567945
research-article2015
JAPXXX10.1177/1078390314567945Journal of the American Psychiatric Nurses AssociationAdams
APNA President’s Column
Psychiatric Mental Health Nursing: “A Seat at the Table”
Journal of the American Psychiatric Nurses Association 2015, Vol. 21(1) 34–37 © The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1078390314567945 jap.sagepub.com
Susie Adams1 As the new president of American Psychiatric Nurses Association (APNA), I invite you to reflect on what it means to be “a psychiatric nurse” and what individually and collectively we bring to the health care table in 2015. As an organization we are more than 10,000 members strong. As a specialty trained workforce, psychiatric mental health nurses in the United States number 133,791 strong (U.S. Department of Health and Human Services, 2010), which includes more than 19,126 advanced practice psychiatric nurses (Heisler & Bagalman, 2014; Institute of Medicine, 2012). We are part of the largest workforce group in the United States—with 3.1 million nurses and growing (U.S. Department of Health and Human Services, 2010). We are at a pivotal time in the history of U.S. health care as the Affordable Care Act (Patient Protection and Affordable Care Act 2010 HR3590, or Affordable Care Act [ACA], 2010) and the Mental Health Parity and Addiction Equity Act (MHPAEA; U.S. Department of Labor, 2008) have provided or expanded health care services including treatment for mental health and substance abuse disorders to over 60 million Americans (Substance Abuse and Mental Health Services Administration [SAMHSA], 2014a). Health insurance reform is shifting payment to population based care with an emphasis on health promotion/ disease prevention—a wellness model focused on keeping people healthy—and away from the traditional fee for service/illness model (SAMHSA, 2014a). Even with the expanded coverage of the ACA and Parity Acts, recent surveys estimate 40.7 million Americans remain uninsured (Collins & Rasmussen, 2014). Government agencies now estimate that nearly one in four U.S. adults, or 61.5 million Americans, have a diagnosable mental health disorder warranting treatment in a given year (Center for Disease Control and Prevention, 2011; National Institutes of Health, National Institute of Mental Health, 2014; SAMHSA, 2012a). Nearly 10 million adults in America experienced a serious mental illness such as schizophrenia, major depression, or bipolar disorder in 2013 (SAMHSA, 2013). Approximately 20% of youth ages 13 to 18 experience severe mental disorders in a given year (SAMHSA, 2013). Persons with serious mental illness die an average of 25 years sooner than the rest of the U.S. population (National Association of State
Mental Health Program Directors Medical Directors Council, 2006). With 319 million Americans and a combined mental health workforce of 292,500, which includes psychiatrists, advanced practice psychiatric nurses, clinical psychologists, psychiatric social workers, and marriage and family counselors, that equates to one mental health care worker per 1,090 people (Heisler & Bagalman, 2014; Institute of Medicine, 2012). Not nearly a sufficient mental health specialty workforce to meet the growing need for mental health and substance use treatment. What does this really mean for psychiatric mental health nurses? These statistics paint a compelling story of the widespread need for mental health and substance abuse services in the United States. Psychiatric mental health nurses bring a unique set of knowledge and skills that embrace a holistic approach and a wellness model in our work with individuals, families, and communities. As an organization APNA seeks opportunities to have the voice of psychiatric nurses represented at key policymaking forums by building collaborative relationships with other professional, government, and consumer organizations. APNA continuously works to “have a psychiatric nurse with a seat at the policymaking table.” Some recent examples include APNA’s role in the Veteran’s Administration “Joining Forces” to address mental health needs of military families; representation on the VA Mental Health Workforce Task Group; representatives on the ongoing LACE Task Force to address multistate licensure, accreditation, certification, and education for advanced practice nurses; and representation on the Institute of Medicine’s Committee on developing Evidence-Based Standards for Psychosocial Interventions for Mental Disorders. Our various councils keep APNA informed about trends, issues, and opportunities for action such as developing white papers, meeting education needs of members, investigating innovative treatment approaches to support evidence-based practice, and 1
Susie Adams, PhD, RN, PMHNP/CNS-BC, FAANP, Vanderbilt University School of Nursing, Nashville, TN, USA Corresponding Author: Susie Adams, Vanderbilt University School of Nursing, 313 Godchaux Hall, 461 21st Ave. South, Nashville, TN 37240, USA. Email: [email protected]
