Journal of the American Psychiatric Nurses Association

Intentional or accidental drug-overdose is a leading cause of mortality in U.S. women of child-bearing age. Opioid use during pregnancy is not only associated with maternal overdose, but with low birth weight at term and neonatal abstinence syndrome (NAS). Buprenorphine was approved as a medication for opioid use disorder (MOUD) in the United States in 2002 and is for many women, a preferred treatment option versus methadone. Buprenorphine is relatively safe during pregnancy and is associated with lower rates of NAS than methadone. Given the importance of MOUD during pregnancy, relatively little information exists regarding patients’ questions and concerns about buprenorphine treatment, including the psychological challenges they face.

The purpose of the study was to describe the perinatal concerns of women with opioid use disorder who posted to an online suboxone forum.

Qualitative descriptive design to analyze some 170 posts from mothers with OUD to an online Suboxone^® support forum over the period 2016–2021.

The analysis of the interview data revealed 4 important themes: (a) Stigma resulting in self-deprecation, low self-esteem, and low self-efficacy; (b) stigma from family members and loved ones; (c) stigma from the medical profession; and (d) stigma from the community at-large (social stigma).

There is compelling evidence to emphasize the importance of open communication and support between medical personnel and patients to ensure optimal outcomes for mother and baby.

Cooperation between families of individuals with mental illnesses and mental health professionals is very important for the quality of mental health care, and there are many barriers to the establishment of cooperation between mental health professionals and families. It is highly important to identify/define barriers to cooperation between families and health professionals from a cultural perspective.

The present study was aimed at identifying barriers to cooperation between mental health professionals and families from the perspectives of mental health professionals and family caregivers in Turkey.

In the sample of this descriptive qualitative study, 12 family caregivers and 11 health professionals were included.

The results of the study indicated seven themes regarding the perceptions of family caregivers and mental health professionals. The themes related to perceptions of family caregivers about barriers are as follows: “learning the process by living,” the perception of “my patient comes first,” and the perception of “being neglected.” The themes related to perceptions of mental health professionals about barriers are as follows: “lack of collaboration within the team,” “family itself as a barrier,” and “lack of education about working with families.” The common theme mentioned by both groups included the “patient-oriented service understanding.”

The results obtained from this study are believed to be a guide for planning and implementing interventions to eliminate the barriers defined from the perspectives of both mental health professionals and family caregivers. Both mental health professionals and family caregivers need psychosocial interventions for strengthening “family cooperation.”

Given the restrictions associated with COVID-19, feelings of loneliness among youth may increase.

The aims of the current study were to assess the prevalence of loneliness among young people at the time of COVID-19 and to identify whether selected variables related to the pandemic predicted the level of loneliness.

A cross-sectional study using WhatsApp and Facebook social media platforms was conducted to survey 1,057 young people aged 15 to 24 years from six Middle Eastern countries. Participants completed survey items including demographic and COVID-19-related questions; the Depression, Anxiety and Stress Scale (DASS); the Satisfaction With Life Scale (SWLS); and the UCLA Loneliness Scale.

The prevalence of experienced loneliness was 1 (0.1%), 625 (59.1%), 429 (40.6%), and 2 (0.2%), reflecting low, moderate, moderately high, and high experiences for loneliness, respectively. History of depression or anxiety, being dissatisfied with life, and having depression at the time of COVID-19 were significant predictors of loneliness among youth. The model was significant (F = 44.95, p < .05) and accounted for 29.8% of the variance in UCLA Loneliness Scale scores.

We found that the high prevalence rate of loneliness during the COVID-19 pandemic was correlated with depression and impaired life satisfaction among Middle Eastern youth. Thus, special attention and interventional action plans need to be developed taking into consideration the youths’ special situation during COVID-19.

Recovery in mental health remains inconclusive where the two most prevailing definitions “clinical” and “personal” remain. In nursing schools, students are predominantly taught straightforward concepts of clinical recovery, which result in only a perfunctory and rudimentary understanding of recovery among the undergraduates.

To explore the perceptions of nursing undergraduates on recovery for people experiencing mental health conditions.

