FARGO — Bill Weber was hired as a registered nurse when Prairie St. John’s launched in 1997 as a 10-bed unit on the fifth floor of St. John’s Hospital in Fargo. Through the owner and leadership changes over the last 20 years, Weber said he’s proud of how Prairie St. John’s has grown and evolved in order to serve the needs of the community.
What began as an acute care hospital serving adolescents experiencing behavioral health crises now also serves adults and has taken over the entire structure at 510 4th St. S. It also offers additional levels of treatment such as residential programs, day treatment, intensive outpatient programs and clinic services.
Weber said Prairie St. John’s used to discharge patients and hope they would follow up with an office appointment.
Today, a team consisting of a doctor, therapist and discharge planner map out a treatment plan extending from the moment they first see a patient to months down the road.
“They’re often so scared, embarrassed or angry when they get here,” Weber said. “Once we get them stabilized and to the point where they’re willing to accept treatment, then they’re scared about what happens next. … We try to make it simpler for them. It’s all written out in their discharge aftercare plan,” he said.
Serving 250 patients a day
Prairie St. John’s was first known as Children’s Psychiatric Hospital when it launched in 1997. Its founders were a group of Dakota Heartland Medical Center psychiatrists who recognized a lack of beds available for children and adolescents experiencing a psychiatric crisis. It soon began providing services for adults and then added substance abuse treatment programs.
Monica McCroskey, director of business development, said it made sense because substance abuse is typically under the same umbrella as mental illness.
“It’s very rare to have someone struggling with an addiction issue that doesn’t have a co-occurring mental health issue,” she said. “They kind of really go hand in hand.”
Today, Prairie St. John’s is the largest privately-owned inpatient psychiatric hospital in North Dakota, South Dakota and Minnesota. The organization sees an average of 250 patients a day and served over 6,500 individuals in 2016.
Prairie St. John’s is on the front line of the community’s most recent behavioral health crisis: opioid addiction.
McConkey said treatment often begins unpaid because insurance companies do not cover opiate detox.
“Whereas alcohol detox is a medical thing and people are in danger of dying when they’re detoxing from alcohol, Opiate detox is not seen the same way,” she said. “I think the view is it’s not going to kill you. You’re just going to be really, really sick. The downside of that is because people feel really, really sick, not many are successful making it through detox sitting at home waiting to get into treatment.”
McConkey said they cannot bill any services until a patient is able to actively participate in treatment, so Prairie St. John’s often provides “charity care” for the first few days.
In addition to counseling, McConkey said two of Prairie’s biggest tools in fighting opioid addiction are the drugs Vivitrol and Suboxone. Vivitrol is a receptor blocker that prevents users from getting a high from opiate use, and Suboxone is a weaker opiate used to wean heavy users off opiates.
McConkey said both are currently covered by health insurance and Medicaid in North Dakota.
New or remodeled location
McConkey said the next big hurdle for the organization will likely be a new or remodeled facility. Universal Health Services, Prairie St. John’s owner since 2010, is considering whether to remodel the existing hospital or build a new facility next door.
The original building was erected in 1904, with additions made in 1935, 1940 and 1965.
If management decides to go with a new hospital, it will be built next to the existing structure, which will be torn down once the new hospital opens.
McConkey anticipates both options will allow for an increase to its current 110 beds.
“This community is going to grow. Although prevention and education programs are in place, you can only assume that the need for psychiatric services will grow as well,” she said. “We want to be poised to be able to meet that demand.”