Downloaded from jap.sagepub.com at FLORIDA INTERNATIONAL UNIV on November 16, 2015
35
Adams informing stakeholders of gaps in service as well as potential strategies to fill service gaps. Current trends include the need for developing, testing, and refining models of integrated care delivery that address both physical and mental health and shifting to population-based treatment approaches focused on wellness, prevention, early intervention, and support full recovery. As a psychiatric mental health nurse the most important “table” that we “have a seat” is at our kitchen tables, our dinner tables, our lunch room tables—anywhere we gather with family, friends, neighbors, coworkers, and colleagues—to talk about the work we do as a psychiatric nurses and the compelling stories about the need for mental health services in our communities. With one in four Americans experiencing a mental health and/or substance use disorder within any given year, these issues touch our own families or someone we know and care. We can be the grass roots movement that dispels the stigma of mental illness and substance abuse through our conversations about available treatments that are effective. Nursing consistently ranks as the “most trusted” profession in the United States for the past 14 years based on the public’s perception of our honesty and ethical standards (Gallup, 2014). We need to capitalize on that trust and tell others about our work as psychiatric mental health nurses that supports individuals in their journey of healing and recovery. What are the core values of psychiatric mental health nurses? The following values are ones that APNA embraces: 1. Full recovery from serious mental illness is feasible and the goal of treatment (SAMHSA, 2012b). 2. Integration of mental health services across the health care delivery system is the goal of holistic health care (SAMHSA, 2014b). 3. All nurses need a solid foundation of psychiatric nursing principles and clinical experience within their basic nursing education. 4. Psychiatric nurses need education that prepares them to provide care across the lifespan (American Nurses Association, American Nurses Credentialing Center, 2014a; National Organization of Nurse Practitioner Faculty, 2013). 5. There can be no physical health without mental health (Kolappa, Henderson, & Kishore, 2013). Pat Deegan, a clinical psychologist who was diagnosed with schizophrenia in late adolescence, first described her own experience of recovery “to live, work, and love in a community in which one makes a significant contribution” (Deegan, 1988, p. 11). Recovery is now recognized as the goal for people with serious mental illness and underpins mental health services (Harrow,
Jobe, & Faull, 2012; SAMHSA, 2012b). Recovery is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to achieve their full potential (SAMHSA, 2012b). The four dimensions that support a life in recovery are (a) health, wherein an individual makes informed, health choices that support physical and emotional well-being; (b) home, where an individual has a stable, safe place to live; (c) purpose, wherein an individual engages in meaningful daily activities (job, school, volunteering), and (d) community, wherein an individual builds relationships and social networks that provide support (SAMHSA, 2012b). Integrated health care is intended to improve health and mental health care outcomes regardless of whether primary care is embedded within mental health care services or vice versa. Over 68% of adults with mental illness have one or more chronic medical conditions and 20% of adults with mental illness have a co-occurring substance use disorder (SAMHSA, 2009). SAMHSA has funded more than 100 different grantees to develop integrated models of care for population-based care for individuals with serious mental illness including medical homes embedded within community behavioral health care centers. The goal of these integrated health care models is to improve access to primary care, prevention and early identification of serious physical illness, reduce the incidence of serious physical illness, increase availability of integrated, holistic care, and improve the overall health status of mental health clients (SAMHSA, 2014b). With the increasing need for mental health and substance abuse services, it is essential for all nurses to be well grounded in psychiatric nursing principles and practice within their basic nursing education at the associate and baccalaureate levels. With the decreasing psychiatric inpatient beds and diminishing numbers of faculty with psychiatric specialty expertise, nursing schools have found it increasingly difficult to secure clinical rotation sites and to provide adequately trained faculty. This has resulted in decreased psychiatric nursing content and clinical experience in the curriculum. Efforts are underway to re-infuse psychiatric nursing content into basic nursing education. Since 2008, education for psychiatric mental health nurses at the RN-C and APRN levels have been focused across the lifespan to provide a more flexible mental health nursing workforce. This goal has been reinforced by eligibility requirements to take psychiatric-mental health certification exams (American Nurses Association, American Nurses Credentialing Center, 2014b) and PMHNP competencies (National Organization of Nurse Practitioner Faculty, 2013). This education and certification requirement for PMHNPs has been building workforce capacity
