Psychiatric Mental Health Nurses Help Fill NC Emergency Department Shortages

Wake County, NC National Alliance on Mental Illness (NAMI) Report:  Long waits and severe problems in our Emergency Departments

Psychiatric Mental Health Nurse Practitioner (PMHNP) graduates from The University of North Carolina at Chapel Hill School of Nursing (SON) will be able to fill the some of the need to assist in caring for the overflow of psychiatric patients in North Carolina (NC) Emergency Rooms in the next few months.  With the decrease in psychiatrists across NC and limited state hospital beds, the overflow of severe and persistently mentally ill patients have ended up in our ED, sometimes for two days or as much as several weeks.  Nearly 1,500 patients were reported to have waited 48 hours to be seen and 200 patients waited seven days or longer.

The recent report released by Wake County NAMI describes the state of our emergency departments in NC.   In response to this urgent need, Associate Clinical Professor Victoria Soltis-Jarrett reports that UNC Chapel Hill School of Nursing has received permission to allow its graduates of the PMHNP program to apply for Emergency Department  positions as part of their service payback for the State Scholarships that have been awarded by the State of North Carolina to help relieve the mental health professionals shortage.

NAMI Wake State Psych Hospital Delays Report

HRSA Awards $700,000 to Educate Psychiatric Mental Health Nurses

Project Director and Associate Professor Victoria Soltis-Jarrett, PhD, PMHCNS/NP-BC was just awarded a $700,000 continuation grant from the Health Resources and Services Administration (HRSA) for the project: Psych NPs (Nurse Practitioners)–Meeting the Needs of the Underserved in North Carolina (aka PsychNP-NC). The additional funding will help enhance the curriculum, expand the geographical impact and increase access of mental health care services for citizens who live in an additional 37 rural and remote North Carolina (NC) counties.

Overall, NC has a shortage of health care providers.  Roughly one-third of the state’s counties, the majority being rural and remote, do not have any psychiatrists.  Of those counties lacking mental health care:  33% are without general (adult) psychiatrists and 75% do not have any child psychiatrists.  PsychNP-NC prepares Psychiatric Mental Health Nurse Practitioners (PMHNPs) to provide essential advanced practice nursing care for the citizens of NC who are suffering from mental health problems and those with severe and persistent psychiatric illnesses.

These highly-trained specialty nurses often come from minority/disadvantaged backgrounds, reside in areas of the state that are designated medically underserved/health professional shortage areas, and return to their communities to address these shortages after their education is complete.

This new grant gives the project director the ability to better meet the changing needs of the rural and remote NC residents by including new program contaent to focus on lifespan issues, including child/adolescence and aging adults.  It will enable the program to expand from the current 31 counties to reach a total of 68 counties, and increase patient access by linking with the North Carolina Area Health Education Centers (AHEC) and the Department of Health and Human Services to assist with clinical site development and clinical placements after students graduate.

This builds upon the commitment already made by the NC Legislature to provide $125,000 per year in recurring scholarship funds for students who are willing to commit to work in mental health agencies across the state upon graduation.  The role of the PMHNP is a relatively new one for North Carolina, and the DHHS is taking a lead to help integrate this important primary care practitioner into the mental health system.

Soltis-Jarrett says that this project supports the current National Mental Health Agenda set forth by the goals of Healthy People 2010, the overarching goals of Healthy People 2020, and the Bureau of Health Professions Goals 1-4, which is to eliminate barriers to care; eliminate health disparities, assure quality of care and improve public health and health care systems.

Upon completion of this nurse practitioner program, students will sit for the ANCC Certification examination and be eligible for employment serving the needs of rural and underserved NC populations.

Psych-mental health NPs — meeting needs in North Carolina

Did you know that Thorazine treats uncontrollable hiccups?  Do you know how to manage treatment resistant depression?  How about neuroleptic malignant syndrome?  What are the current treatments for reactive attachment disorders?  Where do you refer a child with autism?  What are the current benefits to using acetylcholinesterase inhibitors to treatment the symptoms of dementia? Who would know the answers to these questions?

A psychiatric-mental health nurse practitioner!  (PMHNP)

·        A psychiatric-mental health nurse practitioner is educationally prepared at the master’s (and Doctorate of Nursing Practice) level to provide a full range of psychiatric services, including (but not limited to) assessment and diagnostic reasoning; implementing treatments, such as the prescribing of medications and implementation of individual, group and/or family psychotherapies.

·         PMHNP competencies incorporate the health promotion, health protection, disease prevention and treatment focus of psychiatric-mental health nurse practitioner practice.  For more information, go to this site:

*  In 2000, the first certification for PMHNP was offered by ANCC.

*  In 2009, there are 96 out of 100 counties in North Carolina that are medically underserved areas (MUA) or health professional shortage areas (HPSA), and many counties still do not have physicians, psychiatrists or nurse practitioners that can manage the psychiatric and mental health needs of their communities.

* Since 2004, the University of North Carolina at Chapel Hill SON has prepared psychiatric-mental health nurse practitioners to provide services to two specific patient populations:  Adult (ages 13+) and family (ages birth to late life).

* In 2009, there are 50 students in the SON MSN program in PMHN and approximately 20 will graduate in this academic year.

* In 2009, there are 51 certified PMHNPs in the state of NC.

* From 2010- 2015, the PMHN APA at UNC predicts there will be approximately 20 new UNC graduates per year (or 100 NEW grads by 2015) to help meet the mental health needs of thousands of citizens in the MUA and HPSA counties across North Carolina.

To learn more about the SON’s psychiatric-mental health nurse practitioner program:

News & Observer Covers Psychiatric-Mental Health Nurse Practitioner Program

In Monday’s News & Observer (3/31), reporter Jean Fisher gave media coverage to the School’s Nurses Enhancing Mental Health Options – or NEMHO – program. This program trains ethnic minority or otherwise disadvantaged nurses from rural and underserved areas throughout the state to provide psychiatric and mental health services to patients who do not qualify for inpatient care.

The NEMHO program is the only one of its kind in the state. Many of the rural areas in the state do not have psychiatrists, so qualified nurse practitioners are essential to getting these services to people who need them.

Fisher not only describes the program through interviews with faculty members Linda Beeber, PhD, RN, FAAN, and Victoria Soltis-Jarrett, PhD, PMH-NP, but she also spoke with a recent graduate who will soon practice in Jacksonville and a current student to show how NEMHO graduates are immediately filling the psychiatric provider gap.

To read the entire story, click here:


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