the teams that go around the state. How does that work?

Sue Abderholden  26:55

So so they try to handle things over the phone, and there’s a lot that you can handle over the phone, frankly, you know, kind of talking to this mental health professional or peer specialists about what’s going on, they can give good advice they can talk about means restriction education, they can say this sounds like the person really needs to go to the ER, they probably going to need inpatient, so they can work through all of that with someone. But sometimes you need to come out to actually deescalate a situation, try to engage the person so that they’ll go to treatment voluntarily. But I think the important thing to remember is that you figure it’s 21 million for the entire state. And what one departments, you know, city’s police department is, we don’t fund our mobile mental health crisis teams like we do any other first responder. And so they can’t always respond within the same timelines. But they also, again, don’t always need to be there immediately. They can, again, do a lot over the phone, or why they’re on their way.

Chanda Smith Baker  27:49

And so who is doing this best in the country? Like, are there exemplars in the country that you would point to, that we could be learning from or else that they’re they’re exemplars?

Sue Abderholden  28:01

Well, I think we’re doing it in Minnesota, we just need to fully fund it. And we’ve been doing it for a lot longer, you know, people have referred to, you know, one city that’s doing it, well, the whole state isn’t doing it in those areas. Our whole state is trying to do this, so that we make sure that everyone is covered. And you know, again, we have standards, we have data reporting, so we can really measure what’s happening out there, but we need to fully fund it. And people forget sometimes that well, it’s a healthcare service, so they should bill for it. But, you know, think about the fire department, we pay them to be idle, because we pay them to be ready to respond to a call. And so we need to do the same thing with our crisis teams. So, I think what we have is good, we just need to expand it to make sure that they can fully meet the needs of the community. And I will say if someone has a weapon, you’re going to have police go out because it is not safe for, you know, a mental health professional to go out. If there’s, for example, a gun and vote. And that’s when the CO responder model becomes really helpful to make sure that we can create a safe scene for the mental health professional to do their work.

Chanda Smith Baker  29:03

Then we have the recent case with Tekle, who seemed to be clearly having a mental health crisis, knowing that we were not on seeing and we’re not attorneys, and we’re not making an assessment here. But in community, it feels like based on what I know, on this particular case, there were signs of crisis that were happening. And I can think about people that have I’ve been around where there’s been signs of crisis. And you pointed out that many families are afraid to call 911 or they don’t know where to call, right? Like there’s something going on with my child. They’re displaying something and I cannot get services for them. I don’t know what to do, and they have a weapon, and I can’t get the weapon taken away from them. Like what should we be doing if we recognize those behaviors and someone that we’re either working with, living with or living next door to do you have recommendations there?

Sue Abderholden  30:00

That’s, that’s a really tough one. The first thing I would say is means restriction education is really important. So, you know, if you know that someone is, you know, living with depression or you know, schizophrenia, bipolar disorder, you should be removing any weapons that you know of. And if you think they’re headed towards a crisis, really remove anything that they could hurt themselves or others with, get them out of the house, right? Lock them in your car trunk, do whatever you can, that would be kind of the first step because you don’t want them to have access to those things. Because just in terms of hurting themselves, not even hurting others. And then the other thing is you can call the crisis teams before it’s a full-blown crisis. And you can call them to say, No, I’m worried about my loved one, what is it that I can do to help? Is there someone who can come out and talk to them? Again, before we hit that point, we actually passed something a couple of years ago when we redid the commitment act, and it’s called voluntary engagement. And unfortunately, we don’t have counties who have opted in yet. But what we’ve heard over and over again, from families is, you know, I can see that my loved one is decompensating, I can see the symptoms come back. And if I, if I call the county call pre-petition screening, or whomever, they’ll say, Well, are they willing to go to treatment voluntarily? And I’ll say no, and they’ll say, well, then you have to wait till they’re a danger to themselves or others, which is really kind of absurd when you think about it. So what the volunteer engagement law would do would actually allow families to call or friends to call and to say, I am worried about my loved one, they would send someone out. And if the person said, no, they come back again, and again, and again, and try to engage that person into treatment voluntarily. At the same time, they could check, does the person have housing? You know, do they have insurance? Do they have a mental health professional, they could educate the family about means restriction education? How do you talk to someone who’s having delusional thoughts or negative voices in their head? How do you do that? And how do you support them? And you know, then we’re intervening early, right, and trying to get someone into treatment. And that part is totally missing in the mental health systems across the country. And here we have it in our statute, and we can’t get any counties to do it. And yet, I think if you can talk to any family, you know, who’s had a loved one with a serious mental illness? They will say, doing this would have absolutely helped.

