The University of Nebraska Medical Center College of Nursing has received
a $750,000 federal grant that will help ease Nebraskas shortage of rural
health professionals by preparing students in the dual capacity of a family
nurse practitioner and advanced practice psychiatric/mental health nurse.
The U.S. Health and Human Services Bureau of Health Professions Division
of Nursing is funding the grant.
There are many vulnerable populations of rural and urban Nebraskans
who dont have access to mental health services and whose physical and
mental health care needs are not met, said Kate Fiandt, D.N.S., UNMC College
of Nursing associate professor of nursing and project director of the grant.
In Nebraskas rural areas, theres a huge lack of qualified mental health
practitioners who can make a diagnosis and prescribe medications.
Dr. Fiandt said many rural communities cant support a full-time psychiatric/mental
health advanced practice nurse, but one with both physical and mental health
skills is an asset.
This practitioner will be a valuable resource in Nebraska where 75
percent of rural counties are federally designated mental health professional
shortage areas and 36 percent of rural counties are federally designated
primary care health professional shortage areas, Dr. Fiandt said. Though
there are some dual-certified advanced practice nurses with this specialty,
this may be the first one in the country that prepares the nurse for certification
in both areas at the same time. The state very badly needs people skilled
in both.
Dr. Fiandt, who has been a family nurse practitioner for 27 years, said
in some clinics, 80 percent of the people who seek family or primary care
services have both physical and mental health needs.
Mental problems get in the way of physical health, and poor, unmanaged
health causes mental health problems, she said. If you treat depression,
diabetes gets better. Various health conditions like diabetes and cancer
can cause depression. This takes two different programs and streamlines
them into one to enable a practitioner to treat both conditions.
The specialty will prepare students as advanced practice nurses. Advance
practice nurses are those with masters degrees and advanced clinical experience
who diagnose, treat and manage illness, including nurse practitioners,
clinical nurse specialists, nurse midwives, nurse anesthetists and other
specialties. Some also prescribe medication.
This fall, the college will accept seven full-time students with bachelors
degrees in nursing. Students will spend the first year in academics. They
will use distance education technologies such as the Internet, CD-ROMs
and conference calls, and occasionally will be required to drive to UNMC
College of Nursing sites in Omaha, Kearney or Scottsbluff. Along with classroom
content during the second and third years of the program, students receive
850 clinical hours of experience under the supervision of a preceptor in
or nearby their communities.
Dr. Fiandt said another advantage of the new specialty is that people
can go to a health professional for their mental health needs without the
stigma.
In rural communities, many times people wont go to a psychiatrist.
If they could go to see a primary care professional who is skilled in managing
psychological problems, then it protects them from this stigma, Dr. Fiandt
said.
The grant also supports research on the role and integration of the
two specialties.
The importance and priority of such programs is evident in a recent
report by the President’s New Freedom Commission on Mental Health (available
at www.MentalHealthCommission.gov). In 86 pages, the authors discuss the
failings of the current system and describe six major goals for transformation.
The report estimates that 5 to 7 percent of adults have a serious mental
illness. In children, about 5 to 9 percent have a serious emotional disturbance.
The commission believes that Americans must come to understand that
mental health is integral to their overall health, and recommends that
mental illnesses be addressed with the same urgency as other medical problems.
The commission also said stigma attached to mental illness must be eliminated
because it discourages people from seeking care.
Minorities and people in rural areas, the commission finds, have worse
access to care, and often receive services that are not responsive to their
needs. As a result, the burden of mental illness is heavier for these individuals.
Dr. Fiandt said another example of how the practitioner could help is
provide early intervention for families with children who have behavioral
problems such as discipline and control issues. This practitioner could
work with the family and get them back in charge of the situation, Dr.
Fiandt said. Getting someone help before a situation generates into a
crisis is important.
Other UNMC nursing faculty involved in the program are Cecilia Barron,
Ph.D., co-project director, Julia Houfek, Ph.D., Susan Muhlbauer, Ph.D.,
and Polly Hulme, Ph.D. Other faculty with dual certification will be recruited.
For more information about the program, contact Dani Eveloff at (402)
559-5184, or 1-800-626-8431, ext. 9-5184, or develoff@unmc.edu.