Mental Health
Transforming Behavioral Health Care in North Dakota
The transformation of North Dakota's behavioral health system is currently underway, focusing on enhancing access to coordinated services across the state. This shift is part of a broader national initiative that began in 2014 with the development of the Certified Community Behavioral Health Clinics (CCBHC) model, aiming to address significant gaps in behavioral health care.
The CCBHC Model and Its Implementation
The CCBHC model was developed to ensure that individuals can access a comprehensive range of behavioral health services when needed. North Dakota has embraced this model, with eight regional Human Service Centers located in key areas including Fargo, Grand Forks, Devils Lake, Jamestown, Bismarck, Minot, Dickinson, and Williston. These centers offer 24/7 access to a full continuum of care, which includes crisis response and outpatient treatment services.
By prioritizing community-based care, the CCBHC model aims to reduce crises and improve continuity of care, thereby avoiding the need for institutionalization and mitigating chaos in patients' lives. The state is in the process of transitioning clinics to CCBHCs statewide, with the North Central Human Service Center being the first to achieve this certification. Certified clinics are required to provide round-the-clock crisis services, which addresses the high demand for mental health care services in the area.
Addressing Youth Mental Health Challenges
North Dakota is also focused on enhancing mental health care access for its youth, a need that has become more pronounced following a post-COVID spike in mental health issues among this demographic. This has led to increased anxiety, concerns about school attendance and grades, and a rise in thoughts of suicide and self-harm. At one Bismarck school alone, there were 25 psychiatric hospitalizations, although this number has halved since its peak.
An estimated 18,000 youth in North Dakota require treatment, yet only 73 were treated in human service centers two years ago. This number has significantly increased, with 966 youths receiving treatment in the 2023-2024 fiscal year. Recognizing that 74% of youth in the juvenile system have mental health issues, the state has piloted two programs to improve access to mental health care. These programs are part of a comprehensive System of Care that includes the Spirit Lake and Turtle Mountain reservations, as well as the Bismarck area, which encompasses the MHA Nation and Standing Rock.
System of Care and Legislative Support
The System of Care implemented in North Dakota was initiated following a 2018 behavioral health study ordered by the state Legislature, which highlighted the need to focus on youth behavioral health services. This system aims to streamline care for those facing mental health challenges and break down service barriers, ensuring a more integrated approach to care.
One of the key elements of this system is the integration of therapy and psychiatry, with providers collaborating on shared goals to enhance treatment outcomes. Regular evidence-based questionnaires are used to measure progress and make real-time adjustments to care, fostering stronger relationships between patients and clinicians. By employing clinicians as staff rather than contractors, the system aims to provide more consistent and reliable care.
Innovative Use of Technology and Accountability
North Dakota's behavioral health system transformation also incorporates the use of technology to improve service delivery. A technology platform featuring a matching algorithm and the 'My Care Journey' dashboard is utilized to track patient progress and ensure accountability in mental health care.
This platform supports the provision of both virtual and in-person therapy options, making mental health care more accessible and affordable. By analyzing engagement data, the system seeks to enhance patient interactions and reduce the time to first appointments. The focus on measurement-based care is central to improving outcomes, with an emphasis on accountability to ensure that care is both effective and responsive to patient needs.