Cynthia Handrup, DNP, APRN, PMHCNS-BC, FAAN, serves as the Director of the Psychiatric Mental Health Nurse Practitioner DNP program and Director of the Primary Care Mental Health Concentration. She is passionate about shaping policies and agendas for behavioral health and social justice, structural racism, human trafficking, justice reform, global mental health, and LGBTQ issues. Handrup, along with colleague Kathleen Delaney, PhD, APRN, PMH-NP, FAAN, explains how enhancing mental health policy can benefit rural, underserved areas in Illinois.
Q: Could you outline the current toll of mental illness in the United States and the challenges associated with it?
A: Mental illness is a pressing concern in the U.S., affecting about 1 in 5 adults annually. The population is aging, and as a result, we’re seeing a growing need for mental health services to manage comorbid conditions. However, this demand isn’t confined to older adults; mental health services are increasingly in demand across all age groups. Compounding this challenge is a critical shortage in the behavioral health workforce, especially in rural areas, where 1 in 5 individuals have limited access to care. Primary care clinicians also struggle to secure mental health referrals for patients with complex needs, which puts more strain on the system.
Q: What roles do Psychiatric Mental Health Nurse Practitioners (PMHNPs) play in addressing these challenges?
A: PMHNPs are pivotal in improving access to mental health care, especially in underserved and rural areas. They bring expertise in assessing, diagnosing, and treating psychiatric and mental health disorders. Beyond diagnosis and treatment, PMHNPs provide psychotherapy and medication management, offering a holistic approach to mental healthcare. They also collaborate with other healthcare professionals to provide integrated and coordinated care, ensuring that both mental and physical health needs are addressed. Additionally, they can leverage telehealth technologies to expand access to care in underserved areas.
Q: What are some barriers PMHNPs face in their practice, particularly in addressing workforce shortages?
A: One major barrier is the variation in state policies regarding independent practice. In 27 states, PMHNPs have full practice authority, which allows them to evaluate, diagnose, and treat patients independently. In the remaining states, including Illinois, they require a collaborative agreement with an MD for a period before achieving independence. This creates unnecessary delays in meeting the needs of underserved populations. Additionally, PMHNPs are often underutilized due to limited visibility in workforce planning, and their contributions are underreported in workforce data, which hindering funding and resource allocation.
Q: How can strategic investments and policy changes enhance the role of PMHNPs in addressing mental health needs?
A: States should prioritize granting full practice authority to PMHNPs, as evidence shows this improves access to care, particularly in rural areas, without compromising quality. Investments in PMHNP training programs and providing incentives to practice in underserved areas are also critical. Moreover, better integration of PMHNPs within primary care settings can ensure a comprehensive approach to mental health care. Finally, addressing underreporting in workforce data and increasing awareness of the PMHNP role can support more effective workforce planning and resource allocation.
Q: Finally, how can the public and healthcare systems better support PMHNPs in fulfilling their potential?
A: Public awareness of the role and capabilities of PMHNPs is crucial. Healthcare systems need to invest in their training and ensure they are included in workforce planning and decision-making processes. Collaboration with policymakers to address barriers like restrictive practice laws is essential. Ultimately, empowering PMHNPs to work to the full extent of their training and expertise will be key to improving mental health outcomes across the country.
