Q & A With Treatment Providers in the Twin Cities

Photo by weston m / Unsplash

We reached out to several providers in the Twin Cities to check in about their successes and challenges. All of them are seeing an increase in utilization of their services.

What types of substance use (SUD) / mental health (MH) disorders are you seeing more of?

Jeremiah Gardner
Hazelden Betty Ford
We are seeing more acute mental health and substance use disorders of all kinds. For much of the pandemic, people put off getting care for lots of things, including substance use and mental health issues. As a result, many people grew progressively sicker and by the time we saw them at Hazelden Betty Ford, they were struggling mightily. We saw higher levels of severe disease among our patients throughout the past couple of years. Now, on the tail of the pandemic, more people are interested and seeking care, and in many cases, they’re quite sick. The need for comprehensive services has become even more paramount. Just like it is for the country, now is becoming a time for recovery and renewal for many individuals and families.

Molly Gilbert
Vinland National Center
I think most of us in the field have witnessed an increase in mental health acuity levels over the past few years, which seems only to be increasing. We have to stabilize clients’ mental health before we can (really) start working on their SUD issues. This is something we’ve always done, but the urgency and demand for MH services has definitely increased.

Mark Berven
Nystrom & Associates
We are happy to serve an increasing number of people in both our residential and outpatient programs. Our clients come with a wide assortment of issues and needs. We continue to provide addiction treatment, and also treat co-occurring and psychiatric needs. We are the top one-stop-shop for all behavioral health needs.

Kara Frahm
Elite Recovery and Elite Empower for Women
All mental health disorders are elevated. Substance use is consistent for type, more fentanyl.

What types of challenges are you facing right now in providing services to the substance use disorder population?

Kara Frahm
Elite Recovery and Elite Empower for Women
MH challenges are high acuity and people are struggling with co-occurring more, so focusing on just SUD isn’t an option anymore.

Mark Berven
Nystrom & Associates
As Covid-19 lingers and the opioid epidemic continues, our greatest challenge is to keep up with the growing demand for treatment. We are pleased to offer hybrid treatment and services in 24 licensed facilities around the state, making it possible to come in person and to meet client needs with a remote option.

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Jeremiah Gardner
Hazelden Betty Ford
Not only are the people who grew sicker during the pandemic beginning to seek care now in greater numbers, but so too are people who are earlier in the progression of their substance use disorder. The continuum of care needs to expand on both ends—we need more options for people with mild and moderate substance use disorders and we need more resources and delivery mechanisms to support individuals and families through the long-term process of recovering from severe SUDs.

We’re also seeing more people reach out for mental health care first. The reality is that most of our patients have co-occurring substance use and mental health conditions, but many may identify one before the other. Our responsibility as caregivers is to widen the door and meet people where they are, and to, in fact, offer many doors so that behavioral health care is accessible as possible.

Other challenges we’re tackling include workforce demands―hiring enough skilled clinicians to keep up with demand―and of course fentanyl, a particularly poisonous opioid that is now commonly laced into many substances sold illicitly, and responsible for the nation’s continued rise in overdose deaths.

Molly Gilbert
Vinland National Center
That not all counties nor providers are on the same page regarding Direct Access and how it works. Then of course, some insurance companies creating more barriers for their clients to access care.

What successes are you seeing in delivering services to clients with SUD?

Mark Berven
Nystrom & Associates
Every day we see people getting better and building a life in recovery. Addiction is treatable!

Jeremiah Gardner
Hazelden Betty Ford
The longer patients and families engage in a continuum of comprehensive care and support services, the healthier they tend to report feeling, so we see a lot of success when that happens. Recovery is everywhere, and thousands of our patients continue to initiate and sustain recovery every day, providing a constant, powerful source of healing and hope for those who are struggling.

Molly Gilbert
Vinland National Center
I think we all get to witness miracles in this field of work daily. Remembering these success stories during challenging times is important for all of us, and is a great reminder of why we do what we do every day.

Kara Frahm
Elite Recovery and Elite Empower for Women
Being able to deliver a full continuum of care (from intervention to residential and everything in between) whether it be within our organization or because of our strong community partnerships. Our team is strong and we act quickly, so seeing potential clients get into the right level of care fast and also watching our groups grow in numbers that we have not seen before. Utilizing treatment coordination and peer recovery is helping our clients address their MH issues alongside SUD. We see each person as an individual and believe client-centered care is ideal. Because of this, we are seeing more people feeling a sense of belonging and getting the specialized care and/or wrap around services for a total package recovery.

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Is there anything else you can share with us about what you are seeing in the field?

Mark Berven
Nystrom & Associates
Treatment is, more and more, happening on a continuum of care. No matter where a person enters treatment, they will slide up or down in intensity of services to the correct level of support. This is determined by a client’s progress and behaviors. People are not “discharged” from treatment but moved to the appropriate level of care.

Molly Gilbert
Vinland National Center
I believe that we are extremely fortunate within the state of MN to have so many great resources for people who are looking for and wanting help. Whether it be SUD detox services or mental health emergency care; SUD services and MH combined; from eating disorders to disability specialists, to step-down programs like sober living or supportive housing, we are truly fortunate to have some of the best in the field within our midst. I rely on these partners daily in trying to help people get the proper care and services they need, and am so grateful to work with these outstanding professionals who care deeply about the people and services they provide.

Jeremiah Gardner
Hazelden Betty Ford
Navigating health care is not easy. Patients need us to facilitate access, not just provide it. That means creating systems where there is no wrong door to entry, and making sure we are able to provide what they need, when and where they need it. We are continuing to invest in both facility-based care as well as new digital and virtual pathways for patients that empower them to engage and stay engaged. It’s a hybridized world now, and we’re embracing the opportunities that presents for our patients.


A special thank you to the providers who participated in our survey.

Last Updated on September 9, 2022

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