Giving birth has been cited as one of the most miraculous events of mankind. Yet sometimes, new mothers and fathers battle with postpartum depression, anxiety and obsessive-compulsive disorder (OCD). In a sea of uncertainty and feelings of being alone, those in western North Dakota have resources they might not be aware of.
On the Western Edge, mental health issues and the lack of services remain a constant topic of discussion by elected officials, commissioners, law enforcement and more. The lack of resources continue to worsen as the current state of mental health for communities in southwestern North Dakota leave many without help. In the second article of a three-part series, called Breaking Point, The Press visited with three medical professionals who are diligently working toward filling a gap in the west with their own mental health services in Dickinson called Wonderment Therapies.
In 2019, Jenna Weisz decided that she wanted to begin her own mental health practice, offering occupational therapy services to children, adolescents while applying behavior analysis services. As an occupational therapist for more than five years and an applied behavioral analyst for three years, Weisz noted that services they provide vary from autism to managing behavioral skills.
Recently, Wonderment Therapies introduced perinatal mental health services, which covers mental health before, during and post-pregnancy for mothers, fathers or partners (biological, adoptive, surrogate). This therapy also helps those who are suffering from infertility or loss.
'Where do new moms go?'
According to Weisz, the closest maternal mental health care is located in either Bismarck or Billings — 101 miles east or 317 miles west, repectfully.
“Where do new moms go? Even myself, as a new mom, we spent the first two or three weeks traveling to Bismarck for medical appointments and I can relate to some of these families now that you don’t have the time to be on the road that much,” Weisz noted. “... Mental health impacts all aspects of life and so occupational therapy encompasses your whole life so anything that you do (from) bathing, showering, dressing, feeding, work, handwriting and reading. Play is a big one, especially for us with kids.”
Perinatal mental health care can include treatment of mood and anxiety disorders, breastfeeding or bottle feeding, gestation, postpartum bonding, self-care and medication management.
“So many people (are) pushing medications too (and saying) this is the only way. It's not the only way. We can address so much before medication (by) trying a variety of different interventions and methods before medication. Not that medication doesn't have its place but there's so much more we can do,” Weisz said, remarking, “It gives me goosebumps just thinking about it because... we work to fill the gaps here in town.”
Kelsie Schaefer, who joined Wonderment Therapies in 2020, works with clients dealing with postpartum depression, anxiety, OCD, postpartum psychosis, feeding, etc. Schaefer has been an occupational therapist for four years and said she hopes to get more referrals with this new added care.
“I would encourage moms to seek out if they're needing some help or even just somebody to talk to. Even if they're like I don't know if this is normal (or) if I'm supposed to feel this way. Okay, well let's talk about it and we'll figure that out together,” Schaefer said. “Why should a parent maybe seek a referral for their child? If they're noticing some delays or if somebody else like a doctor is noticing some delays or if they're just needing some help… (it encompasses) that whole umbrella.”
The third occupational therapist Erin McCurry joined Wonderment Therapies in June and has experience working in the mental health field for more than nine years. She is working toward becoming trauma certified as well, as many children do go through a traumatic experience. This will add another layer to the therapy service, she said.
“I have a 12-year-old that has ADHD and anxiety… (and) I can relate to these families. I've been in the (same) place where a lot of them are — where you just don't know who to turn to; you don't know where to go; you don't know what to do next,” McCurry said. “... I feel like a lot of times I'm treating the parent as much as I am the child. You're not alone, please reach out if you struggle. I don't care if it's after hours. I don't care if it's on a weekend please, because I've been that mom.”
Wonderment Therapies offers home and community based services, which means they are going into a child’s natural environment. They also try to get into classrooms throughout the school district, educating students on mental health programs, skills and services.
“I worked in the clinic before coming on (with) Jenna and I saw a lot of the same patients. And just seeing kids in the home, it's so much more effective. In the clinic, they come in and you just get this little snapshot of them for 45 minutes or an hour a week, sometimes twice a week. But you don't see their dynamic, you don't see how the home works and how the structure is and you don't see how they interact with mom and dad and siblings and maybe neighborhood friends and their routine. And so you get them in their own setting in their own environment and you see, it's so much more real life and it's so much more effective because you're dealing with things on the spot as they're happening versus trying to simulate in the clinic,” McCurry said. “Even for me, just the sibling piece of things has been huge because ...they're around, they participate, they'll do the same thing as we are; I can see the dynamic between them. I can even step in and correct their way of thinking sometimes and involve them. So you're essentially treating almost the whole family.”
'On their last straw'
Though McCurry is a North Dakota native, prior to her arrival in Dickinson she spent nearly 10 years working in Billings. Now back in her home state, she has witnessed firsthand the lack of mental health services throughout the state as compared with the Big Sky country.
“There are mental health services on every corner. (If) you need a child psychiatrist or a child psychologist, just look — you’ll find one. When we were moving here and I was getting ready to transfer care, it was like, ‘There is no one,’” McCurry said. “I think the closest child psychologist is Bismarck. (But) even then, it's not direct access. To get in there, you have to have a referral for your primary care. I don't know if it's just a difference in the state laws and mandates, but in Billings, you just called, made an appointment and went in. So it's much different.”
McCurry continued, “I think some of it is just the demographic. If you look at medical hubs, Bismarck is the medical hub and that's where people go… Billings is the medical hub for that region... Western North Dakota really didn't blow up in population until the last 10 years and then it was all oil it wasn't. So I think it's just going to take some time for the families that have stayed for those services to fall into place.”
Many families are forced to travel to either Fargo, Bismarck, Billings or elsewhere to receive care, McCurry added.
“Or it takes three months to get in. When you have a child who is on their last straw and on the parents' last nerve, they don't have three months to wait. So it gets to the point where these parents are like, ‘I'm going to take them to the ER, if I don't find a way to effectively deal with these children,’” she said.
When some people view mental health, there are misconceptions, McCurry noted.
“They think back to the ‘80s or the ‘90s when kids were given Ritalin and then they didn't have a personality or they were snowed. We've come so far and so, a lot of times I relate to them would you deny a diabetic insulin? No. Would you deny someone their glasses? No, how are you going to function and drive without your glasses? It's the same thing for a child that has mental health needs. Their brains are not functioning normal per se,” McCurry said.
Wonderment Therapies is currently based on referrals via pediatricians, primary care doctors, etc. From there, they will contact the individual seeking care and schedule an appointment.
On Sept. 1, Wonderment Therapies will be opening a clinical space in downtown Dickinson.
Trying to fill the gap with mental health services has been overall rewarding, but it is still an uphill battle for Wonderment Therapies’ personnel.
“There's still the stigma that surrounds mental health. In North Dakota, especially in western North Dakota, it's buck up and you're okay. It is what it is, we'll get through it type of thing versus seeking out that help,” Weisz said. “Who cares if somebody knows that you're being treated. Ultimately, it comes to your quality of life, it comes to your happiness. What's most important? It is quality of life.”