Gabby Suihkonen knows first-hand the importance of mental health care. As a resident of the northeastern Minnesota town of Tower, she also knows all too well that in her part of the state, accessing that kind care can be tough.
“I grew up with a lot of people in my life with significant mental illness,” Suihkonen said, including loved ones who had to endure long waits for appointments or drive significant distances just to see a therapist. “I saw how big a need there is up here on the Iron Range for mental health care. Because of that, I felt pulled in the direction of becoming a social worker.”
The decision became easier when she heard about a program offered by the University of Minnesota-Duluth’s (UMD) Department of Social Work, awarding $10,000 stipend to offset the cost of the required, and unpaid, internship portion of the program for masters’ degree students. “I applied for the program knowing I wanted to stay on the Range,” she said. “I knew I wanted to help with the provider shortage here, and the money was an added bonus.”
These days, Suihkonen is a licensed independent clinical social worker (LICSW), who works as an outpatient therapist at Range Mental Health in Virginia, about a half an hour from Tower.
The $10,000 stipend made it possible for her to focus on her internship and her graduate program without having to work weekends to make ends meet. “Without this money I would’ve struggled,” she said. “It really helped make it possible for me to complete my degree and to start helping people in this part of the state.”
Northern Minnesota desperately needs more people like Suihkonen, educated professionals committed to settling in and helping address the region-wide shortage of mental health providers, said Lake Dziengel, associate professor at UMD’s College of Education and Human Service Professions’ Department of Social Work.
Versions of the stipend have been available to MSW students at UMD for a decade, Dziengel explained, thanks to funding from the federal Health Resources & Services Administration (HRSA). But this year the department was awarded $900,000 — its biggest HRSA grant ever — to administer a new program called PACT, or Providing Advanced Clinical Training, which is aimed at boosting the number of clinically trained social workers working with children, youth and families in Duluth and the surrounding area.
The name PACT isn’t a coincidence, Dziengel explained. Recipients are, “making a commitment, a pact of sorts, to work in underserved areas called Health Professional Shortage Areas, or HPSAs. When they agree to participate in this program they commit to a minimum of two years of working in these areas.” Once program grads are settled in a job, their commitment to the region tends to stick, Dziengel added: “Most people go to a job and stay in it for quite a while.”
One of those people was Matt Delaini, who received a $10,000 HRSA stipend as he was finishing his MSW at UMD in 2020. He said that the funds were particularly helpful when COVID hit the region and many businesses were forced to close. His internship, in the palliative care program at Essentia Health, was put on hold. “Everything got shut down,” Delaini explained. “I had to wait a term to finish my internship, so having that financial cushion really made a difference.”
That kind of support is particularly important to people in the UMD program, Dziengel said. “We tend to draw students without the same level of financial resources as students in other social work programs. We aim to really draw in underrepresented students.”
As a result, “About 20 percent of program participants belong to an underrepresented population,” Dziengel said.
The PACT program also funds a new children and families mental health course that UMD will be teaching for the first time this year, Dziengel added, as well as providing additional financial resources to support students while they are going through the licensing application process and taking the social work licensing exam.
Supporting future social workers from underrepresented populations helps to build a workforce that looks more like the people it serves, Dziengel said. Statewide, more than 90 percent of licensed social workers identify as white, and 88 percent are female. The UMD program, with the help of supports like PACT, and its focus on American Indian communities and populations, is working, one graduate at a time, to shift that reality.
‘Really making a difference’
In Minnesota, most mental health care is provided by licensed social workers, with the vast majority based in the seven-county metro area. The northeastern part of the state, in the area surrounding Duluth, is home to just six percent of all of the state’s 14,353 social workers.
Dziengel said that residents of his region struggle with a number of issues that make the need for mental health services particularly acute. Much of the region is rural and isolated, with a higher rate of poverty than the rest of the state: “The median income for our region is much lower than the U.S. median household income. The biggest concentration of households in poverty is in the Duluth area, but all of the region has a higher percentage of children and families living in poverty.”
Poverty particularly impacts the region’s young people, he continued. In nearby Beltrami County, for instance, more than 24 percent of children under the age of 18 live in poverty. “In social work, we look at the whole picture of what is going on in a person’s life in terms of what impacts their mental health.”
Another goal of the PACT program is to train social workers to feel comfortable working in complex environments. Program participants are required to take targeted courses, including Advanced Practice in Mental Health, another course in clinical social work and other requirements related to interdisciplinary practice. “It helps prepare students for interdisciplinary collaboration, the kind or work they might do if they were working in hospitals or similar settings,” Dziengel said.
Suihkonen works in just that kind of job. At Range Mental Health, she explained, “I do a combination role of outpatient therapy and a new co-responder model.” As the mental health professional tasked with working with law enforcement, EMS, and the fire department on crisis response, she said, “I handle mental health crises and any other additional needs that aren’t met by EMS or fire. I work with housing, basic needs and substance use. Anything where it is not a criminal or a medical need is my responsibility.”
Suihkonen said that her work is challenging, but she also likes being in a job where she’s able to help people at times when they need it the most. “I like how social workers are focused on the whole person and really based on person-centered work,” she said. “It feels like you are really making a difference.”
One way the regional shortage of mental health professionals is evident is in the number of job openings. Regional agencies providing mental health services struggle to find workers, Dziengel said. “Places will have job postings up for a year or more. They can’t hire anyone.” Graduates from the UMD program land jobs quickly, with employers excited to welcome them to their staff. The average starting salary for someone with an MSW is around $65,000 in Minnesota.
The department annually surveys MSW graduates to track where they are working. In 2019, 43 people completed the degree, Dziengel said. Thirty-nine responded to the survey. “Of those who responded, 97 percent were employed. Thirty of them were working in the state of Minnesota. They were employed in mental health in hospitals, schools, chemical dependency residential treatment, in county-based programs. Many were living in the North-Central region.”
Dziengel also follows up with grads at the one-year and two-year mark. “We’ve had people that are working for the VA hospitals or Range Mental Health,” he said. “Some are working in rural Wisconsin. Quite a few are in the Duluth area, working in agencies with kids or families or in hospice.”
Delaini’s first job after earning his MSW was as a therapist at the Human Development Center in Duluth. It was there that he actually saw the real need for mental health workers in the region. “You hear about it in the abstract that here is a real demand,” he said, “but once you get into the field, you start realizing just how many people are seeking mental health care, and you see how you are providing a really needed service right here in the community.”