Downloaded from jap.sagepub.com at FLORIDA INTERNATIONAL UNIV on November 16, 2015
36
Journal of the American Psychiatric Nurses Association 21(1)
to reach underserved populations, especially in rural and inner-city settings. The United Kingdom and the World Health Organization first articulated the proposition that there could be no true physical health without mental health (Chisholm, 1954; Her Majesty’s Government Department of Health Department, 2011). The bidirectional relationship of mental health disorders with physical comorbidities is now widely recognized as influencing health outcomes (Kolappa et al., 2013). In the United States, mental health advocacy groups have embraced this concept to reduce stigma that has been a long-standing barrier to people accessing mental health services and to promote awareness of lifestyle choices that support mental health and wellness (Mental Health America, 2014; No Health Without Mental Health, 2014). The Mental Health Recovery movement in the United States similarly endorses the value that mental health is fundamental to health. As you take a “seat at the table,” I hope you will use your voice and share your reflections on what it means to “be a psychiatric nurse.”
Americans in early 2014. Retrieved from http://www. commonwealthfund.org/publications/blog/2014/sep/newfed-eral-surveys-show-declines-in-number-of-uninsuredamerica-ns-in-early-2014 Deegan, P. (1988). Recovery: The lived experience of rehabilitation. Psychosocial Rehabilitation Journal, 11(4), 11-19. Gallup. (2014). Honesty/ethics in professions. http://www.gallup. com/poll/1654/honesty-ethics-professions.aspx Harrow, M., Jobe, T. H., & Faull, R. N. (2012). Do all schizophrenia patients need antipsychotic treatment continuously throughout their lifetime? A 20-year longitudinal study. Psychological Medicine, 42, 2145-2155. doi:10.1017/ S0033291712000220 Heisler, E. J., & Bagalman, E. (2014, January 7). The mental health workforce: A primer (Congressional Research Service, 7-5700). Retrieved from http://www.fas.org/sgp/ crs/misc/R43255.pdf Her Majesty’s Government Department of Health Department. (2011). No health without mental health: A cross-government mental health outcomes strategy for people of all ages. Retrieved from https://www.gov.uk/government/ uploads/system/uploads/attachment_data/file/138253/ dh_124058.pdf Institute of Medicine. (2012). The Mental Health and Substance Use Workforce for Older Adults: In whose hands? Washington, DC: National Academies Press. Kolappa, K., Henderson, D. C., & Kishore, S. P. (2013). No physical health without mental health: Lessons unlearned? Bulletin of the World Health Organization, 91(1), 3-3A. doi:10.2471/BLT.12.115063 Mental Health America. (2014). Non-profit mental health advocacy organization. Retrieved from http://www.mentalhealthamerica.net/what-we-believe National Association of State Mental Health Program Directors Medical Directors Council. (2006). Morbidity and mortality in persons with serious mental illness. Retrieved from http://www.nasmhpd.org/docs/publications/MDCdocs/ Mortality%20and%20Morbidity%20Final%20Report%20 8.18.08.pdf National Institutes of Health, National Institute of Mental Health. (2014). Statistics: Any disorder among adults. Retrieved from http://www.nimh.nih.gov/statistics/1ANYDIS_ADULT. shtml National Organization of Nurse Practitioner Faculty. (2013). Psychiatric-mental health nurse practitioner competencies. Retrieved from http://c.ymcdn.com/sites/www.nonpf. org/re-source/resmgr/Competencies/CompilationPopFocus Comps2013.pdf No Health Without Mental Health. (2014). Facebook page for non-profit advocacy group. Retrieved from https://www. facebook.com/nhmh1 Patient Protection and Affordable Care Act 2010 HR3590, or Affordable Care Act (ACA) implemented January 1, 2014. Retrieved from http://housedocs.house.gov/energy commerce/ppacacon.pdf Substance Abuse and Mental Health Services Administration. (2009). Results from the 2008 National Survey on Drug
Declaration of Conflicting Interests The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding The author received no financial support for the research, authorship, and/or publication of this article.