Chanda Smith Baker  32:13

And do we have local policy that would allow for a gun to be removed from someone with mental health issues? Does a family have to do it? Or is there laws that actually allow for that to happen?

Sue Abderholden  32:27

The family pretty much has to do it, there’s been, you know, discussions about red flag laws and things like that, that could take the guns away. But we don’t really, um, sometimes some police will allow police departments will allow those guns to be stored at their stations. But it’s, it’s kind of tricky. To be honest, so better if a family member can just remove it when you think it’s unsafe for the person to have one.

Chanda Smith Baker  32:50

So right now in our state is someone went into the hospital on a mental health hold or suicide hold for 48 hours, and they walked in with a weapon, when they went out, they would get that weapon upon release?

Sue Abderholden  33:01

Most likely they would, yes, it’s only when you’ve been committed. And of course, the 72 hour hold is not a commitment, once you’ve been committed, you can’t own a gun. But prior to that you cut. Now the family might be able to convince the hospital not to give them back. And if they actually thought they were still a danger to themselves or others, they just didn’t fully meet the commitment act, they might still not give it back. It would be it would kind of depend on the situation.

Chanda Smith Baker  33:26

And you’ve mentioned a couple of things in terms of what can be scaled and how resources and then use you talked about 988. For those that don’t know what 988 is, can you just provide some context on that?

Sue Abderholden  33:40

Sure. So, we’ve always had, you know, for decades a National Suicide Lifeline that anyone could call. But you know, it was a long number that you weren’t going to remember in a crisis. And so this way, we have just three digits that we have to remember 988, it still connects you to the Suicide Lifeline. And the goal was actually to expand it across the country to include crisis services, to connect people to mobile crisis teams, or whatever was available in their community. So in Minnesota, we do have call centers that will answer those calls. But we did not get the funding this last legislative session to ensure that all the calls from Minnesota are being answered in Minnesota, so they’ll be rolled over. The other thing that happens with this is that it’s not geo based. So they look at your area code. So if you have an area code from another state, 847, something like that, those calls will actually go to that state and that Minnesota, so it’s something nationally that they have to keep working on. But you know, still, again, easier number to remember, you know, if you’re feeling suicidal, or you have a friend who’s suicidal, please encourage them to call that number. You can text and chat to 988 as well. And we can still use the text line in Minnesota where you just text MN to 741741 A lot of young people as you know don’t make phone calls. So texting is actually really important to him?

Chanda Smith Baker  35:01

Can we go back to just anxiety? And I don’t know, like, tell me Sue if this is an area that you haven’t really paid attention to. But this whole thing, and we talked a little bit about culturally specific and diverse workforce, we’ve talked a little bit about anxiety in the workplace. And another area that has come up very frequently is the hybrid model of working right working from home for those of us that have been privileged enough to be able to do that, which is, in fact, not the majority of the world, or our nation, but not being in a environment have macro and microaggressions right, on a daily basis, which also takes a hold on one’s mental health. Right. So the impact of racism on one’s mental health? Have you done any research? Or are you looking at any impact on that, in your work?

