Grand Forks woman among almost 19 percent of Americans suffering from mental illness

Dec. 22--When Veronica Dockter first walked through the doors of Mountainbrooke Recovery Center, she said she kept a ball cap on and her head down.

A little more than two years later, the Grand Forks woman diagnosed with depression and other illnesses wants the community to know she is more than a stereotype.

"People say we drain the government of money, that we're not useful, that we're not worthwhile," Dockter said. "They don't treat us as human beings, they treat us as a disability."

Years ago, Dockter said she talked about her illness and people didn't understand and grew tired of hearing about it.

"It was all I knew at the time," she said. "Now, I know wellness. I have good things to talk about."

Dockter is among the nearly 19 percent of Americans -- about 43.7 million people -- reportedly suffering from some type of mental illness, according to a 2012 survey conducted by the National Institute of Mental Health.

Even though mental illness pierces through age groups, race, gender, occupations and income levels, shame still surrounds the phrase "mental illness." But the shadows are slowly being dispelled as more and more seek treatment and speak out.

Of the 43.7 million documented mental health cases in 2012, the National Survey on Drug Use and Health recorded 9.6 million were considered serious. In the same year, 4 percent of North Dakotans and 3.9 percent of Minnesotans were diagnosed with a serious mental illness.

For as many as it affects, mental illness often is swept out of view until tragedy reminds the world of its existence.

"It's one thing to talk about this globally, but when it happens to you or your family, it's very different," said JoAnne Hoesel, director of the mental division of the North Dakota Department of Human Services. "It's at that point the stigma rears its ugly head and people can have difficulties getting what they need."

Through an eight-day series, the Herald will delve deeper into the prevalence of mental illness in the region and its effects on people, finances and communities.

From rural areas to schools, prisons, businesses and the home, experts and patients will reveal their stories to readers.

Changing attitudes

Society's perception of mental illness continues to evolve as awareness increases and new, more effective treatments are developed.

"I think there certainly has been an increase in awareness," Hoesel said. "I remember not too many years ago there was really questioning about if adolescents can have depression and whether it was a valid thing for adults as well."

Still, negative stigma surrounds it in all states, including North Dakota, where rural communities are close-knit and spread thin among the state's 70,700 square miles of prairie.

Every county in the state save for Burleigh, Cass, Grand Forks, McHenry, Morton and Ward counties is considered to be a mental health professional shortage area. That means there are 30,000 or more people for every psychiatrist, according to the Health Resources and Services Administration.

The rural setting can make providing access to treatment difficult -- though people and attitudes also can play a role.

"I'm generalizing, but I think we have an attitude in the state that people need to pick themselves up by their bootstraps and get over it -- not recognizing that these are brain-based illnesses that are legitimate," Hoesel said.

Amber Frohlich, the youngest client of Mountainbrooke at 19, said her high school friends were aware of her diagnoses, which include depression, PTSD and ADHD, but others weren't as understanding.

"People pick up on it, and they treat you like you're some sort of freak," Frohlich said. "I can't control this. I've been through hell, and I've had traumatic issues and it makes things different."

Adding to that difficulty can be communities themselves, whose members do not want mental health and substance abuse treatment facilities within their neighborhoods or city limits, Hoesel said.

Employers who do not make accommodations for those diagnosed with mental illnesses also are a challenge.

Brian Charley, 39, has lost two jobs because of panic attacks he suffers as part of his depression and anxiety. His time at Mountainbrooke has been spent talking with peers and participating in programs.

"There are a couple other people here who have the same kind of disorder as me, so we talk -- talk about things that we can do to help each other get out of panic attacks," Charley said.

The negative views and attitudes surrounding mental illness also can serve as a barrier to treatment for some, casting doubt on their condition and keeping them from seeking help.

There are bright spots, including North Dakota doubling the number of people with a serious mental illness employed in 2012. Thirty-seven percent of that group were employed compared with the national average of 17 percent, according to the Substance Abuse and Mental Health Services Administration.

Both locally and nationally, how mental illness is treated also is shifting, moving toward evidence-based practices, which rely on treatments with research proving their effectiveness.

These type of treatments result in improved conditions and fewer emergency room visits for patients, Hoesel said.

State efforts

In North Dakota, Substance Abuse and Mental Health Services Administration data indicate nearly 18,000 sought treatment from state mental health agencies in 2013. Those agencies include the state's eight regional human services centers and the state hospital located in Jamestown.

The numbers only represent part of the picture when it comes to mental health access and treatment in the state.

"It's a very difficult thing to get a handle on what's provided privately because there isn't any one (entity) that collects all that information," Hoesel said.

The state does contract with some private agencies to provide treatment services, and those patients would count toward the state's total, such as those treated at Mountainbrooke. Mountainbrooke is one of eight such recovery centers in the state.

In its 2011-2013 biennium report, the state Department of Human Services noted its mental health program spending as $13.5 million -- about 0.6 percent of the overall programming budget.

The demand for services will continue to grow with the state's population, and facilities will have to adapt to their clientele, Hoesel said.

"We have a lot of individuals coming to this state that don't have ties here," she said. "That can lead to isolation and all kinds of things that would affect someone's mental health."

Nationally, the number of mental health counselors and marriage and family therapists is expected to grow by 29 percent from 2012 to 2022, according to the U.S. Bureau of Labor statistics.

That's an addition of about 48,000 jobs. It's a similar story for substance abuse and behavioral disorder counselors who will increase at a rate of 31 percent during that time frame.

Individuals who have been diagnosed with mental illness or who have overcome substance abuse make up an important population that's also growing in the mental health treatment industry, Hoesel said, adding they are critical to the mental health service delivery system.

"These are all individuals that have been there and can be enormous and critical value to people that are entering into treatment," Hoesel said.

These people provide peer and recovery support for those choosing to seek treatment.

The importance of peer support is evident at Mountainbrooke, where clients gather formally in support groups and informally in the center's TV area -- referred to by Director Charlotte Gregerson as the living room -- and its dining area.

"Here, individuals learn that they are not alone in their struggles with their illness," Gregerson said. "The reason the program works is because individuals here support each other."

Gordon Liddy had signed up to be a member of the recovery center only Wednesday. Liddy, diagnosed with cyclothymic disorder and seasonal affective disorder, said he has nothing but good things to say so far.

"I think this environment is just great," he said.

While providing treatment and support is important, another key part of the mental health issue is educating the public about the illnesses.

Called mental health promotion, the state Human Services Department works to help people identify mental illness and let people know there are services available to them, and they are not alone.

"It's really about normalizing it," Hoesel said.

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