Rising to the occasion

UND-led grant team answers skyrocketing demand for mental health guidance amid COVID-19 pandemic

The core staff for the Mountain Prairie Mental Health Technology Transfer Center posed over Zoom for a team photo orchestrated by Associate Professor Shawnda Schroeder (middle, top row). The team has rapidly expanded its mental health resource output in wake of COVID-19. Image courtesy of MHTTC.

Mere months ago, UND project coordinator David Terry counted himself lucky if his team’s seminars for mental health professionals drew 40 or 50 attendees.

That was then.

Now, the Zoom seminars offered by Terry and the Mountain Plains Mental Health Technology Transfer Center (MHTTC) draw viewers by the thousands, as teachers, psychologists and others from across a six-state region “Zoom” in to learn about pandemic-related programs, identifying mental health issues and best practices.

“I have a heart monitor watch, and I was hovering around 67 (before the first max-capacity seminar), then it was 80,” Terry said.

“When the session started, it spiked all the way up to 120. You think about doing something online and that it’s not going to be as intense, but would you go up in front of an audience of 1,000 people at a conference, and not feel some pressure or nerves?”

Dennis Mohatt, MHTTC co-project lead and Western Interstate Commission for Higher Education director, leads off a Zoom session by introducing the six states and multiple institutions comprising the Mountain Plains region. YouTube screenshot.

Responding to demand

The Mountain Plains Mental Health Technology Transfer Center is one of 12 centers that make up the larger MHTTC Network. The network is funded by the Substance Abuse and Mental Health Services Administration, the agency within the U.S. Department of Health and Human Services that leads the country’s efforts to advance behavioral health.

Thomasine Heitkamp

UND Chester Fritz Distinguished Professor Thomasine Heitkamp, principal investigator on the $3.8 million grant that helps pay for the Mountain Plains center, described the work of her team as combining research, training and technical assistance for those on the frontlines of identifying mental health crises in their communities.

In October 2019, UND Today wrote about a supplement of the grant providing mental health training webinars, resources and on-site training to faculty and staff at rural schools in North Dakota and South Dakota.

Before the COVID-19 pandemic swept through the United States this spring, work on the grant was moving as-planned. Then the world of healthcare flipped. Nearly all of the country faced potentials of social isolation, quarantine and stress – all of which translated to immediate concerns for mental health. Also, telehealth quickly became the only possibility for a majority of healthcare delivery and consultation.

As the pandemic took hold in the Mountain Plans region, Heitkamp started getting calls from providers who were concerned about its implications.

“COVID created such a layer of complexity,” Heitkamp said. “And I felt like the University of North Dakota and the MHTTC team had such a good capacity to respond.”

Shawnda Schroeder

In March, Heitkamp and Associate Professor of Rural Health Shawnda Schroeder put together webpages of resources for educators, as well as parents. They, along with Terry, started a weekly webinar series exclusively focused on telehealth, called TLC (for Telehealth Learning and Consultation) Tuesdays.

The mass transition to telehealth prompted a deluge of questions from health providers about federal regulations, billing, reciprocity, working with children and more, said Heitkamp.

All of a sudden, audiences for webinars spiked. The 40-50 regular attendees who were invested in mental health work turned into thousands of people tuning in and accessing the archived sessions. The scope of MHTTC’s work exploded.

“We had already been doing trainings remotely; we’d already been doing webinars; and we had the website and the platform established,” said Schroeder. “So while the type of work we were doing didn’t change, the topic area and the speed at which we had to do things changed exponentially.”

David Terry

Now well into summer, Terry described the adjustments to unprecedented demand as “process refinement.” Early on, everyone on the team felt the pressure of getting things right while working remotely. Terry, charged with the technical tasks of hosting Zoom sessions, said the first TLC Tuesday session, where his heart rate spiked, was planned and executed within a week.

As the topics of webinar sessions have shifted to topics previously established in the grant’s work plan, amid the COVID-specific conversations, Terry said there have been large amounts of repeat attendees.

Since that first TLC Tuesday, the MHTTC team has hosted 26 trainings online. Since August 2019, through July 2020, more than 5,500 people have attended grant-supported events.

In addition to archived training sessions recorded through Zoom, the MHTTC website has a variety of resources to download in relation to mental health and the COVID-19 pandemic. MHTTC website screenshot.

‘We felt such a strong need’

Today’s version of the MHTTC website is filled with COVID-19-adjacent information, downloadable resources and archives of past seminars.

Schroeder commented on the diversity of topics covered – ranging from suicide risk and screening in primary care, to working with transition-aged youth moving to college campuses, to farm stress – all of which have video recordings and accompanying PowerPoint slides available through the website.

“Every training now, no matter the topic, has an element of the pandemic included,” Schroeder said. “Our presenters are all going to talk about mental health programs, and how they worked pre-COVID. Then the second half of their session is, ‘But now what?’”

That “shared element,” as Schroeder phrased the pandemic, has fueled the team to fill in the gaps around mental health services.

“Thomasine, David and I have always felt mission-driven by this particular grant, and knowing that mental health training is needed and has a direct, visible impact,” Schroeder told UND Today. “Post-pandemic, we felt such a stronger need. I’ve never been working extra hours because someone demanded it, but because nobody else was meeting those needs.

“We aren’t frontline workers, per se, preventing COVID-19, but we knew that people were having mental health crises. And if there is a way we can help them, then we want to do that.”

Following Schroeder’s remarks, Terry commented that in his years working in direct care, programs such as the MHTTC didn’t exist. He always felt in need of training, or for a place to access resources tailored by experts and professionals.

“I’m personally very driven and see a real connection to the work that we do, getting this information to people that need the service the most. So it’s really exciting. I think it’s a great grant to be a part of.”