WHAT IS YOUR REACTION/RESPONSE ON THE ESSAY BELOW?
People with mental health conditions often fear workplace reprisals if they seek mental health care with employer-provided insurance. What kind of system changes can improve this situation? How can nurses be involved in getting more people who need attention into mental health care? Read the following 60 Minutes report (you do not need to watch the video – scroll down to read). Given the insurance barriers and many other barriers to long-term mental health care, what can advanced practice registered nurses (APRNs) do for patients and their families once they leave care?
Seeking medical attention for a mental health condition can come with feelings of shame and embarrassment for anyone, but especially to those working in the healthcare system. For a nurse that works alongside providers who may, one day, have to open their chart and see a psychiatric diagnosis, the concern is that that may eventually harbor feelings of mistrust or project personal bias onto that nurse. Especially places that have heavy foot traffic such as an urgent care or emergency department, healthcare workers may be used to seeing patients that are not truthful and manipulative to get what they want. This can lead to little patience and mistrust of patients with a mental health diagnosis, which in turn can provide little comfort for an employee who then seeks mental health services and knows their workplace may be privy to this information. While other healthcare team members may still need to have access to medical history diagnoses, focus should be on trying to break down these biases and stigmas and change the narrative. One study found that using a contact-based 12 hour in-person implementation program with examples relevant to the workplace environment and online modules to supplement the discussion works best to address mental health experiences among healthcare workers (Moll et al., 2018). This is just one way that healthcare facilities can open the discussion about this situation.
Nurses must continue to remain advocates for their patients with mental health needs such as must as for medical needs. Patients seen in a setting such as a critical care unit are particularly at risk for experiencing mental health challenges, even with those who have not had a previous psychiatric diagnosis. Feeling helpless and facing physical challenges can decrease morale and confidence, leaving the patient at risk for even situational depression. Nurses in critical care units must understand their position requires advocacy as a form a leadership, particularly to address mental health needs for patients (Antonacci et al., 2018). However, many patients are not discharged directly from these units, so nurses in other areas of inpatient treatment must also be advocates in mental health needs and relay this information to the provider overseeing the patient’s care. As the APRN, it will be their responsibility to ensure adequate resources are provided for patients and even family members and connect with them after discharge to address barriers for them receiving the mental health services they require.
Antonacci, R., Doucette, E., Sanzone, L., Chevrier, A., Potter, J. L., Bugar, A., … & Hendrick, R. (2018). Stepping up: Supporting critical care nurses in advocating for their patients with a mental health illness in a critical care setting. Canadian Journal of Critical Care Nursing, 29(2).
Moll, S. E., VandenBussche, J., Brooks, K., Kirsh, B., Stuart, H., Patten, S., & MacDermid, J. C. (2018). Workplace mental health training in health care: Key ingredients of implementation. The Canadian Journal of Psychiatry, 63(12), 834-841.
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