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WebMed Mental Health continues expansion of services in Northland

Duluth News-Tribune - 8/12/2022

Aug. 12—CLOQUET — When Tim Weber started seeing clients as a psychiatric nurse practitioner, it was a side gig so he could help a few people with their mental health in his free time. Three years later, his business, WebMed Mental Health Services, has expanded to two locations, more than three-dozen employees, and thousands of patients.

Now with offices in Cloquet and Duluth, WebMed's programming includes therapy and psychiatry; medication management; substance use disorder outpatient treatment; treatment-resistant depression programming; post-traumatic stress disorder treatment; and attention-deficit hyperactivity disorder testing. He also works with area agencies including Minnesota Adult and Teen Challenge, Thunderbird-Wren House and Wesley Residence.

One of Weber's unique offerings is same-day walk-in appointments for mental health care.

"Nobody's doing it," Weber said of his walk-in appointments, which are similar to an urgent care clinic. "To have any service that somebody would really need for mental health, for the most part, available to them at 3 o'clock any day? That is freaking cool."

Patients who need immediate psychiatric care can come to a WebMed clinic around 2 p.m. Mondays through Thursdays to complete paperwork and drug and alcohol testing, and then can be seen for psychiatry or assessments.

"When somebody starts reaching out for help, they've been struggling long enough," Weber said. "Working in the (Cloquet) ER, we'd have people coming in and they wouldn't be in an emergent or a crisis situation, but they were just struggling. So we'd get them set up with an appointment in Duluth — a 30-minute drive — in three to six months. It was really frustrating."

Weber said keeping time slots open every day isn't the best business model financially, but it's necessary to help the people who need services. He said missing appointments is a prime symptom of poorly managed mental health that can be a barrier for people to receive care.

"I speak to a lot of people that have been either dropped, kicked out or had services discontinued due to poor appointment attendance, and that's frustrating because we're cutting off our treatment for people that are struggling," Weber said.

Erik Mattson, clinic manager at WebMed, said he was drawn to Weber's growing business model when he joined the team last year. Mattson worked at The Hills Youth and Family Services for 26 years, up to its closure last summer.

"I was just really, really impressed," Mattson said. "The access to care here is unheard of. I've worked in the field, and to get someone in for an appointment or an assessment, it takes forever. It takes months. Here, somebody could come in for a walk-in appointment or make an appointment and get in within a couple weeks."

Right now, ADHD testing and treatment-resistant depression programming are only offered at the Cloquet WebMed clinic, 1001 Ave. B, Suite 100. The depression program includes Spravato nasal esketamine spray and transcranial magnetic stimulation, which is a magnetic pulse that can improve severe depression after daily sessions. Weber's goal is to get both locations offering the same programs in the next year or two.

Ronda Henry-Seal was told by her behavioral therapist that she may be a good client for Spravato, which is only offered in the Northland at WebMed in Cloquet and at Lakeview Behavioral Health in Hibbing and Grand Rapids. Henry-Seal struggled with depression, anxiety and PTSD for years. She has tried "so many cocktails" of various medications, plus TMS and eye movement desensitization and reprocessing treatment, with no improvement.

Henry-Seal is only on the third week of her Spravato treatment, which is administered twice a week for at least two months, and she's already made significant changes in her demeanor. She said that before her Spravato treatment at WebMed, she would never smile or laugh. She also is able to answer phone calls and go to the store by herself, which she said used to trigger her PTSD and anxiety to the point where she couldn't do it without help from a friend or her service dog.

"I was terrified. I didn't know what to expect out of this, but it's not bad, and I haven't had any of the side effects," Henry-Seal said. "Spravato really has helped me a lot and we're not even into it that far. It's made a big difference."

Family nurse practitioner Tracy Kwapick administers the Spravato, and said working at WebMed is gratifying because she gets close with clients, and then gets to see their improvement.

"I can't speak for everybody and it may not work for everybody, but for me, it's a blessing," Henry-Seal said. "This has been a lot of years' process to get where I am now, and it's because of Tracy."

There are downsides to the treatment, including not being able to drive afterward. Henry-Seal gets rides from Duluth in a medical cab. The treatment also takes two hours for each session. Side effects of Spravato include dissociation, dizziness, nausea and sedation.

WebMed started offering Spravato in the beginning of June, and Kwapick has already seen a big demand for the treatment. She also said all the clients she's had so far have had positive results.

"Usually by the time they get to me, they're like, 'I have no one else to try,'" Kwapick said. "If anyone is struggling with depression and has tried multiple medications, come and talk to us. It's worth it."

Mattson said he appreciates the way WebMed evolves with the needs of patients. For example, Weber changed the medical cannabis program at WebMed to become a full PTSD treatment program, adding psychotherapy and outpatient substance use treatment to the regimen.

Weber, who has an easy-to-understand analogy for every complex mental health condition, compares the combination of medication and therapy to building a Lego house. The medication gives you the Lego pieces you need, while therapy gives you the instructions. With both, you have the tools you need to put the pieces together and build a house — or navigate thought processes and manage mental health.

"I just really like the idea of making mental health care routine care, like the idea of going to the dentist for a check-up," Weber said.

Just like Tylenol would not improve an infection like pneumonia, mental illnesses need proper treatment, like therapy and/or medication, to improve, Weber said.

Weber said he sees some patients with a history of substance use disorder who are blacklisted from receiving ADHD medication at other providers. Methamphetamine is a cheaper, street-accessible stimulant that people with untreated ADHD sometimes use instead of a prescription medication like Adderall.

At WebMed, clients are subject to urinalysis for months during their recovery from substance abuse before a conversation about prescriptions can happen. But Weber, who is in recovery himself, said people still deserve to be medicated properly if their condition would be helped by treatment like Adderall.

WebMed also prescribes suboxone for opiate use disorder, which is paired with outpatient treatment. WebMed's Duluth location in the Northland Medical Center South currently offers outpatient individual and group addiction treatment, plus case workers and Adult Rehabilitative Mental Health Services workers. Weber is in the process of launching outpatient treatment at the Cloquet clinic.

Mattson said the need for more mental health services is dire nationwide.

"There's a lack of mental health services in the Twin Ports. It's really lacking in a big way. You'll see long wait lists to other facilities to get in for psychiatry or med management, so there's just a huge need," Mattson said. "The need keeps increasing, so the more facilities like us, the better to serve people. They need it."

With his near-constant expansion of services, Weber said it has gotten harder for him to get to work directly with clients, which is all he wanted to do when he started the mental health service.

"I didn't start this to run a business and not see people, and that's where I'm at right now and it's really frustrating," Weber said. "I see people at Teen Challenge right now one to two days a week, and it has overloaded my schedule to being unmanageable."

However, he's proud of how many services he's now able to offer to the community.

"Three years ago I would've laughed at the idea of having two functional locations with staff at them all the time," Weber said. "Even last year, I thought there was no way we were going to do TMS or Sprovato. There's no way we're going to have outpatient treatment. And now it's like I kind of have evolved the vision to figure out what makes the most sense with a wraparound service, one-stop shop available for walk-ins. It's kind of cool, I never thought this would happen, honestly."


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