Submitted Photo Cale Homuth attends a Red Hawks baseball game with his children, Liza and Arthur. After struggling to find timely mental health care, Homuth accessed same‑day support through VitellaCare.

A mental health crisis in the fall of 2024 began the start of a journey toward self discovery that has signaled a positive ending for Cale Homuth of Fargo.

Homuth credits the telecare provided by a Minot clinic with playing a large role in guiding him on that journey.

VitellaCare, a clinic managed by Crossover Health and located on the third floor of Trinity Hospital, had opened in December 2024 to provide primary care and mental health therapy. It was the first of VitellaCare’s North Dakota clinics to bring on a mental health therapist, and Homuth was one of the first patients to connect with its therapist, Troy Roness.

“It was just a wonderful conversation,” Homuth said of that initial connection. “It really got me started from there.”

Lack of accessible mental health services has long been a concern, especially in rural communities that may lack even primary care, Roness said.

“At VitellaCare, we try to bridge that gap by providing services that are very collaborative in nature, and so primary care and mental health work together to meet the needs of the individual,” he said. “This clinic and the model that we utilize really emphasizes collaboration, holistic individual care and meeting the individual and their needs where they’re at.”

Homuth said in the fall of 2024 he was dealing with new health care concerns and was under significant stress in his job. About the time he switched to a new job, he said, he could almost feel his elevated blood pressure go down and his vision improve. However, a few months later, feeling stress about leaving his family for a weeklong work-related trip, he experienced what seemed to be an out of body experience, watching his life play out as a spectator.

Alarmed, Homuth debated seeking medical attention as symptoms fluctuated.

“Nothing registered as mental health,” he said. “My mother came over – and who knows you better than your mom. She looked across the table at me, and I was just worked up, out of sorts, and she just flat out asked me, verbatim, she said, “Are you depressed?”

Homuth said he broke down and realized he needed to contact a mental health professional. He called his doctor’s office but wasn’t able to get an appointment for five months. Calling around in the Fargo area, he discovered seeing a therapist would take weeks unless he went through the emergency room.

Homuth eventually found an addiction clinic that offered some mental health services. He was prescribed an antidepressant that negatively impacted him for several months.

“But the journey at least began,” he said.

He later heard about the new VitellaCare, which works with insurance partner Blue Cross Blue Shield of North Dakota. He went to its Fargo clinic for a regular physical and was referred to the Minot clinic’s telehealth because it was the first to be bringing on a therapist. Homuth connected with Roness in short order.

“First and foremost, he really spoke to me like a person,” Homuth said. “He got to try to get to know me and uncover some of the things that might make me tick and suggest some of these cognitive behavior therapies and other ways that I could begin to understand myself and kind of walk along my mental journey without it strictly being a pill.”

When medication was involved, Roness provided information that made him feel more informed on the pharmaceutical portion of his journey, he added.

Homuth said he now hasn’t taken antidepressants for more than six months, after taking varying dosages and experiencing on and off uses last year. It also eased the journey in that VitellaCare helped him smoothly and quickly navigate needed outside referrals to other health care providers, he said.

Roness said VitellaCare’s care navigation team coordinates those referrals and appointment scheduling, taking the burden off the patients and creating a fairly seamless transition between providers. VitellaCare also works in collaboration with those providers to whom patients might be referred.

“We really focus on preventive care here,” said Heidi Peterson, a nurse practitioner for VitellaCare in Minot. “Part of that initial visit is doing the screens for anxiety and depression so we can open up some of those conversions right off the bat.”

Patients also can be introduced to and see a therapist in the same clinic, which breaks down some of the barriers people might feel regarding seeking help, she added. Getting patients in to see a therapist the same or next day to avoid anxiety about an upcoming visit is a focus of the clinic, she said.

“There, obviously, still is stigma about what mental health therapy is, what it does for an individual, and then, of course, cost is always a concern,” Roness said. “With VitellaCare, though, we work hand in hand with Blue Cross Blue Shield and we do everything we can, again, to meet the members where they’re at.”

In the past few months, utilization of VitellaCare’s mental health resources has more than doubled, Roness said.

Peterson said increasingly primary care clinics are including mental health therapists on their staffs.

“We’re seeing it specifically with the community health clinics, the college health clinics. The teams are working hand in hand,” she said.

In Homuth’s case, when he questioned whether he might have some underlying condition that led to stress triggering his depression, VitellaCare referred him for testing that found previously undiagnosed Attention Deficit Hyperactivity Disorder (ADHD). He now is also managing that condition.

“I’m in as good a place as I’ve been, certainly since two Octobers ago,” Homuth said, “and I just continue to understand myself better.”