References American Nurses Association, American Nurses Credentialing Center. (2014a). APRN certification data for advanced practice psychiatric nurses (PMHNP and Psych CNS) from 2005-2013. Retrieved annually from ANCC Statistics: http://www.nursecredentialing.org/Certification/ FacultyEducators/FacultyCategory/Statistics/2013-ANCCCertification-Statistics-pdf.pdf. American Nurses Association, American Nurses Credentialing Center. (2014b). Eligibility criteria for PMHNP certification exam. Retrieved from http://www.nursecredentialing. org/FamilyPsychNP-Eligibility.aspx Center for Disease Control and Prevention. (2011, September 2). CDC report: Mental illness surveillance among U.S. adults. Morbidity and Mortality Weekly Report, 60. Retrieved from http://www.cdc.gov/mentalhealthsurveillance/ Chisholm, B. (1954). Outline for a Study Group on World Health and the Survival of the Human Race (Material drawn from articles and speeches by Brock Chisholm). Geneva, Switzerland: World Health Organization. Retrieved from whqlibdoc.who.int/hist/…/ChisholmBrock_1953_ Compilation.pdf Collins, S. R., & Rasmussen, P. W. (2014, September 16). New federal surveys show declines in number of uninsured
Downloaded from jap.sagepub.com at FLORIDA INTERNATIONAL UNIV on November 16, 2015
37
Adams Use and Health: National findings. Retrieved from http:// archive.samhsa.gov/data/NSDUH/2k8nsduh/2k8results.pdf Substance Abuse and Mental Health Services Administration. (2012a). Results from the 2010 National Survey on Drug Use and Health: Mental health findings (NSDUH Series H-42, HHS Publication No. (SMA) 11-4667). Rockville, MD: Author. Substance Abuse and Mental Health Services Administration. (2012b). Working definition of recovery. Retrieved from http://store.samhsa.gov/product/SAMHSA-s-WorkingDefini-tion-of-Recovery/PEP12-RECDEF Substance Abuse and Mental Health Services Administration. (2013). Results from the 2013 National Survey on Drug Use and Health: Mental health findings. Retrieved from http://www.samhsa.gov/data/sites/default/files/NSDUH mhfr2013/NSDUHmhfr2013.pdf
Substance Abuse and Mental Health Services Administration. (2014a). Health financing: Overview. Retrieved from http://www.samhsa.gov/health-financing Substance Abuse and Mental Health Services Administration. (2014b). SAMHSA Primary and Behavioral Health Care Integration (PBHCI) Program. Retrieved from http:// www.integration.samhsa.gov/about-us/pbhci U.S. Department of Health and Human Services, Health Resources and Services Administration. (2010). The registered nurse population: Findings from the 2008 National Sample Survey of Registered Nurses. Retrieved from http:// bhpr.hrsa.gov/healthworkforce/rnsurveys/rnsurveyfinal. pdf U.S. Department of Labor. (2008). Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Retrieved from http://www.dol.gov/ebsa/newsroom/fsmhpaea.html
Downloaded from jap.sagepub.com at FLORIDA INTERNATIONAL UNIV on November 16, 2015
research-article2015
JAPXXX10.1177/1078390314567945Journal of the American Psychiatric Nurses AssociationAdams
APNA President’s Column
Psychiatric Mental Health Nursing: “A Seat at the Table”
Journal of the American Psychiatric Nurses Association 2015, Vol. 21(1) 34–37 © The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1078390314567945 jap.sagepub.com
Susie Adams1 As the new president of American Psychiatric Nurses Association (APNA), I invite you to reflect on what it means to be “a psychiatric nurse” and what individually and collectively we bring to the health care table in 2015. As an organization we are more than 10,000 members strong. As a specialty trained workforce, psychiatric mental health nurses in the United States number 133,791 strong (U.S. Department of Health and Human Services, 2010), which includes more than 19,126 advanced practice psychiatric nurses (Heisler & Bagalman, 2014; Institute of Medicine, 2012). We are part of the largest workforce group in the United States—with 3.1 million nurses and growing (U.S. Department of Health and Human Services, 2010). We are at a pivotal time in the history of U.S. health care as the Affordable Care Act (Patient Protection and Affordable Care Act 2010 HR3590, or Affordable Care Act [ACA], 2010) and the Mental Health Parity and Addiction Equity Act (MHPAEA; U.S. Department of Labor, 2008) have provided or expanded health care services including treatment for mental health and