INSIDE THIS ISSUE
THEME: MENTAL HEALTH
In this quarterly newsletter, you will find materials regarding training opportunities, department updates and additional tools related to health equity. The goal of this newsletter is to disperse valuable information on ways to improve health equity in North Dakota.
- Term of the Quarter Psychotherapy
- Quarterly Article "The Need for Diversity in theMental Health Workforce"
- Health Equity Champion Spotlight
- Community Engagement Unit [Health Equity Office] Collaborations
- Expanding Equity
- Training Opportunities and Resources
- Song of the Quarter
- Quote of the Quarter
- Contributions to this Issue
TERM OF THE QUARTER
Psychotherapy
(sometimes called “talk therapy”)is a term for a variety of treatment techniques that aim to help a person identify and change troubling emotions, thoughts and behavior. Most psychotherapy takes place with a licensed, trained mental health professional and a patient meeting one-on-one or with other patients in a group setting.
QUARTERLY ARTICLE
THE NEED FOR DIVERSITY IN THE MENTAL HEALTH WORKFORCE
Written by: Morgan Pizur-Kranc, Health Equity Office Graduate Assistant
According to researchers Moreno and Chhatwal (2020), the social or minority stress theory postulates that socially disadvantaged groups experience more stress and stressors with limited access to quality resources than advantaged groups. The resulting end product of these factors is increased mental disorder rates. Levels of intersectionality and adversity that ethnic-minority groups face have the potential to worsen mental health outcomes.
The Association of American Medical Colleges and the American Psychiatric Association (APA) are committed to diversity and inclusion. They work to best serve the needs of underserved populations and bring awareness to mental health disparities. Other organizations such as the Accreditation Council for Graduate Medical Education added a mandate to monitor diversity and equity-specific standards for residency programs, faculty training and cultural competency training. These organizations work to increase the diversity of the mental health workforce to reflect the needs of underrepresented groups.
Researchers estimate that only 6% of the traditionally underrepresented population are working in mental health professionals. This underrepresented population includes women; people of color; lesbian, gay, bisexual, transgender, queer or questioning and two-spirit(LGBTQ2S+); transgender and non-gender conforming peoples, which has been recorded to suffer higher rates of mental illness compared to their White counterparts. The urge to build a more diverse workforce stems from the desire to combat implicit bias from the provider and patient point of view. When both parties feel respected and valued, patient-provider interactions can lead to better health outcomes by cultivating a trusting relationship. Addressing the lack of diversity in the workforce can open opportunities to combat bias and prejudice in mental health treatment for marginalized groups. Having a broader spectrum of providers increases representation and breaks down barriers to quality mental health care.
Another way to yield more positive outcomes is to use the Culturally and Linguistically Appropriate Services Standards to create respectful services that respond to cultural beliefs, language preferences, health literacy and overall communication. In this case, mental health literacy should be advocated for the patient to reach a positive mental state and understand disorders, stigma, treatment and ways to seek help. Using appropriate and inclusive language can foster trust and establish good rapport between the provider and patient. Psychiatric care is deeply dependent on quality oral communication, which ensures providers have the most up-to-date and effective set of tools available. The use of translators has been used to bridge language gaps, especially for those who have limited ability to read, write and/or understand English.
Addressing cultural competency for mental health professionals is an important facet of care since culture and its associated influences on a patient vary widely. A person’s culture may help shape the type of care that they need, whether they seek care to begin with and how the treatment is given. Bringing awareness to underserved population needs will aid in advocating for higher quality care and a more individualized experience for each patient.
Interested in this topic? Check out these resources:
Mental Health Disparities Diversity and Inclusion in Psychiatry Mental Health Resources Help is Here
HEALTH EQUITY CHAMPION SPOTLIGHT
Each quarter, we recognize individuals in our state who are working as champions for health equity. This is your chance to be featured for your work or to nominate someone you know!
This quarter, we are highlighting some of the North Dakota Department of Health and Human Service's Health Equity Ambassadors! Ambassadors receive public health training and host health events in their campus communities. Please read on to learn more about them and their amazing work. If you would like to learn more about this program, please contact the Community Engagement Unit (hhs-engagement@nd.gov).
