This interview originally aired on In the Moment on SDPB Radio.
Today, many experts are working to address mental health care in South Dakota. They're standing on the shoulders of a South Dakota Hall of Fame inductee.
Robert Arnio, Ph.D., came from a Deadwood logging family and had a profound impact on the world of psychology. He redefined how we think about mental health in the state, especially in the rural regions.
He joins In the Moment ahead of his induction into the South Dakota Hall of Fame to reflect on the future of mental health care in the state and the legacy he wants to leave.
Lori Walsh:
You are listening to In the Moment on South Dakota Public Broadcasting. I'm Lori Walsh. Well, today I have the pleasure of sitting down with a man who has changed so many lives. Dr. Bob Arnio is a psychologist, a founder, a teacher, an advocate, a pioneer, and now an inductee into the South Dakota Hall of Fame. Dr. Arnio founded Psychological Associates of the Black Hills in 1981. He founded Learning Solutions in 2001, which provides personalized tutoring services to children and teens with learning or reading challenges.
He's left a mark on the next generation of mental health professionals by teaching at South Dakota State University, USD, and the University of Sioux Falls. And he has long worked to increase access to mental health care in South Dakota's rural communities. It is due to that advocacy for reading, mental health, suicide prevention, that he has earned more words from the South Dakota Psychological Association than any other psychologist. We are just scratching the surface of his accomplishments there. So we will get to know the man and the inductee into the South Dakota Hall of Fame. Bob, welcome. Thank you so much for being here.
Dr. Bob Arnio:
Thank you very much
Lori Walsh:
And congratulations on this honor.
Dr. Bob Arnio:
I appreciate that. It is quite an honor.
Lori Walsh:
I'm guessing that you don't do the things that you do or haven't done the things that you've done in order to get an award or an order to have your plaque up somewhere. What does motivate you over your career? What have been the things that got you out of bed in the morning that got you working really hard to solve the next, what can seem to be an insurmountable problem?
Dr. Bob Arnio:
Well, you don't set out to solve insurmountable problems. You set out if you have an interest. And I attended Black Hills State College and became very interested in psychology. Had a wonderful mentor there, Walter Higby and Walter mentored many, many students. Those people in the audience, I'm sure some will recognize his name. And he showed me what kind of a change you could make working within education. He was a special educator and what kind of change you could make working with disadvantaged students, doing research and so forth. That led to my going to the University of Iowa and becoming a school psychologist and then later returning there into psychology. So I was interested in the area, interested in people. And maybe the basis of it, I'm the seventh of 11 children and so we're interested in people throughout and seeing what people could do.
Once my wife and I who were both from the Lead/Deadwood area, we went to high school together. Once we returned to South Dakota from the University of Iowa, I started a practice and developed into a group practice because of the need. During that time, there was some crisis in mental health that occurred. In particular a cluster of adolescent suicides. We had more adolescent suicides in a period of six months just in Western South Dakota that we could count than we would expect for a full year in the whole state. And so it was a response to that. What do you do? There's a saying, I think it's attributed to an African philosopher, "If you want to go fast, go alone. If you want to go far, go together." And this was obviously a community issue. So we began to pull groups together saying, "What can we do? What can we do with this?"
And that then led into developing education. First thing we found that was necessary was to train people. Remember, this is back in the day before the internet, and if you wanted to learn something as a professional, you either bought a book or you went to Chicago to the workshop. Well, in rural areas, that's really not practical. So we started workshops and for 13 years would bring experts to train people in South Dakota. Then we needed to provide more providers. And so we worked with the social work group, the counselor group, the psychology group, and helped develop licensing laws criteria of what you needed to do to be able to be trained to be a provider, to help that.
And then worked with the legislature and with the insurance industry to make the services available. So when you look back on it as, "Wow, that was a lot of things that we accomplished." One, you didn't do it alone, you worked with many, many other people. And secondly, it was just need-based. These things came up and as just as a human being, even more so as a mental health provider, it's like we have a responsibility to try to make an impact. So that's how it kind of unfolded and it's kind of amazing. It's been 30 years in the process.
Lori Walsh:
And so I'm hearing there are geographical challenges, there are financial challenges, there were challenges of nobody's really thought this through before for our area. Were there other things that you discovered that were really important to who we are culturally, to rural South Dakota particularly, that provided challenges or obstacles to getting mental health services, places, stigmas that needed to be overcome. Or real opportunities that said, "These are people that want to take care of each other," for example, and we're all on board to solving problems. What was unique is what I'm asking about this place that you recall as you did that work?
Dr. Bob Arnio:
Well, everything's a double-edged sword. Some good things have other sides to them. We are fiercely independent and we are all challengers, farmers, ranchers, my family's on the logging business, every day face challenges. And they learn how to handle them on their own and to deal with them. And sometimes mental health was seen as being an aspect of dependency, that just buck up and face that. What changed that is that so many of the referrals for mental health services came from the professional most trusted even by the most fiercely independent family, and that was their physician.