substance abuse disorders to over 60 million Americans (Substance Abuse and Mental Health Services Administration [SAMHSA], 2014a). Health insurance reform is shifting payment to population based care with an emphasis on health promotion/ disease prevention—a wellness model focused on keeping people healthy—and away from the traditional fee for service/illness model (SAMHSA, 2014a). Even with the expanded coverage of the ACA and Parity Acts, recent surveys estimate 40.7 million Americans remain uninsured (Collins & Rasmussen, 2014). Government agencies now estimate that nearly one in four U.S. adults, or 61.5 million Americans, have a diagnosable mental health disorder warranting treatment in a given year (Center for Disease Control and Prevention, 2011; National Institutes of Health, National Institute of Mental Health, 2014; SAMHSA, 2012a). Nearly 10 million adults in America experienced a serious mental illness such as schizophrenia, major depression, or bipolar disorder in 2013 (SAMHSA, 2013). Approximately 20% of youth ages 13 to 18 experience severe mental disorders in a given year (SAMHSA, 2013). Persons with serious mental illness die an average of 25 years sooner than the rest of the U.S. population (National Association of State
Mental Health Program Directors Medical Directors Council, 2006). With 319 million Americans and a combined mental health workforce of 292,500, which includes psychiatrists, advanced practice psychiatric nurses, clinical psychologists, psychiatric social workers, and marriage and family counselors, that equates to one mental health care worker per 1,090 people (Heisler & Bagalman, 2014; Institute of Medicine, 2012). Not nearly a sufficient mental health specialty workforce to meet the growing need for mental health and substance use treatment. What does this really mean for psychiatric mental health nurses? These statistics paint a compelling story of the widespread need for mental health and substance abuse services in the United States. Psychiatric mental health nurses bring a unique set of knowledge and skills that embrace a holistic approach and a wellness model in our work with individuals, families, and communities. As an organization APNA seeks opportunities to have the voice of psychiatric nurses represented at key policymaking forums by building collaborative relationships with other professional, government, and consumer organizations. APNA continuously works to “have a psychiatric nurse with a seat at the policymaking table.” Some recent examples include APNA’s role in the Veteran’s Administration “Joining Forces” to address mental health needs of military families; representation on the VA Mental Health Workforce Task Group; representatives on the ongoing LACE Task Force to address multistate licensure, accreditation, certification, and education for advanced practice nurses; and representation on the Institute of Medicine’s Committee on developing Evidence-Based Standards for Psychosocial Interventions for Mental Disorders. Our various councils keep APNA informed about trends, issues, and opportunities for action such as developing white papers, meeting education needs of members, investigating innovative treatment approaches to support evidence-based practice, and 1
Susie Adams, PhD, RN, PMHNP/CNS-BC, FAANP, Vanderbilt University School of Nursing, Nashville, TN, USA Corresponding Author: Susie Adams, Vanderbilt University School of Nursing, 313 Godchaux Hall, 461 21st Ave. South, Nashville, TN 37240, USA. Email: [email protected]
Downloaded from jap.sagepub.com at FLORIDA INTERNATIONAL UNIV on November 16, 2015
35
Adams informing stakeholders of gaps in service as well as potential strategies to fill service gaps. Current trends include the need for developing, testing, and refining models of integrated care delivery that address both physical and mental health and shifting to population-based treatment approaches focused on wellness, prevention, early intervention, and support full recovery. As a psychiatric mental health nurse the most important “table” that we “have a seat” is at our kitchen tables, our dinner tables, our lunch room tables—anywhere we gather with family, friends, neighbors, coworkers, and colleagues—to talk about the work we do as a psychiatric nurses and the compelling stories about the need for mental health services in our communities. With one in four Americans experiencing