SHAENA RICHARD
HEALTH EQUITY AMBASSADOR
Written by: Ruth Nwatu, Public Health Associate
Health Equity Ambassador, Shaena Richard, is a senior at Minot State University (MSU) pursuing a Nursing Degree. She is an exemplary student devoted to promoting public health knowledge on campus and in the community.
Shaena’s role as an ambassador includes promoting health equity, influencing positive behavior change through peer influence and gathering community health concerns. Since Shaena became an ambassador, she has devised new health education and promotion programs to meet specific or at-large needs of the local community, enhanced awareness of health resources, worked to connect individuals with programs and educated community members on disease prevention, vaccines and mental health resources.
Shaena has gone above and beyond her duty as an ambassador by hosting various events that focus on disease prevention and health promotion. These include immunization pop-up clinics for COVID-19 vaccines, COVID-19 at-home testing kits, blood drive events, social media campaigns, tabling, handing out informational packets on different health equity concerns in the community and informing individuals on community resources.
When asked why she wanted to be a health equity ambassador, Shaena responded,
"TO LEARN MORE ABOUT HEALTH EQUITY AND TO THEN TEACH WHAT I HAVELEARNED TO OTHERS ABOUT HEALTH EQUITY ISSUES AND PROMOTE PUBLICHEALTH KNOWLEDGE IN THE COMMUNITY."
As an advocate for health equity, Shaena understands the impact of social determinants of health from a public health lens. She hosted a blood drive on her college campus to improve the current national blood shortage crisis and help save lives. Hosting a blood drive on campus allowed students at MSU to donate blood and reduced the barrier of transportation, which often limits people from being able to donate even if they want to.
In her own words,
“NOT ALL INDIVIDUALS HAVE A CAR OR MONEY TO GO TO A BLOODDONATION SITE. IT WAS GREAT TO HOST AN EVENT THAT BENEFITED THECOMMUNITY (WITH THE HUGE BLOOD SHORTAGE) AND INDIVIDUALS ONCAMPUS TO HAVE AN EASY AND CONVENIENT OPPORTUNITY TO DONATEBLOOD IF THEY SO WISHED.”
Shaena affirms the importance of addressing health equity issues in North Dakota by improving the resources that increase positive health outcomes. According to Shaena, this means going beyond sharing information on the resources available for communities by providing more opportunities that everyone can take advantage of to live a healthier life.
Shaena is currently working in labor and delivery and the neonatal intensive care unit (NICU) for her nursing school practicum and has completed almost 200 hours. As she steps into the next path in her journey this May, graduating with a Bachelor of Science (BSN) in Nursing, we are confident this is only the beginning for Shaena!
AMY BELGARDE
HEALTH EQUITY AMBASSADOR
Written by: Beverly I. Anaele, Public Health Associate
Pursuing multiple degrees while balancing family, traveling and community service takes a special kind of tenacity. Amy Belgarde, a United Tribes Technical College (UTTC) student and a Health Equity Ambassador, demonstrates that quality and much more. With the drive to earn, not one, but two degrees in her life, there is little surprise to hear that many describe Amy as a go-getter. While Amy went and earned her Bachelor of Science (B.S.) degrees in both criminal justice and business & office, she decided she wanted to go back for more! Amy is completing her third degree, a Bachelor of Science degree in business administration, to build a business to support her native reservation, the Spirit Lake Tribal Reservation.
She describes herself as a hands-on person, most clearly seen by the products she creates. When the COVID-19 pandemic hit, she turned hands adept in woodwork and tinkering into hands that sewed masks for her entire family. As a Health Equity Ambassador, Amy extends her dependable servant leadership to her whole campus community.
But Amy’s story is personal. She battled with the COVID-19 virus herself and suffered its effects. So, when the Community Engagement Unit's [Health Equity Office’s] Ambassador Program came along, she was more than willing to get involved.
