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Introduction
Over the past decade, there have been increased cases of mental illness in the United States. Although the cases were initially reported in the cities and other major towns, the rural areas have continued to experience a surge in cases. As opposed to cities with numerous amenities to offer support to mentally challenged individuals, there are few facilities in rural areas to assist those suffering from the condition. As a result, most areas have adopted the use of Psychiatric Mental Health Nurse Practitioners (PHMHNP) to meet the needs of the mentally challenged in rural areas. Although PHMHNP can be viewed as only focusing on the mentally challenged, the courses focused on an array of issues that are handled by this special group of nurses during the semester. Therefore, the paper will give an insightful reflection on some of the fundamental components of PHMHNP and its roles.
The need for Mental Health Nurse Practitioners in Rural North Carolina
Although mental care is needed in rural areas due to the increased number of patients, remote areas suffer numerous challenges. They lack specific hospitals that can deal with mental care. Additionally, due to high levels of poverty in the regions, they cannot afford mental care (Finley, 2020). As a result, they travel for long distances to access the services from the metropolitan areas. However, they should book an appointment first for the services, and the entire process is often distressful, thus affecting the patient suffering from the disease even further. However, the prescience of PMHNP in rural North Carolina proves to be of benefit to the locals.
First, PMHNP helps in the formulation of healthcare legislation in rural areas. As a result, they help in providing legislation that can help the present generation and take into consideration the welfare of the future generation. This implies that through the laws, they can provide long-term solutions to some of the challenges affecting those who are mentally challenged. Second, PMHNP helps in overcoming the geographical boundaries that affect remote communities (Finley, 2020). Using technology such as telepsychiatry, the PMHNP can provide services to patients. As a result, they relieve the sick from traveling the long distressful distance to seek care. Moreover, they can use telecommunication to diagnose and prescribe medication, which helps prevent missing appointments (Finley, 2020). Finally, in partnership with the educational facilities, PMHNP increases the presence of education by training the locals on how to handle their mental condition. As a result, they promote a long-term solution to the locals as some of the locals also get training to become psychiatric nurses.
Motivational Interviewing
One of the psychiatrists biggest challenges is helping those who have long-standing habitats to change their behavior. However, their duty is mainly based on helping them improve their mental condition. As a result, counselors have adopted motivational interviewing to help those with long-standing negative characters change their attitudes and view. The technique is a combination of emotional and logical appeals, and it has been used as the most effective technique over the past two decades (Levounis et al., 2017). The method is a client-oriented system, and it promotes the alleviation of ambivalence. Moreover, it is an exclusive change talk that the client is made to recognize the need for change, and it should be purely intrinsic, which means the ideas are purely drawn from the client.
Motivational interviewing is anchored on four core principles that should be recognized. According to Levounis et al. (2017), the principles include expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy. Empathy expression is a crucial principle in motivational interviewing. It can determine if the change in prices will be a success or failure. According to Levounis et al. (2017), it helps build a client-staff relationship; it recognizes that the relationship is not all about feelings but the behavior and the environment created. Discrepancy development, however, is the ability of the staff to recognize and separate the personal values and beliefs from the behaviors of the client. In other words, change is supposed to be geared toward evoking the patients behavior. Moreover, rolling with the resistance is the most challenging part of the motivational interview. The staff should learn how to adapt to the resistance created by the patients rather than overcoming resistance. Finally, supporting self-efficacy is all about supporting a change of attitude. The focus should be on providing support as opposed to suggestions and solutions.
Integrated Care
For several decades, mental health has always been regarded as a disease; hence it was exclusively left to the psychiatric-mental health (PMH) nurses to handle patients. However, the perception has begun to change. According to McLoughin (2017), mental illness is being recognized as mental wellness. As a result, it requires an integrated approach to handle it effectively. It does not mean necessarily eradicating mental illness as a disease but improving mental health. Therefore, a holistic, integrated approach can effectively handle the situation; this implies that nurses and healthcare practitioners can work together to find a long-lasting solution.
