Caveat: I have not done psych nursing, but have worked in outpatient psych services.
The facility in which I worked was a CMHC in Oklahoma, which is fiscally upside-down when it comes to funding due to the state governing parties. Whatever direction you lean politically, not funding mental health services has consequences: higher costs for corrections, less productivity, higher health care costs as people are seen in the ER, higher costs for disability, etc. Poo rolls down hill, and due to the high amounts of opioid, meth, and heroin usage in Oklahoma, there's a lot of poo.
Less funding meant seeing more clients, having a lower salary (state workers had pay freezes in place), lack of service coordination, and institutional barriers as to what services we could provide. Our facility provided medical management and social service linkage, and that was about it. The problem with this is that you can medicate a person all you want to treat the symptoms of mental health, but in many cases, unless the root cause is addressed, it's the same shirt, different day.
Many of our clients had co-occurring substance usage, but our area of the state lacked real treatment options apart from 12 Steps. Almost all of our clients had co-morbid health conditions, but due to Oklahoma not expanding their Medicaid services for the ACA, unless you made less than $2000/yr, you fell into the ACA gap. I saw so many people without insurance who, if they had been able to see a PCP, most likely would have had more manageable mental health symptoms because their HTN, DM, thyroid, or vitamin B12/D2 deficiencies would have been in check.
You do see a lot of the same people and that's discouraging. However, when you start looking further up the food chain as to the systems in place that are creating that problem, you realize that it's not your department that is broken, but a lot more.... and that's the discouraging part.