o History of PMHNP Role
▪ First graduate program in psychiatric nursing
-Rutgers University awarded first graduate degree in PMH nursing in 50s
-Hildegarde Peplau created first graduate program
-First APN role was PM
...
o History of PMHNP Role
▪ First graduate program in psychiatric nursing
-Rutgers University awarded first graduate degree in PMH nursing in 50s
-Hildegarde Peplau created first graduate program
-First APN role was PMH clinical nurse specialist
▪ From hospitals to OP
-Began in late 1950s
-Contributing factors included establishment of Medicare/Medicaid in 1965, changing
rules governing involuntary confinement, and passage of legislation supporting
construction of community MH centers
-Initiated shift from custodial model of care to patient-centered, recovery-focused model
o ANA Code of Ethics
▪ What doesthe competency about “anticipatory guidance” mean?
-Standard 5B: Health Teaching & Promotion
-An educated professional nurse is aware of normal developmental and situational
threats to wellness and can educate healthcare consumers to avoid them.
Ex: Moving a toddler from a crib to a bed can prevent injury associated with
climbing out of the crib at that developmental age
▪ What do the standards explain the art of nursing is based on?
-Scope of Nursing Practice
-Based on caring and respect for human dignity
▪ What is the fundamental principle of and attitude that the professional nurse must have
as outlined in provision 1?
-The nurse practices with compassion and respect forthe inherent dignity, worth, and
unique attributes of every person
▪ How should the nurse respond to the discovery of human trafficking in his or her
practice?
-Code of Ethics: Provision 8
-Nurses must “bring attention to human rights violations in allsettings and context”
o Psychiatric-Mental HealthNursing
-Promotes integrated and comprehensive health and wellness through prevention and
education, as well as assessment, diagnosis, care, and tx of full range of PMH disorders,
including SUDs, across the life span
-Both PMHNPs and PMH clinical nurse specialists are considered PMH APRNs. Their roles are
synonymousin purpose, functions, settings, and qualifications. Both have essential roles
in integrating physical and mental health needs. Both work IP and OP.
-Promotion of MH in society and collab with and referral to other health professionals are
elements of role
▪ Key roles of PMHNP
-Provision of psychotherapy
-Provision of psychopharmacological interventions
-Provision of clinical supervision
▪ Consensus Model for APRN Regulation
-Providesrecommendationsforlicensure, accreditation, certification, and education
pertaining to all APRN practice
-PMHNP certification exam criteria set by ANCC
o Mental Illness
-ODPHP: neuropsychiatric disorders are among leading causes of disability, disease burden,
premature mortality, and suicide worldwide
-MH disorders impose significant burden on individuals, families, and society
-Prevalence is high, but tx rates are low: only 10.3% of adults with MI receive tx
-MH professionalsrecognize need for recovery-oriented MH system
-PMHNPs may serve as leaders in their organization and community to advocate for change
▪ Prevalence
-1 in 5 US adults experience MI
-17% of youth (6-17 years) experience MH disorder
-1 in 20 US adults experience SMI
▪ Life expectancy
-People with PMH conditions have higher rates of preventable chronic illness and
decreased life expectancy (approximately 20-year shorter life span)
-Decreased life expectancy impacted by increased risk for suicide & deaths r/t drug OD
o Substance Use Disorders
▪ Affected populations
-People with mental illness use alcohol/drugs/tobacco at higher rates
-Adults with SMI are at highest risk for SUD
▪ Federal priorities
-Comprehensive Addiction and Recovery Act (CARA – 2016)
Allows NPsto receive federal waiver to prescribe buprenorphine
-Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for
Patients and Communities Act (SUPPORT Act – 2018)
Permanently allows NPsto prescribe buprenorphine
o Disparitiesin Mental Health Treatment
▪ Background
-Minority populations (esp minority pts with SMI like schizophrenia or BD) face barriers
to accessing healthcare
-Other disparities include reduced utilization of necessary mental healthcare, decreased
quality of care, and a lack of adherence in tx services
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