"I HAVE ASTHMA, AND I HAD CONTRACTED THE VIRUS. IT HAD SCARRED MY LUNGS AND I WANTED TO LEARN MORE ABOUT IT, AND [THE AMBASSADOR PROGRAM] HELPED ME TO. SO I’M REALLY GRATEFUL FOR THIS [OPPORTUNITY] BECAUSE IT HELPED ME BE EVEN MORE INVOLVED."
Since becoming an ambassador, she has received training on rapid COVID-19 testing kits and has assisted a campus nurse by organizing client files and recording vaccinations. She has also created COVID-19 care packages for two separate events, the more recent occurring at a UTTC job fair. At that event, she developed inserts on reducing the risk of COVID-19 infection in the workplace.
There is still more work to be done to advance public health and address community needs, and Amy is up for the challenge. With one year left until graduation, she is sure to help and encourage others through her servant leadership.
STEFANI THOMAS
HEALTH EQUITY AMBASSADOR
Written by: Beverly I. Anaele, Public Health Associate
Nestled in Ward County, North Dakota, lies a fierce advocate for healthcare, Stefani Thomas. Stefani was born and raised in Minot, where she also weathered the
historic 2011 Souris River flood. She got married during the flood’s peak and later deepened her hometown roots, now attending Minot State University (MSU) as a nursing student, a long-time dream realized. Now, Stefani is also a public health and health equity champion. When asked to describe her view of health equity, she eloquently illustrated a world of equitable access.
"FOR ME, HEALTH EQUITY IS THAT EVERYONE HAS THE ACCESS AND THE MEANSTO THE GOODS AND THE SERVICES THAT THEY NEED TO MAINTAIN AND ACHIEVE THEIR OVERALL HEALTH—THEIR PHYSICAL, THEIR MENTAL, THEIR SPIRITUAL [HEALTH],”
If she had to pick one healthcare concern to fix tomorrow, Stefani would improve access to mental health services, particularly among children. She does not, however, only envision a more equitable world, but she also helps bring it about. In March 2022, she and her MSU ambassador team hosted a campus blood drive to combat the nationwide shortage of blood.
“WE’D ALL KIND OF SEEN THAT THERE WAS [A NATIONWIDE BLOOD SUPPLY] SHORTAGE AND WE THOUGHT, WELL, WE SHOULD DO SOMETHING.”
So, they did. They worked with 14 donors to collect enough blood to help 42 patients in need.
Stefani has engaged in two COVID-19 advocacy events: one to promote an on-campus vaccination clinic and another to hand out at-home test kits. Her enthusiasm and passion for health care contributed to an increased campus vaccination rate. Her team now plans to host a period poverty event, a subject she is learning more about each day. While talking about her experience thus far in the ambassador program, Stefanivoiced the fun she’s had and the new friendships she’s made.
When she’s not on the frontlines, Stefani makes good on doing the things she loves. You can find her baking delectable desserts in the summertime, enjoying time with her family or a million miles away somewhere between the pages of a captivating novel.
Stefani will be graduating with a Bachelor of Science degree in nursing in May. She’s keeping her eye on several avenues but recently discovered a love for pediatric health.
“I’M DOING MY PRACTICUM IN PEDS [PEDIATRICS] IN THE HOSPITAL, AND I’M LOVING IT. I DIDN’T REALLY EXPECT THAT. I’LL HAVE TO SEE WHERE IT [ALL] BRINGS ME.”
Wherever that is, Stefani is bound to inspire change and deliver improved health outcomes for those she serves.
ACHILLE TENEKEU DJUAKEN
HEALTH EQUITY AMBASSADOR
Written by: Juliana Gyamfuah Antwi, Graduate Assistant/Intern
Achille Tenekeu Djauken is a Cameroonian and a third-year student at Minot State University (MSU). He has a great passion for science, and this dedication shows through in his efforts toward a double major in chemistry and biology. Achille joined the Health Equity Ambassador Program last year and feels honored to have the opportunity to be a part of a venture that promotes health equity in his community. Two events he helped organize on the MSU campus included a blood donation program in which they partnered with Vitalant, a blood donation group and a COVID-19 vaccination program.
As a healthy equity ambassador, Achille works together with his colleagues to serve his student community with the goal of extending aid to broader North Dakota. Achille’s team works to roll out a program each month and is currently working on a Period Poverty event, where they plan to provide sanitary materials to women on campus at no cost.
