The Nuts and Bolts of Developing a Mental Health Resources Action Plan by NP Students

A stated goal of Healthy People 2020 is the improvement of mental health through not only prevention but access to appropriate mental health services. In 2009 the United States Preventive Services Task Force  recommended annual screening of adolescents for depression but only when there are systems in place for management and referral. Currently there are systems in place in primary care clinics to address complex physical health issues which require  referral. Typically these clinics often have a list available of those specialists in the community who are  utilized by the practice and a fluid process of referral occurs. However, when there is a mental health issue, whether the patient is in a psychiatric crisis or needs referral for a specific mental health issue such as alcoholism, spousal abuse or post-traumatic stress disorder, the time to manage the patient’s issue and locate a referral source can be extensive.  Time constraints may lead to hesitation by health care providers in a busy practice to acknowledge and address mental health issues with patients. A 2009 survey of primary care physicians revealed that arranging for outpatient mental health services was twice as difficult as arranging for physical health referral services. Due to this practice gap in primary care settings for the management and referral of patients with mental health disorders, a teaching strategy was designed for students in a distance education nurse practitioner program. This innovative approach utilizes Knowles’ adult education principles and includes patient scenarios, interdisciplinary interviews, community services analyses and web-based searches. The final product is a mental health resource tool kit and action plan specific to each student’s community. This resource is  invaluable for having systems in place for the management and referral of patients with complex mental health problems.  If each nurse practitioner program included this type of activity in their curriculum progress could be made in meeting not only the USPSTF mental health screening recommendations but the Healthy People 2020 goal of providing access to appropriate mental health services.