Grief for the Ending, Gratitude for the Experience

In December of 2016, North Memorial Health opened the doors of its outpatient mental health clinic.  The clinic was developed in response to a Community Health Needs Assessment that identified Mental Health and Addiction as critical community needs for the healthcare system to address.  Empowered to develop a clinic that would meet those needs, a physical space was built out, a team of providers was hired, and the existing higher level of care programming, PHP and IOP, was relocated into a new, beautiful clinic in the Robbinsdale Medical Building.  

The PHP and IOP that were already up and running prior to the clinic launch were renowned as the best offering of higher level mental health care in the metro.  Developed through the leadership of Margaret Gavian, PhD , Brian Johns, MD, MFA , Jeff Sawyer, MD and others, the programming and therapeutic approach was based on the model of Mind Body Medicine, weaving in emotion centered processing within groups with holistic mindfulness practices that helped people return to a healthy and accessible sense of embodiment and empowerment.  Each program included trauma sensitive yoga and the groups were led by therapists and psychiatrists who envisioned a different way of supporting patients experiencing distress by helping them recover a sense of safe, mindful awareness and agency that would allow them to reclaim a different sort of existence in the world.  

I had the opportunity to join the department in the early months after the clinic opened and was drawn by the vision articulated by R. John Sutherland, PhD, MHA , David Frenz, M.D. , and others to create a center of excellence for the compassionate care of individuals struggling with the effects of psychological trauma and co-occurring mental health and addiction.  Knowing that the foundation of the programming and work culture was based on a holistic, mind, body, spirit approach to mental health, the opportunity to be part of responding to the needs of the community in such a meaningful way was really exciting.  

Over the first year of the clinic, the entire leadership team changed and while the emphasis on addiction was not fully realized, delivering compassionate, holistic, trauma informed care remained the mission.  In 2018, a Therapeutic Skills PHP was re-launched alongside a Trauma Focused IOP, expanding our capacity to meet the range of needs of the patients seeking out care and creating a continuum of care supporting patients from the first point of entry in the Emergency Department and Inpatient Psychiatric unit through successive steps down back to outpatient appointments.  A strong partnership with Vail Place offered on-site access to case management and housing support.  Trauma-informed DBT programming was added in 2019 as the provider team grew to meet the needs of the community seeking care.  It was incredible to be part of such a comprehensive and dynamic care offering and to witness patients reclaiming their lives.  

More incredible was the quality of the people on the team.  The providers and staff who have been part of this team are heart-centered, humble, thoughtful, mindful, and compassionate, committed to their own learning and development, and consistently engaging one another and our patients with respect and kindness.  

The past four years brought a lot of change. The global covid-19 pandemic forever changed mental healthcare and the department at North Memorial was not exempt.  Alongside the transition to virtual delivery of care, changes within the system resulted in the suspension of PHP and IOP offerings.  While we continued to offer intensive group psychotherapy with hopes of the return of programming, the disruption to the continuum of care was significant.  In the first two years of the pandemic, we experienced significant turnover within both our provider and support teams.  Still the level of care remained incredibly high as providers pivoted to telehealth and virtual group programming continued to be a healing refuge in the lives of patients.

2023 and the early part of 2024 had felt like a turnaround year.  The team had stabilized and begun to grow again; we were extending offers to new providers, even in the weeks before we were informed that the clinic was going to be eliminated.  While continuing to provide care via telehealth, we were offering more in person appointments and at the local department level, we had created a strategic plan to build upon the existing care offerings to better meet the needs of the community.  Sadly, instead of expanding to serve the community, that community will now be left without a vital resource in a time of the highest demand for mental health support that I have seen in my time in the field.  

As we brought the clinic to a close and said our farewells this past Friday, it was resoundingly clear that it was the people that made the place special.  While the team changed over the years, the integrity, competency, and emotional intelligence of the providers and support staff was an enduring characteristic.  It is not common to find a workplace where people consistently engage one another with care, respect, and mindful self-awareness.  What a gift to work with people who can share humor and joy and encouragement while working tirelessly to help ease the suffering of the individuals, never losing sight of the privilege it is for someone to take the risk of allowing us to support their efforts to heal.

In these early hours and days following the clinic closure, there are so many emotions swirling.  I feel profound grief that this team will now be scattered across the metro.  I feel deep sadness that the North Minneapolis community and surrounding areas will no longer have access to such an incredibly compassionate and skillful mental health resource.  I feel so damn proud of this team and the many lives that have been impacted positively by their commitment to creating safety, acknowledging and supporting healing from trauma, and reducing suffering.  And I feel so much gratitude that I was able to be part of something so special for the past 7.5 years.

The poet David Whyte describes good work with the following description:

At its best, work seems never-ending only because, like life, it is a pilgrimage, a journey in which we progress not only through the world but through stages of understanding what we are actually doing and who we are doing it for – good work, done well for the right reasons and with an end in mind, has always been a sign, in most human traditions, of an inner and outer maturity. Its achievement is celebrated as an individual triumph and a gift to our societies; a very hard-won arrival. - Crossing the Unknown Sea:  Work as Pilgrimage of Identity