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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. |
Improving access
“In Nebraska’s rural areas, there’s a huge lack of qualified mental health practitioners who can make a diagnosis and prescribe medications,” said Kate Fiandt, D.N.S., UNMC College of Nursing associate professor of nursing and project director of the grant. “There are many vulnerable populations of rural and urban Nebraskans who don’t have access to mental health services and whose physical and mental health care needs are not met.”
Approximately 75 percent of Nebraska’s 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.
Treating physical, mental health
Many rural communities can’t support a full-time psychiatric/mental health advanced practice nurse, but one with physical and mental health skills is an asset, she said. “Though there are some dual-certified advanced practice nurses with this specialty, the new UNMC program may be the first one in the country that prepares the nurse for certification in both areas at the same time,” Dr. Fiandt said. “The state very badly needs people skilled in both.”
In some clinics, 80 percent of the people who seek family or primary care services have both physical and mental health needs, said Dr. Fiandt, who has been a family nurse practitioner for 27 years.
“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 three-year curriculum takes two different specialties and streamlines them into one to enable a practitioner to treat both conditions.”
Preparing advanced practice nurses
The degree will prepare students as advanced practice nurses. Advanced practice nurses are those with master’s 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.
Students begin new specialty this fall
This fall, the college will accept seven full-time students with bachelor’s 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. During the second and third years of the program, students also receive 850 clinical hours of experience under the supervision of a preceptor in or nearby their communities.
Erasing a stigma
People often won’t go to a psychiatrist because of the perceived negative stigma, Dr. Fiandt said. The new specialty will eliminate this hurdle because individuals can see a primary care professional who is skilled in managing psychological problems.
The grant also supports research on the role and integration of the two specialties.
Early intervention, more information
Another way practitioners can help is to provide early intervention for families with children who have behavioral problems such as discipline and control issues, Dr. Fiandt said. “This practitioner could work with the family and get them back in charge of the situation,” she said. “Getting someone help before a situation generates into a crisis is important.”
Other UNMC nursing faculty members involved in the new specialty are Cecilia Barron, Ph.D., co-project director, Julia Houfek, Ph.D., Susan Muhlbauer, Ph.D., and Polly Hulme, Ph.D. Other faculty members with dual certification will be recruited.
For more information about the new specialty, contact Dani Eveloff at (402) 559-5184, or 1-800-626-8431, or develoff@unmc.edu.