a mental health and/or substance use disorder within any given year, these issues touch our own families or someone we know and care. We can be the grass roots movement that dispels the stigma of mental illness and substance abuse through our conversations about available treatments that are effective. Nursing consistently ranks as the “most trusted” profession in the United States for the past 14 years based on the public’s perception of our honesty and ethical standards (Gallup, 2014). We need to capitalize on that trust and tell others about our work as psychiatric mental health nurses that supports individuals in their journey of healing and recovery. What are the core values of psychiatric mental health nurses? The following values are ones that APNA embraces: 1. Full recovery from serious mental illness is feasible and the goal of treatment (SAMHSA, 2012b). 2. Integration of mental health services across the health care delivery system is the goal of holistic health care (SAMHSA, 2014b). 3. All nurses need a solid foundation of psychiatric nursing principles and clinical experience within their basic nursing education. 4. Psychiatric nurses need education that prepares them to provide care across the lifespan (American Nurses Association, American Nurses Credentialing Center, 2014a; National Organization of Nurse Practitioner Faculty, 2013). 5. There can be no physical health without mental health (Kolappa, Henderson, & Kishore, 2013). Pat Deegan, a clinical psychologist who was diagnosed with schizophrenia in late adolescence, first described her own experience of recovery “to live, work, and love in a community in which one makes a significant contribution” (Deegan, 1988, p. 11). Recovery is now recognized as the goal for people with serious mental illness and underpins mental health services (Harrow,
Jobe, & Faull, 2012; SAMHSA, 2012b). Recovery is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to achieve their full potential (SAMHSA, 2012b). The four dimensions that support a life in recovery are (a) health, wherein an individual makes informed, health choices that support physical and emotional well-being; (b) home, where an individual has a stable, safe place to live; (c) purpose, wherein an individual engages in meaningful daily activities (job, school, volunteering), and (d) community, wherein an individual builds relationships and social networks that provide support (SAMHSA, 2012b). Integrated health care is intended to improve health and mental health care outcomes regardless of whether primary care is embedded within mental health care services or vice versa. Over 68% of adults with mental illness have one or more chronic medical conditions and 20% of adults with mental illness have a co-occurring substance use disorder (SAMHSA, 2009). SAMHSA has funded more than 100 different grantees to develop integrated models of care for population-based care for individuals with serious mental illness including medical homes embedded within community behavioral health care centers. The goal of these integrated health care models is to improve access to primary care, prevention and early identification of serious physical illness, reduce the incidence of serious physical illness, increase availability of integrated, holistic care, and improve the overall health status of mental health clients (SAMHSA, 2014b). With the increasing need for mental health and substance abuse services, it is essential for all nurses to be well grounded in psychiatric nursing principles and practice within their basic nursing education at the associate and baccalaureate levels. With the decreasing psychiatric inpatient beds and diminishing numbers of faculty with psychiatric specialty expertise, nursing schools have found it increasingly difficult to secure clinical rotation sites and to provide adequately trained faculty. This has resulted in decreased psychiatric nursing content and clinical experience in the curriculum. Efforts are underway to re-infuse psychiatric nursing content into basic nursing education. Since 2008, education for psychiatric mental health nurses at the RN-C and APRN levels have been focused across the lifespan to provide a more flexible mental health nursing workforce. This goal has been reinforced by eligibility requirements to take psychiatric-mental health certification exams (American Nurses Association, American Nurses Credentialing Center, 2014b) and PMHNP competencies (National Organization of Nurse Practitioner Faculty, 2013). This education and certification requirement for PMHNPs has been building workforce capacity
