Psychiatric Mental Health Nurse Practitioners Meeting Rural Mental Health Challenges

Abstract

OBJECTIVE: To describe the current rural mental health system crisis in the United States and how psychiatric mental health nurse practitioners (PMHNPs) can holistically mitigate this systemic issue. METHOD: Respective to the objective, relevant literature is reviewed. RESULTS: PMHNPs have successfully increased access to care in underserved rural communities by practicing at the fullest extent of their scope without mandated supervision, utilizing telepsychiatry practice, while expanding PMHNP rural mental health education and research to meet and absolve pressing rural mental health challenges. CONCLUSIONS: Current evidence supports that rural mental health care improves when PMHNPs have full scope of practice, utilize telepsychiatry, engage in related scholarly activity, and have formalized education and training for rural health care delivery, which collectively answer the professional and moral call serving the underserved rural population with mental illness.

Advanced Practice Registered Nurses Using Synchronous Telepsychiatry: An Integrative Systematic Review

“…The majority PMH APRNs work in mental health hospitals and community-based clinics, whereas they are found in higher ratios in New England and states with unrestricted practice authority (Beck et al, 2020; Phoenix, 2019). PMH APRNs have demonstrated a commitment to treating diverse patients across the lifespan and in urban underserved and rural areas (APNA, 2019; Ellington & Repique, 2013; Finley, 2019; Phoenix, 2019). The educational pipeline of PMH APRNs has grown an average of 30% annually for the past 5 years and is expected to conservatively increase the PMH APRN workforce to 18,458 total providers in the next 5 years in light of PMH APRN retirement predictions (Delaney & Vanderhoef, 2019).…”

“…Additionally, payers are allowing for PMH APRN independent billing while increasing reimbursement rates (Delaney et al, 2019; Spetz et al, 2017; Xue et al, 2016). Furthermore, PMH APRNs are expanding their reach using telepsychiatry, defined as delivering mental health care at a distance using electronic audio and visual teleconferencing technology (Ellington & Repique, 2013; Finley, 2019; Love & Carrington, 2018).…”

Implementing an APRN-Led Integrated Behavioral Health Clinic in a Rural Community

“…Incorporating additional health professionals as primary care providers is designed to address disparities in accessible health care (Naylor & Kurtzman, 2010). Ad-vance practice providers, including nurse practitioners (APRNs) have demonstrated the ability to address the primary and behavioral health care provider shortage in rural communities due to increased number of providers in this role, increased likelihood of APRNs settling in rural areas, and decreased cost of care delivery (Finley, 2020; Reising et al, 2021). In addition to addressing the shortage of care providers in the rural setting, providing an integrated approach to access of behavioral health services in a primary care clinic can help to reduce the challenge of engaging rural patients in care due to perceived stigma and its social consequences within a smaller community (Ferris-Day et al, 2021); when patients receive all care in one setting, there is less concern for stigma to affect engagement.…”

Family-focused approaches support outcomes of the patient with bipolar disorder: A family practice lens

“…In rural settings, the lack of resources for mental health is even more evident as considerable health inequities, health disparities, under-funding, and limited access to services have been well established (Goodwin, MacNaughton-Doucet & Allan, 2016). In addition, those with mental health issues in rural areas are less likely to have medical coverage, are more likely to miss their appointments, and are more likely to face other issues such as poverty, homelessness, transportation difficulties, and social stigma (Finley, 2020).…”