There is no health without mental health. Most people would agree with this statement, yet access to quality mental health care remains elusive for millions of Americans. In this issue, our authors offer innovative solutions for quality and safety in mental health care.
When Nursing Administration Quarterly began its inaugural year 40 years ago, scores of state psychiatric hospitals still held patients for weeks, months, or years. Society wanted more humane treatment options and less stigma for psychiatric patients. Today, 95% of those state institutions are shuttered, yet we still struggle with how to provide humane care, accessibility, and less stigma. Professionals are striving to integrate behavioral health care into our health system in order to provide care to those who would otherwise be hospitalized. Future innovations must include a greater focus on early intervention, use of technology, and recovery for all people with mental conditions. Recovery has to go beyond psychiatric symptom remission to include living a self-directed life, health, home, purpose, and community. As always, nursing leadership will be required to improve processes and implement this broader definition of recovery.
Nurse leaders who are infusing excellence into behavioral health care are featured in this issue of Nursing Administration Quarterly. Here are just 3 examples of the leading edge innovations you will discover in this issue:
1. Jane Mahoney, Jennifer Jackson, and Nancy Palyo describe how a psychiatric hospital found that effective shared governance was essential to making the hospital the workplace of choice for psychiatric nurses. It established and has maintained a Pathway to Excellence designation via use of Appreciative Inquiry techniques. The result was higher satisfaction and retention for nurses, a model for other institutions.
2. A team of VA nurse leaders recognized the importance of group facilitation skills for delivering psychoeducation to Veterans, so they devised a Web-based course that enables nurses to develop their group leadership skills. Elizabeth Czekanski reports that the training enables nurses to understand group structure and better manage fluctuations within the psychiatric setting. The group leaders teach concepts such as wellness, health promotion, symptom management, and treatment adherence, which are essential to Veterans for a complete recovery. This program is now offered electronically (both live and on-demand) to VA nurses around the United States.
3. The American Psychiatric Nurses Association's new, Web-based program focuses on bridging the psychiatric-mental health knowledge gap to help better prepare new graduates as well as nurses entering into psychiatric settings. Susie Adams and Patricia Black describe how the modular curriculum, titled APNA Transitions to Practice, focuses on the knowledge and skills needed to ensure the overall care and safety of people with mental and substance use disorders. The program's topics include therapeutic use of self, safety in the workplace, psychopharmacology, risk assessment, and recovery.
These are just 3 of the articles in this issue. All told, this issue addresses a range of approaches to the challenges we face today in behavioral health care. These approaches provide the hope we need to care for the 20% of Americans who struggle with mental health and substance use issues. Treatments work. New treatments will undoubtedly work better. And nurses will play a key leadership role.
-Donna Gage, PhD, RN, NE-BC
Guest Editor
Chief Nursing Officer
Veterans Health Administration
Washington, District of Columbia
-Teena M. McGuinness, PhD, CRNP, FAAN
Guest Editor
Professor and Department Chair
Family, Community, and Health Systems
Co-Director
BVAMC/UAB SON Mental Health Nurse Practitioner Residency
University of Alabama at Birmingham School of Nursing