North Dakota is only meeting 23% of its mental health workforce need, according to a report from the national mental health advocacy organization, Inseparable. This shortage has led to thousands of residents seeking care elsewhere due to a lack of providers. Over 300 people are on Sanford Health's psychology waitlist, with patients waiting months to receive an appointment. The shortage is attributed to a shortage of qualified professionals, with Sanford having adopted a "grow our own" approach, including a psychiatry residency program in partnership with the University of North Dakota medical school. Essentia Health is also working to manage patient volume by transferring stabilized patients back to primary care for medication management, freeing up specialists for higher-need cases.