Patients visit primary care providers, including family nurse practitioners (FNPs), for the treatment of illnesses and injuries, including common mental health concerns such as depression, substance abuse and anxiety. While FNPs are not exclusively psychiatric providers, they develop care plans and, in some cases, prescribe medications for mental health patients.
FNPs provide comprehensive care to all patients, from infancy through adulthood, so treating mental health disorders is well within the scope of practice. Registered nurses (RNs) who become FNPs must be prepared to assist patients with mental health disorders, particularly as FNPs earn the right to autonomous practice.
Angelique Mason, an FNP in Philadelphia, said FNPs are effective in managing mental health issues because they treat symptoms without bias or judgment and focus on a holistic approach.
“Although medication is always an option, we try to focus on external factors ― such as stressors at work or a bad relationship ― that may be exacerbating depressive symptoms. We then work with the patient on developing a plan to help remedy those factors,” she said.
As primary care providers, FNPs work across a variety of settings to evaluate patients, make diagnoses and initiate treatment plans. RNs who are seeking MSN careers must learn about the importance of holistic care in treating mental health disorders and other ailments.
Barriers to Mental Health Treatment
According to the most recent data from the Substance Abuse and Mental Health Services Administration, a branch of the U.S. Department of Health and Human Services, an estimated 44.7 million adults age 18 and older (or about 18 percent) had a mental illness in the previous 12 months. Among them, 25.5 million adults (or 56.9 percent) did not receive any medical help for their mental health issues.
Patients reported a variety of reasons why they did not receive the proper treatment, including:
- Too costly or no health insurance coverage
- Lack of awareness of the severity of the disorder
- Feeling hopeless about treatment prospects
- Concerns about confidentiality
- Social stigma
For the millions of people who live in rural areas where access to providers is limited, mental health treatment is even more difficult to obtain. About 77 million people live in 3,000 mental health professional-shortage areas designated by the U.S. government. About 50 percent of rural counties in the United States have no practicing mental health professional. To receive mental health treatment, residents of rural communities must also have:
- Money to pay for health services or adequate health insurance
- Means to access the services, including transportation and the ability to take paid time off work
- Confidence in their ability to communicate the problems, particularly if the patient has poor healthcare literacy or does not speak English
- Ability to utilize services without compromising privacy
- Trust in the quality of care
FNPs Addressing Mental Health Issues
Studies show that mental and physical health is interconnected and primary care is essential for both mental and physical health. Researchers have found that poor mental health leads to poor physical health, and people with severe mental health problems, such as depression or schizophrenia, are at an increased risk of early death.
For FNPs to properly treat common mental health disorders, they must use evidence-based treatments, psychotherapy and possibly psychopharmacological therapy, researchers from the Kentucky Board of Nursing said. When treating mental health patients, FNPs must be cautious to work within local and state laws and their scope of practice as designated by the American Nurses Association (ANA), the American Association of Nurse Practitioners (AANP) and other nursing organizations. For example, an FNP working in a psychiatric facility and managing the physical health of patients is working within the scope of practice. An FNP working in the same facility and managing the patient’s mental health is working outside the scope of practice.
FNPs say that performing regular patient screenings to check for mental health problems, such as depression, is important. One FNP told the Journal for Nurse Practitioners (the AANP’s official publication) that when she sees patients in a mental health crisis, it is because of a lack of screening.
FNPs caring for mental health patients can access resources that often lead to better outcomes, she said.
“Ideally, screening for negative ruminating thought patterns before depression/anxiety develops could provide patients with the greatest benefits,” she said. “Accomplishing this doesn’t need to be time-consuming.”
For FNPs seeking to help patients and screening for health impairments, including common mental health disorders, the key is earning a Master of Science in Nursing (MSN) degree. The online master’s in nursing program at Duquesne University prepares RNs to work as FNPs, including in private practice.
About Duquesne University’s Online Master of Science in Nursing
Duquesne University’s online master’s in nursing programs prepare graduates for careers as FNPs working in urban, suburban and rural areas to combat the primary healthcare provider shortage. FNPs help patients with a wide range of medical conditions, including common mental health disorders. The university offers Family (Individual Across the Lifespan) Nurse Practitioner MSN and Post-Master’s Certificate programs.
Duquesne University provides one-on-one faculty support to encourage success at every step. The program prepares students for the American Academy of Nurse Practitioners Certification Board (AANPCP) and American Nurses Credentialing Center (ANCC) Family Nurse Practitioner certification examinations. For more information, contact Duquesne University today.
Q&A: What does a nurse practitioner do?: Philly.com
Promoting Access Through Integrated Mental Health Care Education: PMC
Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health: SAMHSA
Healthcare Access in Rural Communities: RHI Hub
Practice: KBN Connection
Should Primary Care Nurse Practitioners Routinely Screen for Depression? NP Journal