The prevalence of mental health disorders in the United States is estimated at 1 in 5 persons in any given year, with a lifetime prevalence of approximately 50% (National Institute of Mental Health, 2016a, 2016b). Despite scientific progress towards effective behavioral and psychopharmacological treatment, nearly 50% of Americans with mental illness do not receive treatment (Substance Abuse and Mental Health Services Administration [SAMHSA], 2014). This project will identify key geographical and logistical factors restricting recruitment and retention of psychiatric providers (MD or NP) for an underserved region in California. The results of the study will be used to develop a model for effective partnerships aimed at a “grow your own” approach to addressing the shortage of psychiatric providers. In California, the Mental Health Services Act (MHSA) was approved by the voters as Proposition 63 in 2004, funding expansion of mental health resources and specifically, workforce development (California Department of Health Care Services [DHCS], 2017). National funding also supports the expansion of PMHNP training and capacity through Health Resources and Service Administration (HRSA) and SAMHSA. Despite administrative and funding resources from MHSA and HRSA, the shortage of psychiatric providers continues in rural and remote areas. While few national studies have included nurse practitioners in the findings, a growing body of evidence suggests that nurse practitioners can serve similar if not the same function as physician colleagues (DiCicco-Bloom & Cunningham, 2014; National Governors Association, 2012; Newhouse et al, 2011). Barriers to mental health services in rural communities include challenges around a) availability, b) accessibility, c) affordability, and d) acceptability (Wilson, Bangs, & Hatting, 2015). Using a descriptive design, this project explores these factors necessary for patient access to psychiatric services in rural areas. A logic model is used to create a summary of the findings, which will be used to propose a clinical training partnership between an urban university-based PMHNP education and a rural clinic-based training to be completed upon conclusion of the project.

Public health concerns were prominent during the COVID-19 pandemic, particularly regarding rising cases of anxiety and depression among adults. U.S. healthcare providers were especially affected by the unrelenting demands on their time and service. Psychiatric Mental Health Nurse Practitioners (PMHNPs) provided patient care during the pandemic to meet the increasing need for mental health services as people began experiencing mood disturbances such as anxiety, depression, and grief. The purpose of this qualitative study was to explore the perceived effect of the COVID-19 pandemic on the mental health of PMHNPs. A qualitative design using the interpretive description method allows researchers to use pre-existing knowledge to inform their research and actively participate in knowledge synthesis, focusing on variations in data. Individual interviews with 18 PMHNPs were conducted via video teleconferencing, and their data were evaluated and interpreted for meaning. After a thorough analysis of the interview transcripts, nine themes were identified: adaptive coping, improved access, support, self-care, work strain, complications, maladaptive coping, pandemic strain, and polarization. This study illuminated the challenges PMHNPs faced during the pandemic and the strategies they employed to cope with difficulties and will inform future research and practice in mental health care.

Registered nurses and registered psychiatric nurses are members of multidisciplinary mental health teams that address the assessment and treatment of vulnerable youth. The phenomenon of interest for this study is nursing's distinct contribution to a multidisciplinary team in this clinical domain. An interpretive description drawing on the perspectives of seven nurses and seven clinicians from the professions of psychiatry, psychology, social work, child and youth care, and registered clinical counselling provides insight into understanding nursing's distinct contribution (NDC) to multidisciplinary mental health teams that serve vulnerable youth (MMHTSVY). Six major themes and multiple subthemes were inductively derived. The findings make explicit nursing’s contribution to MMHTSVY in ways that are meaningful to the clinical practice. / Graduate