Sue Abderholden  35:54

We’re starting to see some research being done on that. And certainly, that’s understandable, right? We don’t want to have those be dealing with those aggressions, you know, every single day. So it’s coming out, I don’t know how we I mean, we look a lot at legislation and, you know, education and support around things. So we haven’t really kind of figured out that piece yet. But we certainly, you know, understand the impact. But I do want to say there’s also the impact of being alone, that also can be really difficult. And you think about how you develop friendships, how people found their spouses, you know, all those kinds of things. It’s usually been in the workplace. And so I think there’s also concern about young adults working from home, for example, not meeting other people that I think can also take a toll on people’s mental health. So it’s like, how do we how do we balance all of that together? How do we make sure that we eliminate right racism and microaggressions in the workplace, as well as making sure that we’re promoting social connection? Because when we look at things like overdoses and suicides, a lot of it is that people are not socially connected? And they’re, they’re lonely, and we want to make sure, you know, they’re just it’s, you know, sometimes we talk about it as despair, we want to make sure people are connected to so I don’t know how we, I don’t know how we do all of that, and, and promote good mental health on top of it. I don’t know if you have thoughts about that. Have you seen that?

Chanda Smith Baker  37:16

You know, I don’t but I just feel like especially in the last couple of years, right? We’ve had new talk about race, right? New talk around diversity, equity and inclusion, new talk about what it means to have a just society, which I think has been largely positive that we are now talking about it in a more substantial way. It does mean that there’s just more of it, right? And there’s lots of awkwardness around it. There’s difficulty, there’s mistakes being made. There’s burdens on on many people of color, that are engaging in that conversation. And I think there’s lots of anxiety on white folks that I have discomfort around it. And you can just see it playing out in the workplace, right? And these very awkward ways. And I said beyond right and community more broadly. And it just feels like right, when you look at the social determinants of health, like that being one of the conditions around health is are you in a place that’s inclusive? Or that is racism free? Feels like utopia? Really?

Sue Abderholden  38:23

Yes,I would agree. It does feel like utopia. But it’s something to move towards, and reading Resmaa’s book, you know, Quaking in America and learning a lot from it. And we just have a lot to work to do, you know, frankly, as a community and as a country on this issue. And I certainly don’t have the answers to that.

Chanda Smith Baker  38:40

So when we were talking about schools and policing, we were talking about students and residents. But we don’t often talk about like the mental health of the teacher or the officer, like I sort of touched on it. But as we were talking, I was thinking, I mean, I’ve ran I have five kids, I’ve ran across some teachers where I’m thinking, I’m not sure everything is working together here. Or it seems like your stress level is so high that you’re creating a lot of anxiety in this classroom right now. And so is there any efforts that are happening in the districts? Right, and recognizing right, like, certainly not in any way minimizing the stressors facing our teachers and support staff in schools right now? But are there any additional supports that are going to them to support them going back into the classroom that you’re aware of?

Sue Abderholden  39:27

I’m not aware of anything specific. But I think we can certainly all admit that teachers went through a pretty stressful time, trying to teach kids remotely, you know, to switch to that so quickly was not easy for them trying to, you know, connect with kids over Zoom. I mean, that that’s just not it’s it’s hard to read kids right on those little screens, and it’s hard for kids to stay engaged too. I know many, when we looked actually at the impact of the pandemic, women were more impacted than men because more of them were actually in charge of distance learning. And so they had that additional stress laid on them. So teachers have been through a lot. And you know, and when I think of, you know, even though the strike in Minneapolis, what they were talking about was right, more support for the paraprofessionals, that they got paid better and more mental health supports for the kids. But they needed to. And I don’t know of any specific activities that have been done to support the teachers coming back. But we also know that many of the schools are struggling to fill out their positions. Some people are just saying, I just can’t do this anymore.

Chanda Smith Baker  40:34

One of the conversations that we had, and I mentioned this, at the front end of this conversation was the presentation that you did to the Minnesota Women’s Economic roundtable. And in that conversation, you were providing some tips for folks, if they were feeling anxious or to use to get grounded, I wonder if you might want to reshare that, because I’ve been trying to repeat it, I’ve completely jacked up whatever it was 54321, or something along that and I’ve messed it up. But I would love it, if you would maybe share that with us.