A descriptive qualitative study was conducted on 14 nursing undergraduates from Years 1 to 4 of the study. Participants were recruited through convenience sampling, and the required sample size was determined by data saturation. Semistructured questions were used during the individual face-to-face interviews from October and December 2019. Recordings were transcribed verbatim; the transcripts were then subjected to thematic analysis.

Three themes were identified to support the research questions: (1) semantics of major terms used in mental health care—where participants provided the description of terminologies used; (2) the meaning of recovery—where participants explained their views on “recovery”; and (3) sources of conceptualization—where participants explained their conceptual understanding on mental health conditions and recovery.

The findings suggest that the need for a more holistic approach encompassing personal recovery should be included in the nursing curriculum. This is necessary to promote enabling support in the recovery of people experiencing mental health conditions beyond medical interventions.

Minority Stress Theory suggests that repeated exposure to enacted stigma adversely affects mental health. States have wide authority to enact policies affecting the level of inclusivity experienced by lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) residents. The purpose of this study was to explore relationships between states’ level of LGBTQ inclusivity and indicators of mental health/risk behaviors among an LGBTQ sample.

The 2018 Human Rights Campaign State Equality Index (SEI) and the 2018 Behavioral Risk Factor Surveillance Survey (BRFSS) were used to examine relationships between states’ levels of LGBTQ inclusivity (predictor variable) and indicators of mental health/risk behaviors (outcome variables). Relationships were explored using descriptive statistics and survey-weighted logistic regression.

Lower state inclusivity increased odds of fair/poor general health (adjusted odds ratio [AOR]: 1.22, 95% confidence interval [CI]: 1.01–1.48), increased odds of poor mental health days (AOR: 1.34, 95% CI: 1.11–1.62), increased odds of smoking (AOR: 1.62, 95% CI: 1.27–2.07), and increased odds of heavy drinking (AOR: 1.54, 95% CI: 1.26–1.86) and binge drinking (AOR: 1.23, 95% CI: 1.01–1.49). State inclusivity did not influence odds of a depressive disorder diagnosis or driving under the influence of alcohol.

LGBTQ persons in restrictive states had increased odds of experiencing several indicators of mental health and risk behaviors. More research is needed to determine whether state policies affect other domains of LGBTQ persons’ health. Health care providers should be mindful of LGBTQ persons’ mental health/risk behaviors and the state policy environment, and should seek to implement mitigating health care strategies such as the use of validated assessment.

Nursing is a demanding profession with constant stressors, which makes nurses vulnerable to the detrimental effects of high stress, burnout, and compassion fatigue. There is a need for a multidimensional group intervention facilitated by a licensed mental health professional to improve mental health and well-being in nurses. An intervention called RISE, which is an acronym for resilience, insight, self-compassion, and empowerment, was developed to promote self-care, protect against burnout, and improve indicators of well-being among nurses. We explain the rationale, theoretical framework, and development of RISE.

RISE is based on an integrative theoretical framework of mindfulness, acceptance and commitment therapy, and cognitive-behavioral therapy. It consists of eight psychoeducational group sessions with topics related to the four RISE themes of resilience, insight, self-compassion, and empowerment.

RISE is a contribution to the literature on well-being interventions for nurses. It will further the understanding of effective interventions to mediate the detrimental effects of stress and burnout in nursing and to improve the mental health and well-being of nurses amid the complex interplay of factors at the individual, unit, and organizational levels.

As an approach that combines education with therapeutic process and support to improve coping and well-being inside and outside of the workplace, RISE addresses the underlying causes and effects of high stress, burnout, and compassion fatigue.

Eating disorders (EDs) are serious, complex illnesses with both behavioral and physical health features. EDs have high rates of medical and psychiatric morbidity, and a 6% mortality rate, the highest of any mental illness. Early detection of EDs offers the best opportunity for recovery; yet, estimates are that as few as one in 10 individuals with an ED receive treatment. The purpose of this article is to provide an ED identification and management overview for inpatient nurse clinicians in general psychiatric and medical settings, helping to facilitate timely recognition and care.