Downloaded from jap.sagepub.com at FLORIDA INTERNATIONAL UNIV on November 16, 2015
36
Journal of the American Psychiatric Nurses Association 21(1)
to reach underserved populations, especially in rural and inner-city settings. The United Kingdom and the World Health Organization first articulated the proposition that there could be no true physical health without mental health (Chisholm, 1954; Her Majesty’s Government Department of Health Department, 2011). The bidirectional relationship of mental health disorders with physical comorbidities is now widely recognized as influencing health outcomes (Kolappa et al., 2013). In the United States, mental health advocacy groups have embraced this concept to reduce stigma that has been a long-standing barrier to people accessing mental health services and to promote awareness of lifestyle choices that support mental health and wellness (Mental Health America, 2014; No Health Without Mental Health, 2014). The Mental Health Recovery movement in the United States similarly endorses the value that mental health is fundamental to health. As you take a “seat at the table,” I hope you will use your voice and share your reflections on what it means to “be a psychiatric nurse.”
Americans in early 2014. Retrieved from http://www. commonwealthfund.org/publications/blog/2014/sep/newfed-eral-surveys-show-declines-in-number-of-uninsuredamerica-ns-in-early-2014 Deegan, P. (1988). Recovery: The lived experience of rehabilitation. Psychosocial Rehabilitation Journal, 11(4), 11-19. Gallup. (2014). Honesty/ethics in professions. http://www.gallup. com/poll/1654/honesty-ethics-professions.aspx Harrow, M., Jobe, T. H., & Faull, R. N. (2012). Do all schizophrenia patients need antipsychotic treatment continuously throughout their lifetime? A 20-year longitudinal study. Psychological Medicine, 42, 2145-2155. doi:10.1017/ S0033291712000220 Heisler, E. J., & Bagalman, E. (2014, January 7). The mental health workforce: A primer (Congressional Research Service, 7-5700). Retrieved from http://www.fas.org/sgp/ crs/misc/R43255.pdf Her Majesty’s Government Department of Health Department. (2011). No health without mental health: A cross-government mental health outcomes strategy for people of all ages. Retrieved from https://www.gov.uk/government/ uploads/system/uploads/attachment_data/file/138253/ dh_124058.pdf Institute of Medicine. (2012). The Mental Health and Substance Use Workforce for Older Adults: In whose hands? Washington, DC: National Academies Press. Kolappa, K., Henderson, D. C., & Kishore, S. P. (2013). No physical health without mental health: Lessons unlearned? Bulletin of the World Health Organization, 91(1), 3-3A. doi:10.2471/BLT.12.115063 Mental Health America. (2014). Non-profit mental health advocacy organization. Retrieved from http://www.mentalhealthamerica.net/what-we-believe National Association of State Mental Health Program Directors Medical Directors Council. (2006). Morbidity and mortality in persons with serious mental illness. Retrieved from http://www.nasmhpd.org/docs/publications/MDCdocs/ Mortality%20and%20Morbidity%20Final%20Report%20 8.18.08.pdf National Institutes of Health, National Institute of Mental Health. (2014). Statistics: Any disorder among adults. Retrieved from http://www.nimh.nih.gov/statistics/1ANYDIS_ADULT. shtml National Organization of Nurse Practitioner Faculty. (2013). Psychiatric-mental health nurse practitioner competencies. Retrieved from http://c.ymcdn.com/sites/www.nonpf. org/re-source/resmgr/Competencies/CompilationPopFocus Comps2013.pdf No Health Without Mental Health. (2014). Facebook page for non-profit advocacy group. Retrieved from https://www. facebook.com/nhmh1 Patient Protection and Affordable Care Act 2010 HR3590, or Affordable Care Act (ACA) implemented January 1, 2014. Retrieved from http://housedocs.house.gov/energy commerce/ppacacon.pdf Substance Abuse and Mental Health Services Administration. (2009). Results from the 2008 National Survey on Drug
Declaration of Conflicting Interests The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding The author received no financial support for the research, authorship, and/or publication of this article.
