NU 680 Discussion 1: NP Role in Managing Mental Health Concerns in the Primary Care Setting

Sample Answer for NU 680 Discussion 1: NP Role in Managing Mental Health Concerns in the Primary Care Setting Included After Question

What is the NP role in managing mental health concerns in the primary care setting

         with respect to scope of practice, conditions treated, and best practices?

            All Nurse Practitioners (NPs) must meet the requirements of the National

Organization of Nurse Practitioner Faculties (NONPF) to provide comprehensive

mental health care to individuals (Brown et al., 2021). This means the role of an NP

covers treatment of physical disorders as well as mental health illnesses. NPs are

trained to diagnose and treat mental illness; however, they may be restricted in their

scope of practice, which may expose them to civil liability and disciplinary action

(Balestra, 2019). Therefore, to avoid civil liability, NPs must know their state’s scope of

practice. A NP in primary care can diagnose and treat a patient with conditions of

uncomplicated mental illness such as mild to moderate anxiety or depressive disorders.

For example, according to Brown et al. (2021) NPs in primary care provide holistic care

which includes mental health disorders. NPs in family practice are often the first

providers to see patients with mental illness. The Patient Health Questionnaire-9

(PHQ-9), the Patient Health Questionnarier-2 (PHQ-2), and the Generalized Anxiety

Disorder 7 (GAD-7) scales are simple screening tools used to detect depression and

anxiety that the NP in a primary care setting can utilize. These screening tools should

prompt the NP to to ask additional questions regarding mental health symptoms. From

there the NP can diagnose the mental health illness and treat a mild to moderate

mental health disorders. The best practices for primary care NPs are to obtain

competency, collaboration, and consultation when necessary (Brown, et al., 2021). NPs

should offer patients with mental health diagnoses evidence-based treatment and be

able to prescribe common psycho-pharmacological interventions to treat anxiety,

depression, post traumatic stress disorder, and substance abuse (Brown et al., 2021). If

an NP determines it is out of their scope of practice, such as in severe depressive

disorder, the NP should refer the patient out to a mental health provider. Integrating

mental health care with primary care, however, can save costs and result in better

outcomes for patients because mental health conditions are often associated with

worsening health conditions.

                                                                     References

Balestra, M. L. (2019). Family Nurse Practitioner Scope of Practice Issues When

         Treating Patients With Mental Health Issues. The Journal for Nurse.

           Practitioners, 15(7), 479–482. https://doi.org/10.1016/j.nurpra.2018.11.007

Links to an external site.

Brown, M., Moore, C. A., MacGregor, J., & Lucey, J. R. (2021). Primary care and mental

          health: overview of integrated care models. The Journal for Nurse Practitioners,  

          17(1), 10–14. https://doi.org/10.1016/j.nurpra.2020.07.005

Discussion 1: NP Role in Managing Mental Health Concerns in the Primary Care Setting

Discussion Board Topic 1

What is the NP role in managing mental health concerns in the primary care setting with respect to scope of practice, conditions treated, and best practices?

Please support your discussion with at least 2 references from scholarly literature (books or journal articles), and comment to two of your peers. APA citations for supporting references must be provided in all discussions. Your response should be 400-600 words.

Discussion Board Assignment Criteria: The purpose of the online discussion board is for the student to demonstrate synthesis of course material through well constructed discussions in an engaging scholarly and professional tone. Initial posts should include the key issues about the topic in an organized, clear discussion, without digression. Response posts should also be direct and clear to the reader, demonstrating an understanding of the author’s commentary and contributing to an evolving discussion.

Student Learning Outcomes:

1. Critically appraise, synthesize and analyze course material in development and explication for scholarly discourse on relevant topics

2. Engage in scholarly professional interchange in discussion with peers

3. Demonstrate knowledge of key concepts

A Sample Answer For the Assignment: NU 680 Discussion 1: NP Role in Managing Mental Health Concerns in the Primary Care Setting

Title: NU 680 Discussion 1: NP Role in Managing Mental Health Concerns in the Primary Care Setting

Screening for mental health concerns is an important aspect of primary care. Mental health disorders commonly go untreated due to many factors. For example, 60% of mental health disorders and 90% of substance use are not adequately treated due to a lack of mental health providers (Brown et al., 2021). Unfortunately, this burden falls on the primary care provider. Proper screening of all physical and mental disorders is in the scope of primary care nurse practitioners. Screening may alert the Nurse Practitioner to issues such as drug dependency and mental health issues. For example, the NP utilizes the PHQ2, and the PHQ9 to screen for depression. If a screening is positive, it is in the scope of the primary care NP to treat uncomplicated mild to moderate mental health issues (Balestra, 2019). Patients with mental illnesses, such as depression, anxiety, and attention deficit/hyperactivity disorder, are often initially treated in primary care. Brown et al. (2021) state the primary care Nurse Practitioner provides holistic care which includes the assessment, diagnosis, and treatment of mental health disorders. However, the nurse practitioner must recognize when they are crossing the scope of practice. Balestra (2019) states breach of the scope of practice can occur with failure to monitor patient outcomes, failure to refer complicated cases, and exceeding prescriptive authority. Therefore, the Nurse Practitioner must work within the scope of practice. By doing so, the Nurse Practitioner can integrate care resulting in cost savings and better patient outcomes. Durbin et al. (2016) state an integrated approach to behavioral health at the level of primary care is commonly proposed to enhance the capacity of primary care providers to manage patient needs related to mental health and substance use conditions and comorbid illnesses because serious mental health issues coincide with worsening health conditions. Unfortunately, there are barriers in primary care that may prevent primary care from diagnosing mental health disorders. These barriers are attributed to time constraints, and a lack of competency or training (Brown et al., 2021). However, According to Brown et al. (2021), treating mental health disorders in primary care often burdens those Nurse Practitioners at don’t feel adequately trained or equipped to manage the issue. Therefore, it is at the discretion of the nurse practitioner whether to refer a patient for expert consultation. Brown et. al. (2021) states that education program content varies, and the best practices are that the NP attain competency in areas such as mental health or seek expert consultation and collaboration when necessary. Therefore, knowing one’s professional limits and when to seek consultation and collaboration is essential to providing competent safe care. 

Vicky

References

Balestra, M. L. (2019). Family nurse practitioner scope of practice issues when treating patients with mental health issues. The Journal for Nurse Practitioners, 15(7), 479–482. https://doi.org/10.1016/j.nurpra.2018.11.007

Brown, M., Moore, C. A., MacGregor, J., & Lucey, J. R. (2021). Primary care and mental health: an overview of integrated care models. The Journal for Nurse Practitioners, 17(1), 10–14. https://doi.org/10.1016/j.nurpra.2020.07.005

Links to an external site.

Durbin, A., Durbin, J., Hensel, J. M., & Deber, R. (2016). Barriers and enablers to integrating mental health into primary care: a policy analysis. The Journal of Behavioral Health Services & Research : Official Publication of the National Council for Behavioral Health, 43(1), 127–139. https://doi.org/10.1007/s11414-013-9359-6