As I sat down at my computer to compose this editorial, I experienced a "reality check." That we are 16 years into the 21st century still gives me a jolt. Wasn't it not long ago that the year 2000 was far into the future, complete with prognostications that included doomsday prophecies and massive technology failures? Yet, here we are, with a mere 9 years left before a quarter of the new century will be past.

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I've been thinking about the passage of time, as I've perused 40 years of Nursing Administration Quarterly (NAQ) editions. The wealth of information, knowledge, and history contained in all those pages is fascinating and informative. Some of the biggest changes, over 4 decades, have been in technology, both at the point of care and in the world of nursing journalism. In 1976, our founding year, there were typewriters instead of computers. There was pen-and-paper editing, without the aid of change tracking software. Most hospital nurses still marked off hours on tape and counted drops as a way of timing intravenous infusions, poured and mixed medications on the nursing unit, and documented care by hand. The majority of hospitals and physician practices were independent, rather than part of larger systems. There were restrictions on licensing and practice, such as those on advanced practitioners. Some specialties and degrees, such as the CNL and DNP (Clinical Nurse Leader and Doctor of Nursing Practice), did not even exist.

A lot has changed, both since the founding of NAQ and the turn of the century. However, there are other things that are so unchanged, we could reprint "old" articles as contemporary offerings. One of these is the subject of this edition, the care challenges we face in the arena of behavioral health.

Guest editors Donna Gage and Teena McGuinness have compiled an impressive group of articles on the current state of what has long been seen as a silo: "psychiatric" care in the United States. The authors offer insight on the continued need for improvement in this very important area of nursing and health. It is inspiring to read about nurse leaders who persistently advocate for total care of people, and who remind us that we have a professional charge to be attentive to how we can care for the mental well-being of everyone.

In 2007, guest editor Anne Kobs wrote, "Let us hope we as leaders can respond and are up to the challenges of meeting new behavioral health population's demands. Let us hope we can be there for whatever the 21^st century brings."1⁽¹⁹⁴⁾ Those of you who serve as nurse leaders still have these challenges, along with a responsibility to nurture hope in those you lead. Because I have met and know so many of you, I have more than hope. I'm certain that as long as there are nurses and nurse leaders, we will continue our quest to improve mental health care as part of our commitment to holistic, person-centered care.

Thanks for choosing to lead.

-Kathleen D. Sanford, DBA, RN, FACHE, FAAN

Editor-in-Chief

Nursing Administration Quarterly

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