Chat with us, powered by LiveChat Reply 2 Discussion: Policy and Practice Issues |

Identify one policy issue related to barriers to accessing psychiatric and mental healthcare that is currently being addressed by your national professional organization and discuss how NPs can become policy-aware, as well as act as patient advocates.
Attach a policy white-paper to support your statement.
Individuals with mental illness face many barriers when accessing a mental healthcare provider (Heath, 2019). A primary reason for limited access to mental healthcare is a shortage of qualified mental healthcare providers, including psychiatric mental health nurse practitioners (PMHHPs) with Doctor of Nursing Practice (DNP) degrees (Heath, 2019). The United States needed over 7,000 more clinicians in 2018 to fill the gap and only 25% of mental health needs were met in 2019 (Heath, 2019). The American Association of Colleges of Nursing (AACN) endorsed a statement on their position regarding the DNP degree in 2004 (McCauley et al., 2020). They set a goal for 2015 that all Master of Science in Nursing (MSN) programs would migrate to DNP programs (McCauley et al., 2020). In 2011, a publication produced by prominent academic nursing leaders purported that clinical partnerships, faculty, and resources necessary for DNP degrees had declined and would affect the costs and lengths of Advanced Practice Nurse Practitioner (APRN) preparation, delaying the goal set by the AACN (McCauley et al., 2020). Since then, other factors have been identified to explain barriers to universal adoption of the DNP degree (McCauley et al., 2020). In 2010, The Future of Nursing Report did not address the need for a DNP as a universal requirement (McCauley et al., 2020). Nevertheless, national DNP programs rose from 92 in 2008 to 354 in 2018 (McCauley et al., 2020). However, the DNP programs did not require clinical sites, the practice component of the DNP ? which was one of the central purposes of a practice doctorate (McCauley et al., 2020). Project hours were not designed to improve APRN clinical proficiency ? they were used to promote leadership initiatives and a final or capstone project (McCauley et al., 2020). Between 2004 and 2018, the number of MSN-prepared APRNs increased from 10,737 to 46,622 (McCauley et al., 2020). In 2019, only 14% of APRNs held a DNP (McCauley et al., 2020). Online DNP programs continue to rise without offering advanced practice skills (McCauley et al., 2020). Nursing professional organizations do not agree about national standards regarding whether or not APRNs should hold DNPs (McCauley et al., 2020).

The National Organization of Nurse Practitioner Faculties (NONPF) issued a white paper on January 18, 2019, titled ?Clarifying the Educational Model DNP Workgroup Dialogue on Seamless DNP Programs? (Finnegan et al., 2019). They reported that the NONPF made a commitment on April 20, 2018 to move all APRN education by 2025 to a DNP degree (Finnegan et al., 2019). Four workgroups have come together with representatives from stakeholders from accreditation, certification, licensure, practice, education, and NONPF (Finnegan et al., 2019). The NONPF is concerned that APRNs are prepared for a complex health care system with systems level skills (Finnegan et al., 2019). Whether students should be permitted to work during the DNP program is another issue that is being discussed (Finnegan et al., 2019). One approach for the DNP program is to have a lot of didactic content with a small amount of clinical at the beginning of the program and a small amount of didactic content with a large amount of clinical at the end of the program (Finnegan et al., 2019). More hours of clinical practicum will enable students to integrate a higher level of content (Finnegan et al., 2019). NONPF acknowledges that there may be a temporary decrease in admissions when the MSN programs are discontinued (Finnegan et al., 2019). Ultimately, the goal is to elevate the practice level and clinical competency evaluation to a doctorate level to meet the needs of an increasingly complex health care system (Finnegan et al., 2019).

PMHNPs can become aware of policies by joining national nursing organizations, including the American Association of Nurse Practitioners (AANP), American Psychiatric Nurses Association (APNA), and American Association of Child and Adolescent Psychiatry (AACAP). PMHNPs can advocate for their patients through innovation in healthcare and providing nursing leadership (Kumar et al., 2020). For example, PMHNPs should align their legislative, educational, and professional goals towards increasing access to higher levels of mental health care within pediatric primary care settings (Kumar et al., 2020). Joining the Advocacy Liaison Network as a member of the AACP enables participation in monthly calls regarding current federal and state effective strategies and initiatives to organize regional grassroots activities (AACAP, 2022). The AACAP provides grassroots advocacy tools to strengthen regional grassroots networks (AACAP, 2022).


American Academy of Child & Adolescent Psychiatry (2022). How to be an advocate.

Finnegan, L., Mainous, R., Knestrick, J., & Ruppert, S. D. (2019, January 18). Clarifying the educational model DNP workgroup dialogue on seamless DNP programs. The National Organization of Nurse Practitioner Faculties.

Heath, S. (2019, August 7). Key barriers limiting patient access to mental healthcare. Patient Engagement HIT.

Kumar, A., Kearney, A., Hoskins, K., & Iyengar, A. (2020). The role of psychiatric mental health nurse practitioners in improving mental and behavioral health care delivery for children and adolescents in multiple settings. Archives of Psychiatric Nursing, 34(5), 275-280. doi:10.1016/j.apnu.2020.07.022

McCauley, L. A., Broome, M. E., Frazier, L., Hayes, R., Kurth, A., Musil, C. M., Norman, L. D., Rideout, K. H., & Villarruel, A. M. (2020). Doctor of nursing practice (DNP) degree in the United States: reflecting, readjusting, and getting back on track. Nurse Outlook, 68, 494-503. doi: 10.1016/j.outlook.2020.03.008