To facilitate the process of expanding community-based mental health support within three rural communities in South Dakota
What has been most instrumental to your progress?:
We conducted listening post in each community in which community leaders were invited to provide input on their perceptions about mental health challenges and to weigh in on perceived service gaps and the mental health needs in their communities. This was an important step for each community as a broad cross section of leaders and agencies together to meet one another and have a guided discussion. Many people didn’t realize the magnitude of the issue and additionally, were not aware of the existing services already in place. This was an interesting development as our communities are small and yet we need more education and awareness of mental health services.
The work team retreats that NAMI South Dakota convened for all of our communities to gather and get to know one another was the most important to me. Although I know people from Milbank, Sisseton and Watertown, I didn’t know that they were having the same issues that we have in Aberdeen. Working together with others made me feel like “We can do this.” Our families and youth deserve more community-based services.
I think that approaching this project from the aspect of Wellness was very important. Our community is just over 3,000 people and so the topic of mental illness can be very difficult to discuss. When we began bringing people to talk about how to stay well in a chronic disease management approach and then introduced mental illness education it helped us address the issue of the mental illness stigma is our community.
Key lessons learned:
The key lesson that I learned was that we have to be inclusive of the whole community. It isn’t just counselors and the hospital that need to be involved. Law enforcement has a huge role in this issue and we need to work with them. We can’t assume whom we think this issue is important to. We have to reach out with good educational materials and let people know how this impacts each of us.
Our key lesson and I guess you might characterize it as a failure was that we cannot rely solely on the Community Mental Health center. Many of them are completely overworked and spread too thin. They struggle with keeping the basic needs addressed. We have to find more families who want to be involved and because of the strong stigma and lack of education we are finding it a bit of a challenge to identify who wants to be involved. We need to be more involved in community events so that people can get to know us and develop some trust.
Reflections on inclusive, collaborative or resourceful problem-solving:
We believe that our first year’s work centered on being inclusive and collaborative. The listening posts in each community allowed us to bring a wide range of voices and opinions to the table and people were able to share their frustrations, concerns, and possible solutions. Even in this larger group setting, some members made connections with others that they hadn’t known shared a similar family issue with mental illness and bonds were formed. Many comments from the listening posts reflected the feeling that “I thought we were the only family.” Helping others from disparate backgrounds understand that they are not alone in their experiences helped develop and sustain the conversation beyond the listening post and brought new volunteers to the discussion.
We also saw the community tap into each other’s resources. For example, when the Milbank community identified that they would like to have trained teachers for the NAMI Basics class for parents and caregivers, the Milbank hospital provided the meeting space and meals free of charge for this two day training. Community members from the other communities were invited and attended this free training.
Other key elements of Community Innovation:
Many members of each of our communities stated that being inclusive, collaborative and resourceful were the foundational elements for this work. However, each community mentioned that they needed to be clear communicators, have consistency in their message to the community and be open to new perspectives and opinions. Mental health challenges are often misunderstood and the group feels that it is imperative that each of our leaders and participants has quality education about mental illness so that we can be ‘one voice’ in this work.
Understanding the problem:
This work has allowed each of our communities to understand the need for mental health supports not only in their own communities but also across the state and region. In order to make a significant change in how we address mental health challenges, we needed to understand the scope of the problem and become more educated about legislative and reimbursement issues. As we continue to learn as a group and invite others into the work team, each member is feeling more confident in providing education to their community members and becoming an advocate for more inclusive services. In year two, we hope to test and implement possible solutions with one another to reach a breakthrough that our communities can sustain.
If you could do it all over again...:
Never underestimate the power of the stigma associated with mental illness. One of the biggest challenges that our community leaders face is the identification, recruitment and retention of volunteers to help us with this work. As our state did not expand our Medicaid program, we have very few payment streams for community based mental health supports such as peer-to-peer mentoring. As such, our core group feels that this Community Innovation process will provide us the opportunity to partner with one another to fill these services gaps for our families and young people.
One last thought:
We are overwhelmed by the amount of work the four communities have done together in one year. The commitment and passion that has been ignited by this project has helped our leaders and volunteers feel that someone is listening; that there is progress being made. This grant award has validated that we have a significant problem that needs to be addressed and has built the confidence of our leaders. Collaboration across the NE region in our four communities has strengthened the commitment to fighting stigma and providing activities and resources for our community.