Mental Health: A RACE I HAVE TO RUN!

My brother is a nurse in a federal prison. We have been talking a lot about mental health issues and need for mental health care providers. My brother suggested if I could become an NP, he said I would be a great resource. I laughed in his face and told him a that being a MHNP is daylight robbery. All you do is write scripts and make at least $250/hr, the money is not worth it. I told him that I would never consider that. Fast forward, 2020, COVID-19 came, and its deja vu, I now get it; boy was I wrong. Nurses Announcements Archive

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When I graduated, my first instincts were to work in a MHU, but did not. Over the years, I have gone to many specialties, but still feel as if something is missing. Before COVID-19, I was contemplating on obtaining a post-masters certificate in MH, but was not sure, but thanks to COVID-19, its the green light for me to pursue this dream!

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Introduction

"There's this stigma or attitude when it comes to the topic of mental health that we aren't supposed to talk about it. We're supposed to ignore "(Grant,2016).

According to the World Health Organization, WHO (2008), mental health and substance abuse, both contribute to the second largest cause of disability and disease burden worldwide. Mental health commodities have adverse health outcomes and increased costs for the individual as well as the broader population (2012). Stigma results in adverse health outcomes, furthermore tragic events such as mass shootings, natural disasters, racism, other acts of violence and last but not least, the COVID-19 pandemic, highlight the need to address the stigma associated with mental illness and substance abuse disorders to improve our public mental health system (Mathers, Fat, Boerma, 2008).

Background in Mental Health

Mental health is a taboo topic in Africa. Growing up in southern Africa, people whispered behind closed doors so that they could not be heard. There was talk of people being mentally unbalanced or being weird in their behavior. After the liberation war, when soldiers came back, they were not the same. Many were withdrawn, abused alcohol and others committed suicide. Suicides were never discussed, they were hushed up and families suffered in silence. In retrospect, people with depression, anxiety, maniac disorders, post-traumatic stress disorder PTSD as the returning soldiers were never treated nor did they get the counseling necessary for their well-being and these were mental health issues that needed treatment and counseling.

Near Miss

When I graduated nursing many years ago my first choice was to work in a mental health unit, MHU. During my psychiatry rotations, I was inspired and motivated by the nurses’ work ethics and caring attitude. I fell in love with many aspects of mental health. The hospital I wanted to work at that time was in the news, a mental health technician was killed by a patient, as a result, my family was up in arms with this decision, so eventually went to the Medical-Surgical unit instead. Through the years, I have worked in the Intensive Care Unit, Telemetry, adjunct clinical instructor, and lecturer. As I have rotated through these units, I never felt accomplished. I always felt as if there was something missing. I struggled for self-identity as a professional. The thought of being a mental health provider always lingered in my thoughts and I always wondered what it would be like to become one.

COVID-19 and Mental Health

In March 2020, the world health Organization declared COVID-19 a pandemic(WHO). Since the pandemic many people have lost their jobs and the resulting downturn of the economy has negatively affected many people’s mental health and resulted in new limitations for people with prior history mental illness and substance use disorders (Panchal et. al., 2020). As the virus keep moving to different states, factors such as school closures, social distancing and isolation and financial distress will increase mental health issues such as anxiety. Social isolation and loneliness result in poor mental health and households with older adults and adolescents are at risk for depression and suicidal ideation (Panchal et. al., 2020). Job loss is correlated with increased depression, anxiety, distress, low self-esteem and may result in higher rates of substance use disorder and suicide (Panchal et. al., 2020). Deaths due to drug overdose have increased more than threefold over the past 19 years.

Stress, Burnout and Fatigue, PTSD in Healthcare Workers

As a healthcare worker on the frontline in New York state, I was stressed and fearful for my life as we did not have enough PPE. I was afraid of bringing the virus to my loved ones. As a nurse in the ICU, the nurse-patient ratio changed from three or four at times. These patients were critically ill and taking care of them was emotionally draining. I have never seen so many deaths at once. Codes and rapid responses were called over the intercom every five minutes, I felt like I was living and playing in a horror movie. I have been having dreams of some of the patients and am sure am suffering from PTSD. Insomnia has set in as well. Most of my fellow nurses have turned to beer or wine to rewind. We have not been given any resources to utilize for coping once the pandemic slowed down. Burnout can eventually lead to mental health issues such as depression and substance use.

