Health-conscious people often hit the gym and eat well-balanced diets. Those are good, solid habits, and experts trumpet their impacts. What people don’t freely discuss when lifting weights is that another part of wellness involves mental health. Statistics show one in four people has a mental health challenge, and South Dakota's aren't immune to maladies of the mind.
This man is no stranger to people in Sioux Falls and other South Dakotans.
"My name is Rick Knobe. I am employed full-time at KSOO Radio, been doing that job for about 20 years. I run a local talk show called Viewpoint University," Knobe says.
Knobe acknowledges he's had a public profile for decades; he even served as mayor from 1974-1984, a time he refers to as "the golden years."
The man doesn’t mince words. Knobe knows a lot about this part of the world and the people in it. It’s his vast experience and participation that recently threatened everything he’s worked for. Knobe says his jobs have always offered him a heaping helping of stress.
"Typical guy thing, you just put your head down and you just keep going," Knobe says.
In 2006 and 2007, Knobe’s stress skyrocketed as he battled prostate cancer and coped with a relationship that just wasn’t working out.
"In 2009, I had a situational reaction to something, and I ended up at Avera Hospital in Sioux Falls for about a week trying to pull myself back together again," Knobe says.
Knobe says he met with counselors there, and he reveals he took medicine for the next year to balance the chemistry in his brain.
"There is a misperception by many, not by all, that it is somehow a weakness of will, a lack of faith, poor upbringing, what have you," Dr. Matt Stanley, who treats patients for mental health-related challenges, says.
"We often use the analogy of things like major depression, bipolar disorder being very similar to diabetes," Stanley says. "You’re born with a genetic predisposition. Your environment will trigger the illness, and once it’s triggered you’ll need a lifetime of managing for that illness."
Steve Lindquist is the vice president of Avera Behavioral Health.
"We thought, as mental health professionals, that families were responsible for a family member having a psychiatric disorder," Lindquist says. "So we’re partly to blame."
He says research during the last several decades shows the cause of mental illness is biological and environment plays a tertiary role. What isn’t biological and, instead, derives directly from society is the way people scrutinize mental illness. Lindquist uses an anecdote to demonstrate the difference.
"I’m out in my backyard. And, my neighbor, I haven’t seen him for a while. Go up and talk with him, ‘Haven’t seen ya. Been on vacation?’ Well, no I’ve been in the hospital for a cardiac issue.’ So all of the sudden we rally around that person. ‘Well, that’s too bad.’ You change that and say, ‘No, I was gone for a week. I was in the behavioral health hospital.’ What happens to us internally when we think about that situation? Do we cringe? Do we back off? Do we not know what to say?" Lindquist asks.
Lindquist says this culture viewed other illness through a similar lens before stigma barriers broke. He wants people to understand that mental struggles, like physical health challenges, are treatable.
"First-time treatment of major depression is successful 80 percent of the time," Lindquist says. "That’s better than a lot of other medical conditions."
Treatment is a vague concept, and it comes with an almost automatic association to prescription drugs. Dr. Matt Stanley says some people do need medicine to establish equilibrium, but treating the mind has another method for rehabilitation.
"Talk therapy, cognitive behavioral therapy, dialectical behavioral therapy, so therapies that are specifically developed to help certain aspects of the mental illness," Stanley says. "In that sense, perhaps we’re even ahead of some of the other illnesses that are treated by other professionals."
With change in the kinds of therapies, so come advancements in the environment people receive treatment at the behavioral health center.
"It was built specifically to counteract what you’re suggesting: the idea of the back ward, the old unit, the sterile lockdown high-security facility," Stanley says.
Stanley notes that security and safety are priorities at the hospital, but that doesn't come at the expense of comfort. He describes a beautiful entryway and a waterfall. Rick Knobe says the design welcomes patients.
"Artwork on the walls, there’s carpeting. It was like staying in a motel room almost. Counseling available, all of that stuff. It was not One Flew Over The Cookoo’s Nest, or it wasn’t anything of those things you read about or saw in movies days of old," Knobe says. "It was a very pleasant setting, and the staff that were there were very pleasant to be around and work with. It was a good experience. It helped me get balance back into my life."
The longtime Sioux Falls resident, public servant, and radio host Rick Knobe says people who seek treatment for mental illness shouldn’t be forced into the shadows to secretly cope with their conditions.
"I think we have an obligation to come forward and say, ‘Hey. This happens. This is real. We’re not strange. We’re not weird. We just have an illness that we need to deal with, and I hope you will accept me even though I’m talking about it,'" Knobe says.
Knobe hopes his willingness to acknowledge his health challenge and embrace his treatment encourages other people to escape the shame and accept help.