Guest Columnist

Addressing a mental health care crisis

A nursing student checks a patient’s blood pressure during a simulation exercise in March 2019. (Stephen Mally/The Gazette)
A nursing student checks a patient’s blood pressure during a simulation exercise in March 2019. (Stephen Mally/The Gazette)

America’s mental health care system is in disarray. A lack of providers who can diagnose mental health disorders, prescribe medications, and provide therapy leaves millions of Americans who desperately need mental health care out in the cold. The latest evidence comes from an assessment by the American Psychiatric Nurses Association that finds a chronic lack of mental health professionals who can care for 56 million Americans with mental health or substance abuse issues.

These problems are even more acute in Iowa, especially in rural areas, where it’s made even worse by the lack of health care of any type. Only 56 communities in Iowa have a physician, nurse practitioner, or physician’s assistant who can provide mental health services.

Changes need to be made. The Iowa Legislature and Gov. Kim Reynolds made a good first step this past session by approving additional access centers for people who need immediate mental health care, and treatment teams to encourage people with mental health conditions to stay on their medication. The bill also requires teachers and anyone else who works with children to undergo training to identify and provide assistance to students who show signs of suicidal mental distress.

But forward momentum is not guaranteed, and future funding continues to be uncertain. In the meantime, the University of Iowa College of Nursing is doing what it can to plug some of those gaps through its educational programs, including a post-graduate nurse practitioner program that can serve as an important resource to deliver health care services to underserved rural areas.

Nurse practitioners are advanced practice registered nurses who take additional training beyond the Bachelors’ degree. They are able to examine patients and assess their health needs, order lab tests, diagnose illnesses, and prescribe medications. Iowa is one of 20 states in which nurse practitioners can work independent of the authority of a physician. Nurse practitioners can also provide specialized care, including psychiatric and mental health care, through additional training.

Every year, about 15 current nurse practitioners study for a post-graduate certificate from the College of Nursing, and more than half who seek additional certification study for a psychiatric/mental health certificate. Most of the students who take the course are from rural Iowa, and most intend to stay in rural Iowa. Iowa currently has 139 psychiatric/mental health nurse practitioners working 32 counties. Most of the classes are offered online, so students don’t have to uproot their lives and move to Iowa City for the 14-month program.

A nurse practitioner certified in both primary care and mental health provides additional benefits for patients, as well. They can see a single provider for all of their health care, physical as well as psychiatric, making it more convenient and less costly.

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The University of Iowa College of Nursing is one of several nursing programs preparing nurse practitioners to provide health care to Iowans. We believe that nurse practitioners dually certified to manage both the psychiatric/mental health and physical needs of their patients is an important part of the solution to the mental health crisis.

• Julie Zerwic is the University of Iowa College of Nursing Kelting Dean and a professor.

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