Ep 23: Building a Mental Health System That Works with Sue Abderholden
The Mental Health Evolution
In this episode of Mental Health Evolution, host Rachel Harrison welcomes Sue Abderholden, a national leader with over 40 years of experience in disability advocacy, mental health policy, and nonprofit leadership. Sue served as Executive Director of NAMI Minnesota (National Alliance on Mental Illness), where she led systems advocacy by engaging grassroots members, shaping legislation, educating policymakers, and shifting public attitudes about mental health. Her work spanned adult and children's mental health, education, criminal justice, housing, employment, healthcare, and insurance reform.
Sue joins Rachel to unpack a powerful reframing: the mental health system isn't "broken" — it's still being built. Drawing on her extensive experience, Sue reflects on systemic improvements over the past decades, practical lessons from school-linked care, workforce development, parity enforcement, and crisis response — and offers thoughtful insights about what's still needed to build a more coordinated and functional system.
KEY TOPICS DISCUSSED (IN ORDER)Sue's background: 40+ years advocating for people with mental illnesses and disabilities
Why the system isn't "broken"—it's evolving and still being built
Shifts in funding and coverage: the impact of Medicaid benefit expansion
Early intervention and school-linked mental health services
Workforce challenges: diversity, supervision, loan forgiveness, and compensation
Mental health parity and the importance of enforcing network adequacy
Crisis care systems: 988, mobile teams, voluntary engagement, and upstream intervention
How coordinated residential and emergency services can improve outcomes
One key message for listeners: You can create change
Reframing the system from "broken" to "still being built" can create momentum for solutions.
Early screening matters most when paired with clear pathways to follow-up care.
Workforce development and diversity require intentional investment and practical policy solutions.
True parity includes enforcing non-quantitative treatment limits and adequate reimbursement.
Crisis response works best when it intervenes before an emergency and connects to supports.
Sue's Minnesota Reformer article — Here's How to Move Forward on a Stronger, Functioning Mental Health Care System
https://minnesotareformer.com/2025/12/01/heres-how-to-move-forward-on-a-stronger-functioning-mental-health-care-system/
KFF — The Landscape of School-Based Mental Health Services
https://www.kff.org/mental-health/the-landscape-of-school-based-mental-health-services/
NASHP — Trends in State Strategies to Improve the Behavioral Health Workforce
https://nashp.org/trends-in-state-strategies-to-improve-the-behavioral-health-workforce/
Milliman — Mental Health Parity & Medicaid Implementation for State Agencies
https://www.milliman.com/en/insight/mental-health-parity-medicaid-implementation-state-agencies
SAMHSA — National Guidelines for a Behavioral Health Coordinated Crisis System
https://988crisissystemshelp.samhsa.gov/sites/default/files/2025-04/national-guidelines-crisis-care-pep24-01-037.pdf
Sue Abderholden
LinkedIn: https://www.linkedin.com/in/sue-abderholden-474b047/
Music Credit: Music by Zach Harrison