Choosing Mental Health

People newly affected, will likely require mental health and substance use services. Those with prior history will continue using the services but there is a shortage of mental health providers (Panchal et. al., 2020). I chose to be a mental health practitioner, MHNP, so that I can help bridge the gap and provide much needed services as existing ones are overwhelmed due to the pandemic. I also would like to educate my fellow Africans that mental health is a disease that needs attention and that there is nothing to be embarrassed about. I chose to be a MHNP so that I can help frontline employee’s suffering from the effects of COVID-19. I chose mental health so that I can help different people in all age groups. Working at a group home with teenagers with mental issues reinforced my will to be a MHNP. As a nurse, I would take the teenagers for their psychiatric evaluations, we would spend the whole day waiting because there were other people who also had appointments with the same psychiatrist who served many group homes and served the whole county.

I would watch the psychiatrist write script after script without properly assessing the patients. As a MHNP, I will take the time to talk to my patients, evaluate the effectiveness of medications before loading them with more pills. Jails have inmates with numerous mental health issues. When released the inmates need proper care, so it is my intention to work with the underprivileged of society and give back as America has allowed me to go beyond my imaginations professionally and improve patient outcomes. The COVID-19 pandemic gave me the green light to pursue what has been in the back of my mind for so long. Sometimes in life, you need a sign to pursue a dream, and I think the pandemic made me open my ears to listen to that inner voice.

I plan to use my education to inform and teach people about mental health. I also plan to continue being an educator specializing in mental health. Nursing students’ curriculum includes mental health but there is a shortage of nursing faculty. I will be a great resource when I become a MHNP and as a result, will become proficient in managing mental health improving patient outcomes.

8 Votes
Specializes in Med Surg, Tele, Geriatrics, home infusion.

I agree there is a large defecit of mental health services here in the US, and I would suspect abroad as well. We spend so much time addressing the fall out, some time on management and almost none on prevention.

Kudos to you for following your dream!

4 Votes

Hi scribblz, BSN, CNA, LPN

Thanks for taking the time to read this article, I totally agree with you, there is such a need for providers across the spectrum. We need to be proactive instead of being reactive. Mental health comes in the light when a celebrity dies, it goes on for two weeks or so and then everyone forgets, then its another round if someone else and this goes on and on. I cannot wait for this challenge, hopefully, I will feel fulfilled professionally.

Yours truly,

simba and mufasa

4 Votes
Specializes in Psychiatric Nurse.

Thank you for your article! As a psychiatric nurse, it was nice to see someone “getting it” ? I love the type of path I took because I think so many people want connection and reassurance they are not alone in their fights in depression and anxiety, etc. I didn’t always feel this could be established in other areas. But I think what others and you have done in COVID is brave and I thank you for this! It’s not easy!

- From another aspiring PMHNP ? BEST OF LUCK!

3 Votes

Hi Beachwave

Thanks for taking the time to read and comment. This is a very important topic and so far has affected everyone around the world. Just like we need our physical pain be taken care off, our mental health has to be managed as well and we need HCP who can bridge the gap. When do you plan to start and do you have a college in mind, good luck to you too.

simba and mufasa.

3 Votes
Specializes in Psychiatric Nurse.

You’re so right. I’m looking at applying for the following year which means many have deadlines by October or January. I’m looking at online programs to balance work. I don’t have one particular in mind, just one that helps me become a better nurse ? how about you?

2 Votes

I am a former student of Walden University so I was given a 5% tuition discount and the application was easy since they have my information. It's 100% online so very doable for me.

Good luck!

simba and mufasa

1 Votes
Specializes in Mental Health.

Thank you for this ? I’ve worked on an inpatient behavioral health unit for years as a mental health associate, and am currently an alternate for nursing programs this fall . I oftentimes wonder what path I should take once I am a nurse (whether to start off in behavioral health or on a medical unit ). Mental health is so very important, and the field very much needs people like you going into it to advocate for some of our most vulnerable patients.

0 Votes
Specializes in Geriatric, Acute, Rehab, Psychiatry.

It's left for the state to make that field "interesting" beyond "pay". I have worked in some prison systems and can understand why most NP's prefer not to specialize in mental health.

0 Votes

Jennylynn25

Once I graduated, I went to the medical unit, did not want to loose some skills straight after nursing school and then later behavioral health.

babatee

mental health is not for everyone, you have to be special, LOL

0 Votes

babatee

Mental health is not limited to prisons, it has many wings, I plan to teach mostly online, I don't want to be bound in an institution or building of any kind. it could be draining.

0 Votes
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