What are DNPs doing about mental health?
With the recent death of Robin Williams, mental health has certainly been in the forefront of many minds. It has been highlighted in the news media, conversations and, of course, the hearts of the many fans of the late actor. But what are we doing about this issue in our healthcare system - especially as primary care providers - and how can we as Doctors of Nursing directly handle mental health in our system?
One in 4 adults experience mental illness and one in 17 adults suffer from severe mental illness, including schizophrenia, major depression, or bipolar disorder.1 About 20% of teens experience severe mental illness in a given year and about 13% of children ages 8 to 15 suffer from a mental health diagnosis.2 Only about 1/3 of these patients needing mental health care are able to receive it in today's healthcare arena.3,4 Serious mental illness costs our health system about $193.2 billion in lost earnings a year and disorders like depression are the number three cause of hospitalization in the U.S.5 As primary care providers, we are the main hubs for patients with mental illness and likely the most accessed resource of patients suffering from these disorders. Yet most of us received little training in mental health and we are confronted with the barrier of insurance reimbursement for mental health diagnoses or screening.
As Doctors of Nursing, we have an amazing opportunity to use our platform to improve the care of mental illness in our country. With the leadership skills gained through our education and the public policy didactic that many programs offers, we have the potential to make changes to improve the care being provided and those offered. One step is on educating ourselves on the care of mental illness. I have seen many providers lift their hands in the air and refer to someone else when a patient comes in suffering from mental illness because they are scared to address these issues. We have to educate ourselves in order to become proficient in this area of care in order to make the first step in changing the treatment of these diseases. With this education we can implement improvements in quality of care, increased screening and detection of illnesses, and ultimately improve the outcomes of patients suffering from mental illness. The second is in the realm of academia. More than one lesson has to be focused on the care of mental illnesses, the medications to be used, and appropriate screening needed to be initiated in primary care. Doctors of Nursing, especially those working in academia, have the potential to change curriculum and improve the education of mental illness in our training. The third is educating insurance companies on the necessity to authorizing care of mental illness in primary care and referring when the care is out of our scope of practice. If we as primary care providers continue to lift our hands up in the air and say this isn't mine to deal with when treating a patient with mental illness, we will continue to have poor outcomes in all areas of health for the vast majority of our patients, because the large percentage are suffering from some sort of mental illness.
Following Robin Williams's death, I read an article entitled "Robin Williams Didn't Kill Himself" 6 and as I read the title I said to myself, "wait, yes he did." When I read further into the article the author stated, "Robin Williams did not kill himself, his disease did." This is the truth for so many Americans suffering from mental illness. Their disease is diminishing their quality of life; they aren't doing it to themselves. Their diseases are killing them, not themselves. We as Doctors of Nursing have a very special place in today's healthcare arena to limit this diminishing quality of life and limit the amount that these diseases are killing our citizens, relatives and patients.
1. National Institutes of Health, National Institute of Mental Health. (n.d.). Statistics: Any Disorder Among Adults. Retrieved March 5, 2013, from http://www.nimh.nih.gov/statistics/1ANYDIS_ADULT.shtml
2. National Institutes of Health, National Institute of Mental Health. (n.d.). Any Disorder Among Children. Retrieved March 5, 2013, from http://www.nimh.nih.gov/statistics/1ANYDIS_CHILD.shtml
3. Substance Abuse and Mental Health Services Administration. (2012). Results from the 2010 National Survey on Drug Use and Health: Mental Health Findings NSDUH Series H-42, HHS Publication No. (SMA) 11-4667). Rockville, Md.; Substance Abuse and Mental Health Services Administration, 2012.
4. National Institute of Mental Health. (n.d.). Use of Mental Health Services and Treatment Among Children. Retrieved March 5, 2013, from http://www.nimh.nih.gov/statistics/1NHANES.shtml
5. Insel, T.R. (2008). Assessing the Economic Costs of Serious Mental Illness. The American Journal of Psychiatry. 165(6), 663-665.
6. http://popchassid.com/robin-williams-didnt-kill/. (2014). Robins Williams Didn't Kill Himself.