Sue Abderholden  41:03

Sure. So, there are some simple things that people can do to really deal with their stress and their anxiety about what’s what’s been happening. One of them is called grounding. And so it’s really to kind of get yourself more aware of your surroundings to help ground you. See five things. So literally point them out my water bottle, right, my printer, my phone, really count them out. And then you feel four things. So touching your shirt, perhaps the desk a warm cup, you hear three things. So listening for, I can hear my white noise machine, right, I can hear someone walking down the hallway, smell two things, and then taste one thing. And that helps ground you, right, because you’re not your mind isn’t going all over the place. It’s really, it’s really looking at what is surrounding you. And that can really help. The other thing that we don’t really talk about a lot is breathing. Breathing is we just do it naturally, right. But when you really focus on your breathing, you can actually quiet yourself down. And I do this all the time in my car, in the elevator when I’m leaving work and feeling stressed. And so if you kind of you know, breathe in to five, or six and breathe out to four with a whooshing sound, you can feel that stress leave your body, which is really important. And then we just try to remind people of all the things that we all know to do exercising, it doesn’t have to be cardio, right, just taking a walk around the block, a walk down the hallway, around your house, anything like that can help. I always, you know, joke about dancing in the kitchen with your kids to some music can also be a really good thing to do. Being in nature helps, which is why parks are such an important part of our city and making sure there’s trees on the Boulevard. Because being in nature can actually help calm us down. And the other thing that we talked about is space and grace. So really giving people space and grace during this time. We’re not doing our best every day, right? Some days, we’re crabby because we’re feeling anxious, or, you know, we didn’t sleep well the night before, things like that. And so really just trying to give people space and grace for what’s happening in front of you will actually make you feel less tense, if you don’t respond to it in more of an angry way.

Chanda Smith Baker  43:15

Sue, I appreciate that. I’ve been thinking about it. And I’ve been you know, even talking to my daughter about you know, just I think I’ve said, see five things smell for things. And I’m like, oh, it’s kind of hard to smell for things. But I definitely love thinking about whatever else I was thinking about. Before we go, I know that you are so embedded in the space. And I’m wondering if you might take a couple of moments to just say maybe what’s coming up next for you or things that you think that for folks that are paying attention to this issue? where might they focus? And where might they be able to perhaps be able to make a difference?

Sue Abderholden  43:52

So, I guess the first thing is to make sure that that you educate yourself. So, September is actually Suicide Prevention Month, there’s a lot of suicide prevention classes. So really learning what are those signs and symptoms? And what can I do, a lot of us have taken first aid, we need to do the same when it comes to mental health, right, we need to know what those signs and symptoms are and what to do. The other thing I would say is that if you’re struggling with your mental health, or you have a family member, you don’t have to do this alone. So, there are support groups out there that are led not by mental health professionals, but by people themselves. And you know, knowing that you’re not on this journey alone can really be helpful. And then the third thing is, you know, there’s elections coming up. And elections have consequences. And so, ask, you know, at a candidate meeting, or if the candidate knocks on your door, ask them so what are you going to do to help build the mental health system? I like to say that our mental health system isn’t broken. The reality is it’s never been built. And we need to continue to improve the funding, really address things like workforce payment rates, all of that to really build our system. And so, ask those people who are running for office, what is it that you’re going to do? And then when the session starts in January, you know, please reach out to your legislators, you know, those who got elected to say we need to fund mental health, we need to take care of this issue. We need not to suspend kids in K through three, you know, we need to fund schooling to mental health, we need to fully fund our crisis teams to really do all of that, so that when people need mental health treatment, they can access it.

Chanda Smith Baker  45:20

I want to go back to the black church comment, because there’s a lot of places that will go to their church or their mosque, or places of faith. And they have been raised to believe this is a place that you go when you are struggling. And that is true. Are there things that you might recommend for those faith communities to do to complement and to offer maybe some additional resources to their congregants?

