Wholeness Healing Center

Building Strong Foundations for Mental Health: An Interview with Susan Hoff, PMHNP

This month, I interviewed with Susan Hoff, Psychiatric Mental Health Nurse Practitioner (PMHNP),who completed a fellowship in integrative psychiatry. Hoff primarily prescribes medication but endorses the importance of therapy along with improving lifestyle changes.

“Medication can be very beneficial for some individuals,” Hoff explains. “I often compare it to a brace for a broken bone. It provides necessary support, but true healing requires more than just the brace. We must also strengthen the foundations of health.

To illustrate this, Hoff uses the image of a table supported by four legs: sleep, nutrition, movement, and connection.

If all four legs are steady, the table is stable. But if even one leg is wobbly, everything feels off balance.

Sleep: The Cornerstone of Emotional Regulation
According to Hoff, healthy sleep patterns are fundamental. “Without regular, restorative sleep, concentration, memory, and emotional tolerance decline,” she says. “Irritability, poor focus, and difficulty managing stress are common consequences of insufficient sleep.” Establishing consistent sleep and wake times is a powerful first step in restoring balance.

Nutrition: Food as Medicine
Diet has a direct impact on mental health. Hoff advocates for whole-food dietary traditions such as the Mediterranean, Japanese, or Scandinavian diets, which emphasize vegetables, fruits, whole grains, and healthy fats.

By contrast, the Standard American Diet (SAD)—characterized by processed meals, fast food, and sugary beverages—undermines both physical and mental well-being. “Small, steady changes are more effective than drastic overhauls,” Hoff notes. “Even adding one serving of vegetables a day can be a meaningful step toward better health.”

She also highlights the value of fermented foods for gut health, colorful produce like berries and cherries for their nutritional density, and the importance of eating at home, which fosters both nutrition and meaningful family connection.

Movement: Finding What Works for You
“Movement does not need to mean training for a marathon,” Hoff emphasizes. “For some, it’s a daily walk; for others, yoga or stretching. The key is to fnd the type of movement your body responds well to.” Find out what your body likes—something that feels supportive rather than forced.

Regular physical activity—whether small or significant—supports mood regulation and resilience.

Connection: The Role of Relationships
Human connection is another critical element. Supportive, positive relationships provide a buffer against stress and foster a sense of belonging. “Spending time with people who uplift instead of drain you is essential,” Hoff explains. “Strong, healthy relationships can be as important to mental health as sleep or nutrition.”

Mindfulness and Coping Strategies
Finally, Hoff highlights the role of mindfulness in strengthening resilience. Mindfulness is the glue that holds it all together. It helps us cope with stress, be more present, and notice what actually works for us. Everyone is different—what helps your best friend may not work for you. It’s about experimenting, being patient, and finding your own path. Practices such as deep breathing, meditation, or intentional self-reflection allow individuals to respond to more effectively.

Small Steps, Lasting Change
Hoff encourages individuals to begin with manageable adjustments rather than drastic changes. Too much can be “Like a puzzle forcing in a piece that doesn’t fit or doesn’t work”. “Find what works for you. Consistency matters more than intensity,” she concludes. Tiny changes build momentum, and over time, they create real transformation. “Whether it is adding one more serving of vegetables, going to bed a little earlier, or taking a short walk, these small steps build a foundation for long-term mental health.”

Susan Hoff, MSN, APRN-BC, PMHNP, Box Butte Butte General Hospital, Alliance, NE. To schedule an appointment, call 308-762-7244.

Tags: Balancing medication needs with other necessary support, strengthening the foundatios of health for mental health