Additionally, numerous nurses interact with psychiatric patients daily, yet they never work in the mental health departments. Therefore, adopting an integrated approach where the nurses are trained on handling the patients can improve the situation before it worsens as it takes a long before recognizing a decline in the mental condition. According to McLoughin, (2017), non-PMH nurses are critical to enhancing mental health, considering that mental health is a key driver in overall health. Therefore, they should be integrated into every aspect of mental healthcare treatment.
Adverse Childhood Experiences (ACEs)
ACEs are the exposure to stressful situations that a child is placed in. They include abuse of any nature, parental neglect and illness, substance dependence, parental absence through incarceration, separation or divorce, and domestic violence. Dr. Harris in her TEDMED presentation, reveals that ACEs are very common. Additionally, ACEs are directly proportional to future health outcomes. In other words, if a person experiences the worst ACE at an early stage, the individual will exhibit worse outcomes in the future. This is mainly because Exposer to early adversities affects the brain development of young children. Although stress activation can be encouraged when reacting to a certain situation, repeated stress activation can have long-term effects as t becomes health-damaging. Children are highly sensitive to repeated stress activation since they have underdeveloped bodies that may not withstand the stress. Therefore, parents should try as much as possible to prevent exposure of children to stressful situations.
The role of the Psychiatric Mental Health Nurse Practitioner
Although there are numerous activities that a PMHNP can undertake, their primary role is to assess, diagnose, and treat patients mental well-being of patients. In assessing mental health, they perform screening of the patients to determine their mental states (Cusack et al., 2017). As a result, they can identify an individuals mental well-being and offer the solution through prescription. Presentation is often done after diagnosing a problem, leading to the second role of a PMHNP nurse, diagnosing. Diagnosing a mental illness means identifying and recognizing that there is a mental condition that needs treatment. A PMHNP deploys various diagnostic techniques to identify a mental situation in a patient (Cusack et al., 2017). After diagnosing, the nurse offers treatment methods, leading to the third role of a PMHNP nurse. Treatment implies using the available mechanism to improve or restore the mental condition of an individual. Therefore, treatment methods have to be strictly followed as prescribed by the PMHNP nurses.
Vicarious Trauma (VT)
VT is an occupational hazard that is often experienced by clinicians working with people living with mental illness. As with any other occupation, people often encounter stressful situations in their careers (Tabor, 2011). For several decades clinicians working with mental illness had always been neglected. They were as solutions to mental health care when none considered their mental states; hence, they suffered in silence. However, these have changed over the years as people recognize the trauma that clinicians dealing with patients with mental illness undergo. As a result, it helps in enhancing the mental well-being of the nurses, hence improving their condition.
Conclusion
In conclusion, mental illness is a condition that affects many people across the States. However, different mechanisms have been adopted to curb the spread. Those who are usually affected are those in rural areas, as in the case of North Carolina. However, with the help of PMHNP, many people can access mental health services. However, for the system to be effective, an integrated approach should be adopted. This implies all non- PMHNP nurses should integrate into mental illness programs to provide effective care. However, the trauma experienced by mental health care providers should also be recognized, thus ensuring the mental well-being of all personnel responsible.
References
Cusack, E., Killoury, F., & Nugent, L. E. (2017). The professional psychiatric/mental health nurse: skills, competencies, and supports required to adopt a recoveryorientated policy in practice. Journal of psychiatric and mental health nursing, 24(2-3), 93-104.
Finley, B. A. (2020). Psychiatric mental health nurse practitioners are meeting rural mental health challenges. Journal of the American Psychiatric Nurses Association, 26(1), 97-101.
Harris, N. B.(2015) How childhood trauma affects health across a lifetime.[Video]. YouTube.
Levounis, P., Arnaout, B., & Marienfeld, C. (Eds.). (2017). Motivational interviewing for clinical practice. American Psychiatric Pub.
McLoughin, K. A. (2017). Whole Health Begins With Mental Health: A Concept Whose Time Has Come. Journal of the American Psychiatric Nurses Association, 23(1), 77-77.
Tabor, P. D. (2011). Vicarious traumatization: Concept analysis. Journal of Forensic Nursing, 7(4), 203-208.
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