Sue Abderholden  45:46

I would recommend that they know what the resources are in their community. So where are the black psychiatrists? Where are the black mental health professionals where are the clinics in your community that really do meet the needs of the community. But also understand, we know that having a faith community actually breaks down that isolation, you know, sometimes giving up your struggles to a higher power can be really helpful. And faith is an important part of people’s recovery. We strongly believe that, but sometimes it’s not enough. And so really kind of encouraging faith communities to say when you’re not enough to help someone to really make sure that you connect people to those other resources.

Chanda Smith Baker  46:27

Sue is there anything that you want to say that I have not asked you?

Sue Abderholden  46:31

I think the only thing is, is just to remember how much the pandemic impacted our mental health. You know, we lived with that uncertainty, not knowing when it would end, right, then that’s really hard for our brains to do. We had a lot of people who were worried about catching COVID, we had a lot of people who died by COVID, including disproportionately people from the BIPOC community and people with schizophrenia. And so we have a lot more grief in the community. We lost out on some of those really important life events, including funerals, and weddings, and for young people, graduations, going off to college, all of those things have been really, really hard on us, we have to recognize that. And then we have to counter it right? By being more mindful about taking care of ourselves and taking care of our mental health. It’s not selfish to take care of yourself. It’s an important thing that we should all be doing.

Chanda Smith Baker  47:22

Yeah. So as a mom, I’m gonna go into my mom hat, which I almost always have on. So, 2020 was a year for me, right? So, I sort of said, I wasn’t going to talk about my mother passing away. But my mother passed away in 2020. I also had a sister-in-law who was 45 that died in 2020. That sort of the sad part of the year, I had a senior in high school who graduated that year, and a senior in college, who graduated that year. And I had a son that was getting married that year, got married that year. So I had two graduations of marriage and two funerals. I mean, it could not have been a more complicated year, right? And so now I have a son who is going into his senior year. And it’s been really incredible to sort of watch the one who missed prom, who missed all of the things leading into that year, sort of witnessed the younger brother. And I’m a little bit at a loss, like, it’s one thing for him to care for his own mental health around those things. It’s something else for me to observe that he is recognizing what he has missed and grieving it. And then the compounding grief. Right? So if you were advising me, and that was just a lot, right? And what I just said, like, what would you I mean, as a mom, and there’s a lot of moms or folks that are working with kids that have these compounded issues or that have multiple things that they’re grieving. You know, I mean, I think you’ve said it in there, get people to therapist get, you know, pay attention to the signs. I think you have set it, to be mindful of it to give grace but you know, I don’t know if there’s other other suggestions.

Sue Abderholden  49:07

And I’m sorry for your loss of it’s, you know, it’s been a it’s been even harder in some ways to lose people during this time. I lost my husband a year ago, unexpectedly and grieving during a pandemic is just harder, right? It just is because you can’t connect with people, your friends or family in the same way that you could before because you don’t want to catch COVID.

Chanda Smith Baker  49:28

Just funerals, right? Like, like she’s gone. I don’t even know if we can celebrate her life with people that I know that loved her. Like we can’t even have more than 60 people in the service or whatever, right? Like that was hard.

Sue Abderholden  49:41

Exactly. Right. And you know, no one’s fault. It’s just what it is. And we kind of call it ambiguous loss. And I think that I think as a mom, you have to talk about it with your with your kids, right? You have to acknowledge it and say, Yes, perfectly legitimate, that you’re sad about this perfectly legitimate that You’re feeling maybe in some ways jealousy that you didn’t get that, right? Because if we don’t acknowledge it, it’s still there. Right, but acknowledging it helps you talk about it. And so kind of opening that door so that they can talk about it, I think is really important.

Chanda Smith Baker  50:16

And because because I mean, you know, I made that deeply personal, but from a systems point of view, like, is there a role that the school can do in acknowledging for young people like is that that day come and gone, or like, it just feels like there needs to be sort of wraparound of those of us that are responsible for caring for our community to acknowledge the loss?