And we worked very closely with the medical community because the physicians had the trust of the patients and the family, and it would take physicians to say, "Look, I'm not going to be able to help you with this the way that this other person can." And in the beginning of my practice, all of our offices were within medical clinics and those were the referrals came from. So the independence is a good thing. You want to say, "Well, yes, we want you to be independent. We want you to learn the skills to fight a depression." The depression is the monster that's creating the difficulties and you need new skills the same way you might need new equipment on your job to handle something that's occurred. You need something to begin to handle these things that you can't otherwise know how or should be expected to know how to address.
Lori Walsh:
So coming off of that original really dramatic crisis that many of us who live here still remember, flash forward to a pandemic and the days that we're living through now, we have the internet, we have social media. Again, double-edged sword. Good, bad. What is some of the work that you think needs to be done in 2023? What's next for mental health in the Black Hills in South Dakota?
Dr. Bob Arnio:
Well, I think what's next for mental health in general is dealing with some of the negative side of the sort of social media. I think there's clear data to show that as social media has become more prominent and particularly adolescents and young adults have engaged in more and more hours of social media, mental health issues including suicide have shown a rise. And to be able to work with that and to find within a social context some way to not let this happen, much of what happens on social media, in my opinion, doesn't need to happen. And so we need to address that. That's the epidemic of today.
Lori Walsh:
If I could interrupt and jump in, because what I'm wondering is from your perspective, is it what is happening while you're on social media or is it what you're not doing?
Dr. Bob Arnio:
Well, it's both, but a great deal of it is what happens while you're on social media, particularly among adolescents and young adults. And so to be able to address that, and I think that it sounds like legislators are beginning to look at that and say, "Well, let's not let this run wild." I think the other thing, and I think schools are stepping forward, is that we need more assistance in places where all children go. For example, I ran a tutoring company, but the difficulty was that a lot of the children who need tutoring could not afford that. A lot of people who need things, can't afford it, and public school is the one place where we can do that. There's a lot of programs being developed to help children learn how to deal with bullying, to help children know how to deal with some of the social media issues that are coming up.
And my own belief is that this needs to be part of the curriculum. This is part of the things that we need to learn how to manage in our lives because even if we move forward and get better control over some of the negative side of the social media, a negative side of these things that are happening, we need greater supports. I don't think any parent is born with the skills to know how to work with their child and some of the things that they're going to encounter in today's society, watching people being blown up in the war of Ukraine, watching these things happen. These are not types of things that we used to experience, particularly at younger ages. So I think there is a challenge, and of course, with every challenge is an opportunity that we can come forward and we can work with that and make the changes and give the people the support that they need. And again, the African saying, we need to do it together. We need to move forward together and not just have mental health people working, but we're in conjunction with others.
Lori Walsh:
I was just listening on the way in to the US Surgeon General's podcast and he was interviewing David Brooks and they were talking about why are we so sad? Why are we so mean? And getting back to what you're saying about bullying and then just the isolation, loneliness that is rampant, that is an epidemic right now. Is it getting more mental health providers in the right communities and having them be more accessible? Is that the biggest challenge? Are there other things other than that that you think are important community uplifters?
Dr. Bob Arnio:
I think the accessibility is probably the most immediate issue. Most therapists, even though we were able to greatly expand the number of mental health providers, through all the things that I've talked about, most have waiting lists to get in and many will not see new people, they're full. Even mental health centers have a hard time meeting the demand. So the most immediate issue is access. Part of that gets related to also funding, mental health funding, because even if you have a sliding fee scale, a Cadillac for $5,000 is a tremendous value if you have $5,000. And in my family, we grew up with the things that we needed, but we didn't have any excess. And to be able to provide those services to the people that are there. Again, it takes a group. It takes a group. We have to, "Okay, how do we look at the accessibility?"
We have to have the providers, but then there also be the accessibility to do that. Beyond that, then we need to look at the things that are feeding some of these issues. Yes, we are at a time where civil conversations seem to be rare. There are times when families cannot talk, cannot express their views. You are in the news, the threats that happen. If someone expresses a view that someone else doesn't like, they're not only threatened to kill them, they've set out to do it.
And this is something that, again, as a group, we need to turn back and say, "I don't care what your belief is. I don't care what your thoughts are. We do not do that, and we will not accept that, and we certainly do not cheer it. We don't clap and say 'Yes,' when somebody is exhibiting that type of behavior." Human beings have tremendous adaptability, but part of our adaptability is to be very aggressive, and we need to modify that, and we need to deal with that as saying, "Okay, as civilized people, we don't do that. We have other ways of doing that," because in the long run, it will all fall apart.
And in the long run we're not going to survive under those types of things. Now we have the capacity to do good, and we have the capacity to make that good face some of the challenges we have. So the most immediate thing is accessibility. And that involves several prongs, availability, geographics, financial, all kinds of things. But the other part is to come together as society and say, "Look, we are different." On the moment of my conception, it was decided that I would not be the center for the Boston Celtics. I'm five foot six, so that's not going to happen. So we all have differences, but we can live with that and we can find happiness with it, and we can support each other in the process.
Lori Walsh:
The wisdom of a Dr. Robert Arnio, an inductee into the South Dakota Hall of Fame, it has been a delight to get to know you just a little bit. Thank you for the work that you've done on behalf of all South Dakotans and congratulations.
Dr. Bob Arnio:
Thank you very much. I appreciate it.