An overview of ED diagnostic criteria and two evidence-based ED tools are introduced for consideration.

Opportunities to identify and help manage an ED are numerous. Most individuals with an ED make several health care visits in either medical or psychiatric settings without ever being screened for an ED. General ED screening and assessment tool familiarization can facilitate a treatment trajectory for these patients, improve overall quality of life, and may potentially result in a life-saving intervention for this often-deadly cluster of medical and psychiatric disorders.

Screening and assessment in general clinical settings, identifying patients with undiagnosed EDs, beginning basic treatment plans, and referrals for appropriate follow-up care, have the potential to reduce ED recidivism and related health care costs. Simultaneously, and most important, long-term outcomes for patients with EDs may improve.

Implementation of programs that increase both psychiatric patient education and their involvement in treatment programming can lead to positive outcomes postdischarge. Patients involved in programs focusing on skills, recovery, and that are individualized show a reduction in symptoms as well as an increase in engagement, treatment, and recovery posthospitalization.

This quality improvement project examines (1) the effectiveness of a safety planning group on an inpatient psychiatric unit for developing individualized safety plans, (2) the usefulness of the safety plans upon discharge, and (3) how helpful the patient found them.

A standardized safety plan was presented during 1-hour groups on an adult inpatient unit. Completed safety plans scored using a rubric to determine how patients individualized the content. One week postdischarge, patients were contacted to determine location and use of the safety plan since discharge.

Patient’s (n = 124) safety plans were relatively individualized when compared to the standardized safety plan (mean [SD] = 32.85 [8.27] on a 44-point rating). Of those patients who were contacted postdischarge (n = 76), 73 (96.1%) had a copy of their safety plan 1-week postdischarge while 28 (36.8%) reported using their safety plan since discharge. Many of the patients who used their safety plan reported that it was helpful (n = 19; 67.9%).

Developing a safety plan can be a helpful tool for individuals admitted to a psychiatric inpatient unit.

All patients of a nurse-led federally qualified health center and faculty practice interested in medication management were automatically referred to the psychiatric mental health nurse practitioner in the clinic. This approach was not sustainable to provide access to patients who needed both simple and complex medication management. Thus, a search for a new care model that also focused on the full-scope practice of a psychiatric RN was initiated.

The specific aims of this project were to create a fully integrated, nurse-led model of a psychiatric nurse practitioner and behavioral health care team within primary care to facilitate (1) patients receiving an appropriate level of care and (2) care team members performing at the top of their scope of practice.

The guiding model for process implementation was Rapid Cycle Quality Improvement. Three task forces were established to develop interventions in the areas of Roles and Responsibilities, Training and Implementation, and the electronic health record.

The process measures of referrals to the psychiatric care team and psychiatric assessment intakes performed as expected. Both measures were higher at the onset of the project and lower 1 year later. The outcome indicator, number of case reviews, increased dramatically over time.

For psychiatric nurse practitioners, this quality improvement effort provides evidence that a consultative role can be effective in supporting primary care providers. Through providing education, establishing patient tiers, and establishing an effective workflow, more patients may have access to psychiatric services.

There are a growing number of civilian mental health providers who are treating active duty service members (ADSM) from referrals of local emergency rooms, directly from military installations, or when a military mental health program is unavailable. Civilian providers may be unprepared to address issues that are unique to this population.

The purpose of this quality improvement project was to develop and implement a survey-based knowledge assessment, in order to assess civilian psychiatric advanced practice nurse’s (APN) perceptions, knowledge, and practice of treating ADSMs.

The investigator developed and validated a survey that was posted on the American Psychiatric Nurses Association All-Purpose Discussion Forum, and the snowball technique was utilized to enhance psychiatric APN colleague recruitment.

Seventy-eight participants scored extremely low with average score of 40.4%; however, the psychiatric APNs who received formal training from the Department of Defense on unique mental health issues of ADSMs scored significantly higher (49.6%) than participants without the formal training (38.2%; p = .03).

Understanding the knowledge gap of psychiatric APNs as it relates to the care of ADSMs will allow educators to recommend available trainings or develop trainings that are tailored to meet their needs.