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Living in a rural area comes with many benefits, but sometimes things are a considerable drive away or require a long wait. Housing, daycare, and various services are sometimes flooded with applicants and overly competitive. Unfortunately, this also applies to mental health services. Our country is facing a mental health crisis and the demand for services is not being met.

Closures and insight

Mental Health
Joel Beiswenger, President & CEO of Astera Health

“The need for mental health services has only increased over the years,” said Joel Beiswenger, President & CEO of Astera Health. In a recent interview, Beiswenger gauged the struggles with mental health in our Central Minnesota region. He went on to explain the impact Astera Health’s current operations have on the greater community and its staff. Astera Health has expanded its behavioral health offerings several times. Most recently, the organization added Alicia Elliott, DO, a licensed psychiatrist to its roster of mental health professionals.

“To be honest I cannot recall a time when mental health was not in short supply no matter what part of the U.S. we are talking about,” said Dr. Elliott. Dr. Elliott has also witnessed a pronounced decline in behavioral health offerings with prominent facilities announcing closures. She believes closing inpatient services will increase the demand for outpatient services. Additionally, she believes the severity of these cases will undoubtedly increase.

“The whole nation has shortages in mental health care whether that is counseling, medication management, crisis services, or outpatient care.  A unique issue to a rural area is the distance one must travel, especially if they need psychiatric hospitalization, day programming, electroconvulsive therapy, or Ketamine therapy,” explained Dr. Elliott. Dr. Elliott brought up some of the recruitment challenges for rural facilities as well. Providing care in an area like Central Minnesota can feel quite isolated, especially if they are the only provider with that specialty.

Mental health across generations

Mental Health
Alicia Elliott, DO

Additionally, Dr. Elliott shared other concerns that might be exacerbating mental health issues in the region. Through her work, she has noticed many instances of generational trauma that might be fueling the crises. Generational trauma occurs when a member of a family suffers from a traumatic experience that leads to mental health problems, these problems are not treated adequately and spread to the next generation of family members and so on. This is difficult to treat because those suffering often don’t realize anything is amiss. The behavior they endured is normalized and passed along to the next. Dr. Elliott also pointed out substance abuse as a key factor in declining mental health.

When asked about the biggest risk for providing comprehensive mental health services, Beiswenger responded with the mounting staffing recruitment and retention challenges and the financial risks of taking on such services.

Rural Minnesota needs help.

Current offerings at Astera Health are predicted to remain steady. Astera Health administration has expressed a desire to expand services to meet regional needs but is facing challenges without aid. The issues facing mental health practitioners have not gone unnoticed. Currently, steps are being taken to fill the gaps. Learn more about these efforts from the Minnesota State Legislature website.



“In my view, payment for these services by both government and commercial insurance payers is not adequate to cover the cost of services.  Additionally, it is very hard work. Patients seeking this care are going through some of the most difficult challenges in their lives. This is an emotionally intense profession, so it is likely not an attractive career for most. Psychiatrists, Advanced Practice Providers, and counselors are always in short supply,” said Beiswenger.

Stigma and avoidance

Medical professionals agree that the stigma surrounding mental health continues in Central Minnesota. “I feel a lot of struggles in a rural area may be traced back to the stigma that can remain attached to mental health. In our rural community people are more familiar with one another and no one wishes to feel judged and looked down upon.  The amount of trauma in the area is more than what I anticipated when I moved to the area,” said Dr. Elliott.

An appointment at Astera Health

To learn more about behavioral health offerings at Astera Health, please visit To schedule an appointment, call 218-631-3510. Remember to follow Astea Health on social media for important wellness tips and updates.

If you are experiencing suicidal thoughts. Please call the national suicide support line by dialing 988.

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