Psychiatric mental health nursing: Why 2011 brings a pivotal moment

Abstract

Psychiatric nurses in the United States (US) stand at the edge of a changing mental health care landscape. Federal initiatives are moving into place; ones that aim to increase access to care, place a greater emphasis on prevention and wellness, and position recovery as the focus of mental health treatment. The Psychiatric Mental Health (PMH) specialty is at a pivotal moment of choice: it can organize around a future vision of PMH nursing or can silently acquiesce to a marginalized position. At this pivotal time, PMH nurses must build a greater presence in national workforce dialogue and convey the need for nursing in mental health care service delivery; a policy message build on the PMH nurses ability to provide access to safe and quality mental health care and substance use services. This paper discusses how to put these strategies into place via workforce development, strategic alliances, and critical conceptual shifts. Key wordsPsychiatric nurses, Psychiatric mental health, Pivotal moment Psychiatric mental health nurses in the United States (US) stand at the edge of a changing mental health care landscape. The key drivers of change are US health care reform with its emphasis on access, prevention and wellness; an explosion of neurobiological research laying down seeds for future innovation, and recovery as the focus of mental health treatment. Specific to psychiatric mental health (PMH) nursing, a major change is occurring in the certification and licensure of advanced practice nurses (APNs) that moves PMH APNs to a life-span nurse practitioner (NP) role. The specialty is at a pivotal moment of choice: it can organize around a future vision of PMH nursing or we can silently acquiesce to a marginalized position. Indeed PMH nurses can either sort out how our core values fit with health care innovation and move our vision into action or we can remain locked in a titling controversy, tied to traditional models of education, fail to align with recovery, and fall short in gaining a stronger foothold in new health services models. The key drivers of change set the context of PMH nurses' decision since it is these dynamics that are shaping the service delivery landscape.

A Modern History of Psychiatric–Mental Health Nursing

“…After some discussion, APNA and ISPN both supported the resolution that the PMH-NP would be the entry-level APRN psychiatric nursing degree in 2010 (Delaney, 2011). Some psychiatric nurses felt disenfranchised by the LACE document, particularly CNSs who had a long history of independent practice.…”

“…However, the training will need to accommodate an insurance governed environment prevention, treatment and creative efforts leading to recovery (Delaney, 2011). These are the same things mandated in the 1980 Mental Health Systems Act-but never implemented due to Congressional defunding.…”

“…Additionally, it prohibits yearly or lifetime limits on any healthcare, including mental health/substance abuse coverage (U.S. Department of Health & Human Services, 2014). It is anticipated the expanded access to mental health and substance abuse services facilitated by the ACA will increase the demand for PMH NPs and CNSs (Delaney, 2011;Pearlman, 2013).…”

Psychiatric Mental Health Nurses

“…Health care reform has created new roles for nurses via policies that strengthened wellness/prevention, expanded primary care, and incentivized care collaboration (Newhouse et al, 2012). Owing to concerns around the physical health of individuals with serious mental illness and expansion of state insurance structures, a new mental health care service landscape is evolving—one that favors integrated care, behavioral health care homes, and wellness outcomes (American Psychiatric Association, 2011; Delaney, 2011). Incentives such as value-based purchasing will bring greater emphasis on consumer involvement and patient-centered care, while the mechanisms to enforce preventable 30-day readmissions may result in a more judicious use of the remaining inpatient beds (Berenson, 2010; Burke, Donzé, & Schnipper, 2013).…”

Exploring College Students' Perceptions of College Gun Violence

“…After reviewing its yearly outcome, this group wellness appointments within a recoverybased self-management program that emphasized improving relationships, coping, and life choice has shown improving access to wellness care as well as clients' 27 perceiving quality of life. This DNP project clearly illustrated the significant clinical services research that was accomplished by PMH DNP students and their faculty mentors (Delaney, 2011). This example also reflects the fact that doctorate prepared advanced nurses are in a pivotal position to apply evidence-based practice to improve the health of our nation including college students.…”