References American Nurses Association, American Nurses Credentialing Center. (2014a). APRN certification data for advanced practice psychiatric nurses (PMHNP and Psych CNS) from 2005-2013. Retrieved annually from ANCC Statistics: http://www.nursecredentialing.org/Certification/ FacultyEducators/FacultyCategory/Statistics/2013-ANCCCertification-Statistics-pdf.pdf. American Nurses Association, American Nurses Credentialing Center. (2014b). Eligibility criteria for PMHNP certification exam. Retrieved from http://www.nursecredentialing. org/FamilyPsychNP-Eligibility.aspx Center for Disease Control and Prevention. (2011, September 2). CDC report: Mental illness surveillance among U.S. adults. Morbidity and Mortality Weekly Report, 60. Retrieved from http://www.cdc.gov/mentalhealthsurveillance/ Chisholm, B. (1954). Outline for a Study Group on World Health and the Survival of the Human Race (Material drawn from articles and speeches by Brock Chisholm). Geneva, Switzerland: World Health Organization. Retrieved from whqlibdoc.who.int/hist/…/ChisholmBrock_1953_ Compilation.pdf Collins, S. R., & Rasmussen, P. W. (2014, September 16). New federal surveys show declines in number of uninsured
Downloaded from jap.sagepub.com at FLORIDA INTERNATIONAL UNIV on November 16, 2015
37
Adams Use and Health: National findings. Retrieved from http:// archive.samhsa.gov/data/NSDUH/2k8nsduh/2k8results.pdf Substance Abuse and Mental Health Services Administration. (2012a). Results from the 2010 National Survey on Drug Use and Health: Mental health findings (NSDUH Series H-42, HHS Publication No. (SMA) 11-4667). Rockville, MD: Author. Substance Abuse and Mental Health Services Administration. (2012b). Working definition of recovery. Retrieved from http://store.samhsa.gov/product/SAMHSA-s-WorkingDefini-tion-of-Recovery/PEP12-RECDEF Substance Abuse and Mental Health Services Administration. (2013). Results from the 2013 National Survey on Drug Use and Health: Mental health findings. Retrieved from http://www.samhsa.gov/data/sites/default/files/NSDUH mhfr2013/NSDUHmhfr2013.pdf
Substance Abuse and Mental Health Services Administration. (2014a). Health financing: Overview. Retrieved from http://www.samhsa.gov/health-financing Substance Abuse and Mental Health Services Administration. (2014b). SAMHSA Primary and Behavioral Health Care Integration (PBHCI) Program. Retrieved from http:// www.integration.samhsa.gov/about-us/pbhci U.S. Department of Health and Human Services, Health Resources and Services Administration. (2010). The registered nurse population: Findings from the 2008 National Sample Survey of Registered Nurses. Retrieved from http:// bhpr.hrsa.gov/healthworkforce/rnsurveys/rnsurveyfinal. pdf U.S. Department of Labor. (2008). Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Retrieved from http://www.dol.gov/ebsa/newsroom/fsmhpaea.html
Downloaded from jap.sagepub.com at FLORIDA INTERNATIONAL UNIV on November 16, 2015
