The demand for behavioral and mental health nurses continues to grow

Nicholas Hatcher, APN “Entering the mental health industry as a nurse equipped with a holistic care model gives you an advantage,” said Nicholas Hatcher, DNP, APN, AGACNP-BC, PMHNP-BC, DBT-C. “From the beginning of nursing school, we are all trained to use the biopsychosocial model and address several factors that impact physical and mental health. The complex nature of physical and mental illness comes as no surprise to the nurse who is accustomed to navigating patient care that operates within this model.” Moreover, there may be a necessity for behavioral health in all places, said Connie Vogel, PhD, RN, CNE. “I think experienced nurses would agree… that anxiety, depression, post-traumatic stress disorder (PTSD), psychosis and personality disorders can be found in every medical specialty,” Vogel said. “Often these conditions need to be managed in conjunction with the corresponding acute medical condition, and nurses in all settings really need knowledge about behavioral health conditions.”

To meet the mental health needs of patients, one nurse may fit in several facilities, as Hatcher is an example. He primarily practices outpatient psychiatry in public health settings and owns and operates Catharsis Health, a non-public practice specializing in providing virtual psychiatric services in Washington State that’s seeking to potentially expand its reach. “[I am] I hope to expand to other states with a full practice in the near future,” explained Hatcher, who also works as a PRN (as needed) at a local hospital as a hospitalist/intensivist.

Career options range from private practice to bedside

In inpatient psychiatric nursing settings, the nurse deals with acute, urgent and emergency mental illnesses such as acute suicidal or homicidal ideation, forensic examinations, acute withdrawal and detoxification, acute psychosis, etc. In the outpatient setting, nurses deal with chronic and some acute psychiatric disorders. diseases. Career options in nursing can be narrowed depending on the population of interest. For example, nurses may focus on adult or child/adolescent populations, according to Hatcher. “As a student, I used to be told that you might select a selected psychiatric disease or subset of diseases and achieve success in subspecialty practice, given the severe shortage of mental health providers across the United States,” said Hatcher, who, amongst his other skilled responsibilities, is an assistant professor of nursing at Cleveland State Community College in Cleveland, Tennessee, and at Husson University in Bangor, Maine. “So, if you want to specialize in the treatment of attention deficit hyperactivity disorder, post-traumatic disorder, substance use disorder, mood disorders, etc., you can certainly deepen your knowledge of this population and focus on treating these specific conditions ” Hatcher said psychiatric nurses work in several settings, including:

• Outpatient general psychiatry
• Inpatient psychiatry
• Detoxification units
• Addiction and rehabilitation
• Forensic nursing
• Counseling and coaching provided by a nurse
• Child and adolescent psychiatry
• Consultative psychiatry
• Psychosomatic medicine
• Geriatric psychiatry

The academy is another career option for mental health nurses. Vogel is currently a faculty member at Capella University’s School of Nursing and Health Sciences. He teaches in the MSN sub-specialty, psychiatry/mental health nursing sub-specialty, and writes continuing education programs in his specialties, including geriatric mental health and addiction issues. Vogel has had a diverse career as a mental health nurse. She was a clinical nurse specialist in a private psychiatric practice, worked in a mental health facility and veterans facility, and provided psychiatric/mental health counseling in long-term care.

The shortage puts mental health nurses in the driver’s seat

According to Hatcher, there is a significant shortage of mental health providers across the United States, a situation that has become more pronounced with the pandemic.

“The number of people seeking help for mental illness and its symptoms has certainly increased,” Hatcher said. “It has given me the opportunity to expand my business and start my own practice, so I can increase access to psychiatric services for those in need.”

In psychiatry, it’s easier for nurses to practice to the total extent of their license and training, Hatcher said. “For this reason, I find psychiatry very rewarding, especially because it provides the level of autonomy that I prefer,” he said. For nurses or those eager about pursuing the practice, Vogel said there is a large need for behavioral health providers.

“Psychiatrists are in short supply outside major population centers, and there is a need for ARNPs who can manage psychotropic medications and treatment plans in behavioral health settings,” Vogel said.

For nurses who usually are not NPs, psychiatric nurses are all the time needed on hospital units, in accordance with Maria Ingalli, DNP, PMHNPBC, PMHC, owner and practice at Paperflower Psychiatry in Phoenix, Arizona, and professor of mental health nursing at Arizona State University. Urgent care is not the only facility that tries to supply housing for patients. Many facilities and practices also face staffing challenges. In Arizona, for instance, the necessity for inpatient RNs for psychiatrists is growing, but the provision of inpatient beds just isn’t, Ingalla says. She explained: “There are not enough beds, so patients are being turned away and placed in an outpatient hospital.” According to Ingalla, many patients affected by mental illness wait months to see a psychiatrist. “An evaluation at a local mental health center can take weeks or months. When I worked in such facilities, I always had four to eight weeks off. And this was at the beginning of the pandemic,” Ingalla said. “Now that I am in private practice, I have received about 400 referrals in the last four months [and] They hired another NP.”

Time is one other challenge

Ingalla wrote concerning the disadvantages she experienced in local mental health facilities in a blog post at: Madness in America side. “I worked at a mental health facility for a while,” Ingalla said. “Not a big fan…basically a pill pusher. About four patients per hour come for follow-up visits and very quick tests lasting 30 to 60 minutes, which are not very comprehensive. This is one of the places where neuropsychologists start and end up with burnout.” Meeting demands without sacrificing quality is a challenge for today’s mental health nurse.

“I think it’s really difficult to meet the demand qualitatively because I was able to see all the patients pretty quickly, but we do 90-minute assessments and 30-minute follow-ups, respond to emails and try to make sure everyone feels supported,” Ingalla said. . – It takes a variety of time.

Ingalla, who recently gave birth, said attempting to balance family and work is an added burden during this busy time. “The most helpful thing was that I took it upon myself to do it [nurse practitioner] students in my private practice. I teach them to gain experience in dealing with patients. They can also see patients during the day when I’m delivering the baby or supervising the baby,” Ingalla said. Teaching gives Ingalli a fresh perspective and time away from direct patient care. “I love [teaching]. Sometimes being around people who are excited about learning is a break from reality,” she said. “We really need nurses with mental health experience to teach. I would highly recommend applying for a simulation-only or clinical instructor position and starting from there. Then you can integrate and move up.” To change into a clinical nursing instructor, many colleges only require an Associate’s or Bachelor’s degree. According to Ingalla, those that wish to teach typically need a Ph.D.

Path to a Career in Mental Health

According to Vogel, nurses considering a profession change to mental health practice profit from further education. The certification offered by the American Nurses Credentialing Center is the PMH-BC, Psychiatric-Mental Health Nursing Board certification. This is a competency-based certification validating entry-level practice in psychiatric/mental health nursing. According to Vogel, requirements include 2,000 hours of clinical practice in mental health, 30 CEUs in the sphere and successful completion of an exam. Psychiatric nurses can change into certified as ARNPs with a specialization in psychiatric care/mental health, Vogel said. Ingalla said that after earning a bachelor’s degree in nursing, a master’s degree is one other yr or two of study and about 600 hours of teaching. “You can then prescribe medications, diagnose mental health conditions and treat people in the various places you choose to work,” Ingalla said.