Psychiatric Nurse Practitioner Students in a Clinical Rotation in an Outpatient Counseling Center: An Interdisciplinary Approach to Training

It is important to provide Psychiatric Nurse Practitioner students with training in emerging areas of practice.   The confluence of several trends over the past fifty years is placing new demands in the training of training mental health/psychiatric nurse practitioners.  The number of psychiatric beds per capital has dramatically decreased, with complementary increases in the prevalence of mental illness in prisons and among the homeless. The integration of mental health services into primary care practices is an emerging trend.  With the advent of the Affordable Care Act, it is anticipated that there will be a great increase in the demand for mental services in primary care settings.  Further, interdisciplinary team approaches to care are increasingly advocated by health care leaders and policy makers.  Collaborative care approaches have been developed to address issues related to co-morbidity among medical conditions and mental health problems.  These developments have resulted in the need for the training of mental health/psychiatric nurse practitioners in new settings.  In order to provide a psychiatric clinical rotation that emphasizes interdisciplinary approaches, the author developed a collaborative care team within a university-based mental health training center that includes graduate students in training from pharmacy, nursing, and psychology.  This outpatient counseling center serves the vulnerable populations for whom collaborative care was developed.  Patients at the center pay on a sliding fee schedule, with most paying a nominal fee.  The targeted population consists of patients being seen at the center who present with mental health issues and co-morbid chronic medical problems (e.g. morbid obesity, diabetes, hypertension, multiple sclerosis, etc.) and/or are taking prescribed psychiatric medications.  Feedback from the graduate students in three disciplines (psychologists, pharmacists, and nurses) reveals a high level of satisfaction and support for the process.  Positive benefits from the interdisciplinary process and recommendations for changes at the patient, provider, and setting levels are discussed.  This entire process addresses any physical disorders the client may be experiencing. Co-morbid conditions are often overlooked when treating mental health clients.  The site views the establishment of this clinical rotation as a step in developing a more holistic approach to treatment.