One project Achille considers to be his greatest achievement is a recent COVID-19 vaccination clinic which had a large turnout. He voices pride in being part of a group with great mentors and flawless communication, all of which portray a united front. Organizing events can be stressful at times, but the fulfillment that comes with every project always leaves him looking forward to the next one.
TO ACHILLE, HEALTH EQUITY IS ABOUT SERVING UNDERSERVED POPULATIONS THAT EXPERIENCE DISPARATE ACCESS TO HEALTH CARE; AS SHOWN BY HIS UNRELENTING EFFORTS TO ENSURE THAT THESE GROUPS RECEIVE THE HIGHEST LEVEL OF HEALTH CARE THAT MEETS THEIR NEEDS.
Achille plans on becoming a physician, like his father, who has been an inspiration to him. Achille is passionate about health care and health equity; becoming a physician will allow him the opportunity to fulfill this passion.
COMMUNITY ENGAGEMENT UNIT [HEALTH EQUITY OFFICE] COLLABORATIONS
Centers for Disease Control and Prevention Initiatives to Address COVID-19 Disparities. The CE Unit [HEO] is actively seeking a collaboration with the Islamic Society of Fargo Moorhead. The goals of this collaboration are to: (1) promote COVID-19education, outreach and immunizations among populations in the Fargo-Moorhead area; (2)
address barriers to immunizations (COVID-19 and others); and (3) understand vaccine hesitancies and create culturally appropriate materials to address those hesitancies. For more information, please contact the Community Engagement Unit (hhs-engagement@nd.gov).The Make Every Connection Together Conference. The CE Unit [HEO] is collaborating with the ND Health and Human Services (ND HHS) Division of Sexually Transmitted and Bloodborne Diseases to organize an exciting health equity conference in June. For more information, click here or contact the Community Engagement Unit (hhs-engagement@nd.gov).
Our Smallest Warriors COVID-19 Books. The CE Unit [HEO] is partnering with the Johns Hopkins University’s Center for American Indian Health to deliver free children’s books on COVID-19 resiliency to in-state American Indian families and organizations. Recipients can order their copy here (expired). For more information, please contact the Community Engagement Unit (hhs-engagement@nd.gov).
Survey on Tribal Nation Food Insecurities. The CE Unit [HEO] is collaborating with the ND HHS Health Statistics & Performance Section to build a survey on tribal nation food insecurities and changes pre/post-COVID. For more information, please contact the Community Engagement Unit (hhs-engagement@nd.gov).
Increasing Vaccination Rates. The CE Unit [HEO] is collaborating with the ND HHS Special Supplemental Nutritional Program for Women, Infants and Children (WIC) program to increase the vaccination rates of WIC clients. For more information, please contact the Community Engagement Unit (hhs-engagement@nd.gov).
Expanding a Cass/Clay County Food Survey. The CE Unit [HEO] is collaborating with Great Plains Food Bank to expand a Cass/Clay County food survey to more regions of the state and more cultural groups. For more information, please contact the Community Engagement Unit (hhs-engagement@nd.gov).
- Youth Public Health Programming. The CE Unit [HEO] Youth Advisory Board (YAB) is initiating a TikTok campaign that highlights youth-related health issues. Check out the first TikTok release here (discontinued)! Youth Advisory Board activities also include a task force for the ParentsLead program and transitional phase assistance. For more information, please contact the Community Engagement Unit (hhs-engagement@nd.gov).
EXPANDING EQUITY
PERSONS WITH DISABILITIES
Written by: Jorden Laducer, CE Unit [HEO] Special Populations Coordinator
Welcome to Expanding Equity! Each issue, this new section will provide specialized health equity and cultural awareness information about one special population. In this issue, we will look at a special population: persons with Disabilities.
The term "persons with disabilities" refers to all people with disabilities, including those who have long-term physical, mental, intellectual or sensory impairments that, when combined with various behavioral and environmental barriers, prevent them from participating fully and effectively in society on an equal basis with others. Many social barriers for people with disabilities have been removed or reduced since the Americans with Disabilities Act was enacted in 1990. However, more work needs to be done to assist people with disabilities to become more independent and involved in their communities.
