Psychiatric Services & Medication Management
Our experienced nurse practitioners take time with each client to understand their unique strengths, challenges, and needs. They provide comprehensive evaluation of psychiatric issues from a holistic approach. This can include but is not limited to: Integrative Medicine, Natural Therapies, Mind-Body Therapies, Essential Oils, etc. A collaborative model is used to identify therapeutic approaches to best meet the needs of the individual.
Our providers also prescribe prescription grade supplements as an alternative therapy, or to augment other medications to promote optimal wellness.
DNP, RN, CNP, Psychiatric-Mental Health Nurse Practitioner
Grant Gregory is a board certified Psychiatric-Mental Health Nurse Practitioner and received his Doctor of Nursing Practice from the University of Minnesota in 2014. He has enjoyed working in the behavioral health field since 2006. He has worked and trained in a variety of settings including chemical dependency facilities, adult/child/adolescent inpatient hospitals, outpatient and forensic settings, and in residential treatment of severe and persistent mental illnesses. Most of his work has been in the inpatient setting treating adults with a variety of mental health issues.
Grant provides comprehensive mental health treatment including diagnostic assessments and medication management for clients. He uses the mind/body connection to help educate and provide clients with the tools and skills needed to improve their emotional, physical, and mental health. He enjoys working with diverse individuals and helps treat those with various mental illnesses with collaborative and holistic approaches.
Grant’s Care Philosophy:
- I work with individuals ages 18 and older.
- If you saw a previous provider for medication, I recommend bringing a copy of your records prior to our first meeting so I am able to review past history and improve continuity of care.
- Explanation of Drug Testing Philosophy:
- To help ensure the highest quality of care, I routinely ask for drug testing prior to prescribing any controlled substances as well as randomly as needed (e.g., if drug or alcohol use is suspected) per our controlled substance agreement you’ll be asked to sign. Controlled substances are not advised in any form of drug, alcohol or prescription medication abuse. If you decline to be drug tested, this may directly impact my ability to provide high quality care and to prescribe certain medications, including benzodiazepines, hypnotics and stimulants.
- Consistent with the literature available, regular or long-term use of benzodiazepines is not advisable for psychiatric treatment. Literature showing any benefit of benzodiazepine use after 3 months is lacking. Cognitive behavior therapy has shown superior efficacy for the treatment of anxiety and sleep disorders, and benzodiazepines may actually impair a patient’s ability to benefit from psychotherapy. Benzodiazepine use can result in short and long term cognitive impairment, amnesia, worsening anxiety, dementia, and abuse/dependence. I will work with those being given regular or chronic prescriptions for benzodiazepines on a plan to slowly and comfortably taper them off, and I typically only provide small amounts when starting anyone on these medications to help minimize the above risks.
- I treat adults with ADHD but rarely diagnose it due to the extensive testing involved for an accurate diagnosis. Providing documentation of ADHD testing and/or records confirming the diagnosis of ADHD will be requested prior to prescribing stimulants.
- For those being prescribed opiates, including those in recovery for an opioid use disorder taking buprenorphine or methadone – the use of concurrent benzodiazepine medication can be dangerous. This combination may result in increased respiratory depression, coma and death. Nearly one-third of deaths from opioid overdoses involve benzodiazepines. Due to the severity of this medication combination and the concern of safety for my clients, I do not feel that the use of benzodiazepines with opiates is in the best interest of my clients.
Greta Ortega (Lindberg)
PMHNP-BC, CNP Psychiatric Mental Health Nurse Practitioner
Greta holds a Masters of Science in Psychiatric Mental Health Nursing from the University of South Alabama, Bachelor of Science in Nursing from the College of Saint Scholastica, and Bachelor of Science in Health and Wellness and Public Health from the University of Minnesota.
Certified as a Psychiatric-Mental Health Nurse Practitioner with the American Nurses Credentialing Center, Greta is certified to provide psychiatric diagnostic evaluations, ongoing medication management, and psychotherapy for individuals across the lifespan. Greta specializes in psychiatric medication management for children, adolescents, and young adults.
Greta has worked and trained in a variety of mental health settings including inpatient, partial hospitalization programs, community health centers, dialectical behavioral therapy outpatient clinic, and intensive outpatient programs. She has experience in treating a wide variety of mental health concerns including depression, anxiety, mood disorders, ADHD, impulse control disorders, ODD, PTSD, and OCD.
Greta believes in providing a holistic and individualized treatment plan for each client. Treatment plans may include medications, incorporating the mind-body connection, supplements, referrals to therapy/mental health programs, incorporating health and wellness interventions, pro-social activities, and addressing biological or social factors.
Greta enjoys working with clients and their families together through life's unique challenges to provide the tools and resources towards improving their mental health.
Melissa received her Bachelors degree in nursing from the College of St Catherine. She has over 16 years of psychiatric nursing experience working with clients across the lifespan. Melissa enjoys working closely with the psychiatric providers to get a better understanding of each client and their treatment needs.
River Valley and their nursing staff now offer GeneSight testing. GeneSight Psychotropic is a pharmacogenomic test which means that it analyzes how your genes may affect medication outcomes. The GeneSight test analyzes clinically important genetic variations in your DNA. Results can inform your prescriber about how you may break down or respond to certain medications commonly prescribed for adults to treat depression, anxiety and mood disorders.
Ask your provider if you qualify for this testing. More information available at https://genesight.com