Enhancing outpatient anxiety treatment with mobile technology: A quality improvement study.

INTRODUCTION: Mobile mental health applications are a novel treatment method with unique qualities and capabilities for enhancing existing psychiatric treatments. Outpatient settings such as Mile Square Health Clinic have identified a need to leverage this new technology into their routine care. BACKGROUND: In the U.S., over 40 million people suffer from an anxiety disorder, however, only 1 in 4 responds to pharmacological treatment. Preliminary research indicates mental health apps are acceptable, feasible, and can improve patient outcomes for those with anxiety. METHODS: Participants from two different outpatient psychiatric clinics locations with generalized anxiety disorder were identified and recruited by participating nurse practitioners. Participants were instructed on how to download and use IntelliCare by the Project Lead. The Project Lead administered a semi-structured interview to collect qualitative data at three weeks and six weeks follow-up. RESULTS AND CONCLUSIONS: Survey responses at three and six weeks showed relevant themes of increased journaling, increased feelings of connectedness, positive associations with gamification, and IntelliCare being most useful for a moderate to severe level of anxiety. RECOMMENDATIONS: The results of this QI project demonstrate the clinical utility of incorporating the IntelliCare app into regular outpatient practice. IntelliCare should be used with those with moderate to severe anxiety and journaling features should follow research developments to incorporate best-practice guidelines.

Community Health Outside the Exam Room: Extracurricular Learning to Augment Nurse Practitioner Student Practice Readiness.

BACKGROUND: The curricular requirements of nurse practitioner (NP) programs are well established. NP students' clinical practicums provide a context for the extracurricular acquisition of administrative, operational, and systems-focused NP skills. PROBLEM: Acquisition of extracurricular NP skills is variable and highly dependent on a student's clinical placements. The COVID-19 pandemic exacerbated this variability by limiting students' access to traditional clinical rotations. APPROACH: With our practice partners, we inventoried the behaviors that are associated with new graduate NP readiness for practice in community health centers. We then developed an extracurricular seminar series to develop these behaviors. Each seminar in the series was presented by a preceptor. OUTCOMES: Students reported gains in their perceived readiness to practice. The casual format and preceptor presenters were highly valued by students. CONCLUSIONS: NP educators should consider leveraging academic-practice partnerships to standardize students' acquisition of administrative, operational, and systems-focused NP competencies.

Where is the psychotherapy content in PMHNP programs?

PURPOSE: Psychotherapy is the essence of the Psychiatric-Mental Health Nurse Practitioner (PMHNP) role. Yet much debate exists within programs as to the best way to include psychotherapy in an already loaded curriculum. CONCLUSION: Two large midwestern universities review their approaches to psychotherapy education; student evaluations measure the quality and effectiveness. Data revealed a high level of student satisfaction. PRACTICE IMPLICATIONS: Programs will vary on how to teach psychotherapy skills, but the use of psychotherapy within the PMHNP role is crucial and informs the entire practice. Examples of how others teach psychotherapy can inform educators of innovative ways to prepare PMHNP students to practice psychotherapy.

Establishing a path to unity: Recommendations for the Biden/Harris administration.

The Biden/Harris Administration faces many challenges, from systems and policies that do not work for or benefit all Americans to stark social and political divisions. Multiple courses of action will be necessary, and there must be commitment and investment for the "long haul." When considering the nation's challenges, overarching themes emerge that must be addressed. For instance, recommendations for justice reform cannot be followed without significant focus on race and equity. This focus will also be needed in considering solutions to affordable housing shortages, economic crises, and social and economic immobility concerns. In a similar vein, if the interests and rights of our nation's children are not recognized now, the social consequences will impact every aspect of their livelihoods-and those of future generations. The recommendations put forward by the Global Alliance are bold and will take time to fully implement. The implementation of these recommendations will challenge our systems and our policymakers to acknowledge our past and reenvision the future-and they will help address the multifaceted behavioral health and well-being needs of our nation, its communities, and its people. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Global mental health: A call to action.

Mental health needs have been recognized as a priority area by the World Health Organization (WHO), and a Comprehensive Mental Health Action Plan (2013) was proposed to address the needs of millions of people around the world. Concerns have been raised about the degree to which current global efforts are appropriate and sufficient for promoting mental health (MH), reducing the risk for common MH disorders, and addressing the needs of individuals experiencing mental illness. This commentary expands on the presentation of the Global Alliance for Behavioral Health and Social Justice's Task Force on Global Mental Health at the 16th Biennial Conference of the Society for Community Research and Action, held in Ottawa, Ontario, Canada June 21-24, 2017, "Building Capacity to Address Mental Illness and Emotional Distress in Low-Resource Settings and Among Refugee Populations." Utilizing a socioecological framework, this commentary offers a call to action in addressing global mental health by emphasizing the need for greater investments in wellness promotion, prevention, treatment, and recovery. Importantly, such efforts need to value local knowledge and culture, harness natural existing resources and assets, and ensure equitable distribution of key resources for MH. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Challenges in Treatment of Comorbid Chronic Pain, Depression, and Anxiety.

Meeting the needs of patients who experience physical pain and a psychiatric illness presents challenges as well as opportunities to optimize collaborative partnerships between specialty and primary care services. It is imperative that patients with pain be evaluated for depression and those who present with depression be evaluated for pain to prevent chronic opiate overuse. Given the overlap in symptomatology patients can present in either primary care or psychiatric care, an understanding of the comorbid presentation and lived experience of these patients is essential to holistic and complementary care. The current article examines the nature of pain and comorbid depression and anxiety along with suggested treatment modalities that can modify psychological processes and behavior that perpetuate the pain experience and increase need for opiate medication. [Journal of Psychosocial Nursing and Mental Health Services, 56(12), 17-21.].