Disability is a broad term that is often difficult to define. A variety of professionals and organizations use the term disability but in a variety of contexts. Numerous disabilities can be identified as falling under the categories of health, physical, learning, psychological and other cognitive impairments. Some people are born with a disability, while others develop them as they age or as a result of an injury or illness. People with disabilities may require interventions to remove environmental or social barriers. Disability does not imply an illness or incapacity to learn, work or perform a task. By understanding the population with disabilities, community leaders can better align services to meet the upcoming and/or current needs of the community.
NEW INCOME ELIGIBILITY FOR CHILDREN AND YOUTH IN NORTH DAKOTA
According to the NDDoH Division of Special Health Services (SHS), one out of every five children in North Dakota has a special healthcare need. While many of these children are covered by health insurance, SHS programs fill in the gaps for over 100 medically eligible conditions and promote access to quality health care.
The eligibility guidelines for treatment services have increased as of May 1, 2022, based on changes in federal poverty levels. The change raises the amount of income that a family can earn while still qualifying for services. A family of four can earn up to $51,348 annually (or $4,279 per month per household) and still meet the income eligibility requirements.
SHS promotes services that improve the health and well-being of people with special health care needs and their families, thanks to funding from the Maternal and Child Health Block Grant. The SHS Financial Coverage Program assists families in paying for medical services for eligible children, youth and young adults from birth to 21 years old who require specialty care to diagnose and treat chronic health conditions. Dental services, medications, therapy, nutrition services, laboratory tests and medical equipment are examples of medical services.
DISABILITY IMPACTS IN NORTH DAKOTA
Although “persons with disabilities” sometimes refers to a single population, this is actually a diverse group of people with a wide range of needs. Two people with the same type of disability can be affected in very different ways. Some disabilities may be hidden or not easy to see. To better assist people with disabilities, everyone can play a role in supporting more inclusive state programs, and community health care to help people with, or at risk for, disabilities be well and active in their communities.
NORTH DAKOTA PROGRAMS
Interested in finding out what services North Dakota has to offer for people with disabilities? Explore North Dakota Health and Human Service's website for topics relating to:
- Developmental Disabilities Division
- Division of Vocational Rehabilitation
- Disability Determination Services
- Early Intervention Program
- Vision Services
- Independent Living Services
- North Dakota State Council on DevelopmentalDisabilities
- Client Assistance Programs
- Medicaid's 1915(c) Waiver
- Autism Services/Autism Waiver
- Children with Disabilities Waiver
- Children's Medically Fragile Waive
TRAINING OPPORTUNITIES AND RESOURCES
North Dakota Mental Health Services and Resources | North Dakota Health and Human Services
Living Mentally Healthy | Mental Health America
Disaster Distress Helpline | U.S. Department of Health & Human Services
SONG OF THE QUARTER
Who You Are
Jessie J
QUOTE OF THE QUARTER
”HEALING TAKES TIME, AND ASKING FOR HELP IS A COURAGEOUS STEP.”
- Mariska Hargitay
CONTRIBUTIONS TO THIS ISSUE
- Morgan Pizur-Kranc
- Ruth Nwatu
- Beverly I. Anaele, MPH
- Valentina Asiedu
- Juliana Antwi
- Jorden Laducer-Dix
- Hannah Anderson
- Krissie Guerard, MS
- Sara Upgren
- Marie Moe
- Kim N. Mertz, RN, BNSC
HEALTH EQUITY MATTERS IS A NEWSLETTER PRODUCED FROM NORTH DAKOTA HEALTH AND HUMAN SERVICES COMMUNITY ENGAGEMENT UNIT.
We welcome your feedback. Email us here (hhs-engagement@nd.gov).
The NDHHS CE Unit [NDDoH's Health Equity Office] works to understand and reduce health disparities among all North Dakotans. Our goal is to reduce rates of disease by providing opportunities for interventions and improving access to health care, thereby striving for the highest quality of health for all North Dakotans.