Sue Abderholden  50:39

You know, I’ve heard of some places doing a delayed graduation, you know, and just kind of bringing the students together and saying, Yeah, you missed out on this, but we’re gonna bring you together to provide some closure. Honestly, it’s not the same. Not walking across the stage, hearing your family scream in the background, right. But we’re going to bring all the graduates together from you know, two years ago, just to be able to gather and talk and maybe in some ways kind of process through that. We’ve heard of delayed proms, you know, just things like that, again, might seem silly, but me again, at my age, I don’t remember graduating from high school. Right. But when you’re 19,18, 20, right, you remember that, and that’s a really important rite of passage that you missed out on, we have to talk about, and if there’s a way to make up for it at this point, I would still definitely, you know, encourage schools to do that probably easier in smaller places, and smaller schools and larger ones. But we have to acknowledge this. This was really hard for young people.

Chanda Smith Baker  51:37

Yeah, it was. So I appreciate the work that you are leading. I think this was, you know, important conversation for us to have, because there’s not a many conversations and I am in right in my work at the Minneapolis Foundation where the issue of mental health does not enter the conversation, whether or not we’re talking about education or criminal justice, or if we’re talking about workplace self-care, like it just feels like it is in the water in terms of how we’re talking about it. But it doesn’t feel like it’s that way in terms of surfacing solutions and scaling those solutions.

Sue Abderholden  52:13

It is but it’s never in the paper. I mean that one of the few appropriation bills to pass this legislative session was a mental health with over $90 million dollars. Most people didn’t know that that happened. So that’s kind of the hard part. Any I see every legislative session, good things happen. More money for things like crisis services, or schooling to mental health, addressing some key issues like competency restoration, talking about what can we do in the schools? What can we do in terms of housing, so those discussions are happening at the Capitol, there are good bills that are passed, but nobody knows about them. I would encourage people if you’re really interested in kind of the Legislative and Public policy issues, we actually put out every weekend a legislative update that lets people know what’s happening on the state and federal level in terms of mental health policy, so people can really see what’s happening. We have in Minnesota, the mental health legislative network, it’s over 40 organizations that come together to work together during the legislative session, we actually just held a retreat where we identified what’s going well, what’s not going well, and what are some of the legislative solutions so that we can come in, you know, there’s going to be a lot of new legislators. So we’re going to come in with just a limited number of bills to not kind of like overwhelm them about all that needs to be done so that we can really make it clear about what are the next steps to build our mental health system. So there is a lot going on. But again, it’s never in the media.

Chanda Smith Baker  53:37

Where would the where would folks find that information? If they were to look for it?

Sue Abderholden  53:41

They can go to the NAMI Minnesota website, which is just Perfect. Thank you. So, thank you so much for inviting me this morning. I appreciate it.

Souphak Kienitz  53:54

If you enjoy this show and want to learn more about what we do here at the Minneapolis Foundation, please visit us online at Minneapolis And of course, if you want to follow Chanda or the Minneapolis Foundation on Twitter or Instagram, that’s ChandaSBaker or MPLSfoundation. This is Souphak Kienitz. Thanks for listening.

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About Our Guest

Sue Abderholden

Sue Abderholden has devoted her career to changing laws and attitudes that affect people with disabilities and their families. Since the fall of 2001, she has served as the executive director for NAMI Minnesota (National Alliance on Mental Illness). She has held leadership positions with Arc of Minnesota, U.S. Senator Paul D. Wellstone, and PACER Center. Sue has a B.A. in political science from Macalester College and a master’s degree in public health administration from the University of Minnesota. She and her family had a foster care license for many years providing respite care for families of children with disabilities and youth aging out of foster care. She is a community faculty member for the U of MN School of Social Work teaching health and mental health policy.

Sue has received numerous awards for her advocacy including the 2020 Esther Wattenberg Policy Award, being named one of the 100 most influential health care leaders by MN Physician, the 2018 Rona and Ken Purdy Award to End Discrimination from National NAMI, Excellence in Mental Health Advocacy and Policy Award from the International African Mental Health Providers, 2013 Gaylord Anderson Leadership Award from the U of M School of Public Health and many more.