Practice for APRN in Mental Health

Scope and Standards

History of Psychiatric-Mental Health Practice

The history of psychiatric-mental health practice is unfortunately one in which some rather unethical practices appear to have been accepted by and large by communities at one time or another. However, after reflecting on the evolution of psychiatric-mental health nursing, the deinstitutionalization movement stands out to me as a significant turning point. This shift from large-scale mental institutions to community-based care models is one that I view as helpful overall. At the same time, I recognize that there are challenges that remain as a result. For instance, this change does permit patients to live in less restrictive environments and encourages patient autonomy—but it has also exposed the lack of adequate community resources for mental health in some cases, particularly where support networks are needed. If we can really understand the best way to support mental health practice, we can keep this positive change going in the right direction, but we cannot rest on our laurels so to speak. Understanding this transition in history can help us to appreciate the current practice context and the necessity for continuing to improve community mental health services.

Levels of Psychiatric Mental Health Nursing Practice

In my view, the delineation between basic and advanced practice psychiatric nursing is of utmost importance. While both are invaluable, each has its own unique roles, responsibilities, and competencies that contribute to comprehensive mental health care. Basic-level nurses provide direct care and promote mental health: this includes monitoring patients\\\' physical and mental health status, administering medication, providing basic treatment, and educating patients on how to manage their health conditions. Advanced practice nurses, on the other hand, have a greater role in assessment, diagnosis, and treatment planning, including psychotherapy and prescription authority: this means they might conduct comprehensive psychiatric evaluations, develop and manage treatment plans, provide psychotherapy, and have the authority to prescribe medications, including psychiatric drugs. This distinction supports a broad and flexible range of interventions that can be tailored to the individual needs of patients (Psychiatric-Mental Health Nursing: Scope & Standards of Practice, 2022).

Contemporary Issues

One of the most pressing contemporary issues in the field is the stigma associated with mental illness. Despite advancements in knowledge and understanding, societal attitudes towards mental health remain a barrier to seeking help and achieving recovery. As psychiatric-mental health nurses, one has a crucial role in combating this stigma through patient advocacy, public education, and promoting mental health as integral to overall health. At the individual level, this might involve teaching patients and families about strategies to maintain or improve mental health, such as stress management techniques or healthy lifestyle habits. Nurses can also influence policy at various levels to combat stigma and improve mental health outcomes. This might involve advocating for policies that support mental health, such as increased funding for mental health services or legislation protecting the rights of individuals with mental illness. Overall, this issue shows the need for mental health nursing to extend beyond direct care and influence broader societal attitudes and policy.