Mental health nursing can be rewarding, but it is also demanding. This guide covers how to provide better care for patients with mental health challenges.
Health Disparities for Patients With Mental Health Challenges
- Nationally, 29.7% of patients with a cognitive disability could not see a mental health provider because of cost, and the rate varies widely by state: 18.5% in Rhode Island versus 40.7% in Texas.
- African Americans were the least likely of any racial group to receive mental health care, with only 45% reporting access to treatment.
- African Americans are less likely than white patients to receive culturally competent care. Physicians are 33% more likely to use patient-centered communication with white patients than with African Americans.
- Biracial adults report mental health conditions at the highest rate of any group: 24.9%, compared with 22.7% of American Indian and Alaska Native adults, 19% of white adults, and 16.8% of African American adults.
- Among transgender adults, 48% reported considering suicide, compared with 4% of all adults.
Barriers to Care
Several barriers stand between patients and mental health care:
- Too few providers and poor access, especially in rural and low-income communities
- Trouble finding in-network providers
- High cost, especially for the uninsured or those with high deductibles or copays
- Stigma, the perception that mental health problems reflect personal or moral weakness
- Cultural beliefs that depression or anxiety isn't real, or that those who experience it are weak
- Distrust of the medical establishment, especially among African Americans
- A lack of public education about mental health conditions and treatment
- Difficulty finding culturally competent care or care in one's own language
Many of these barriers feed each other. People without access are more likely to face financial hardship, which further limits access, and those who hold stigmatizing beliefs are less likely to seek out education that might change them.
Best Practices for Caring for These Patients
You can address many of these barriers by educating yourself, your patients, and your community, and by advocating for better access.
-
Build your cultural competence. Improve through formal education, mentoring, and independent study. Use resources from your hospital or public library, online and in-person courses, and conferences.
-
Keep learning. Most states require continuing education to maintain a license, which keeps you current on best practices and new developments in care.
-
Educate your patients. Many people carry misconceptions, like the idea that depression is just feeling down or that cognitive decline is a normal part of aging. Correct those and help patients find appropriate care.
-
Consider becoming a mental health nurse. The field is in demand, with strong programs for registered nurses and psychiatric nurse practitioners. If you carry student loans, working in underserved areas may make you eligible for loan forgiveness.
-
Advocate for funding and access. Nurses and nursing associations carry weight in policy. Write to legislators and newspaper editors, and push your organization's leadership on funding and access.
-
Protect your own mental health. This work is demanding. Take care of yourself so you can keep taking care of others.
Mental Health Resources for Nurses
- Mental Health America promotes awareness and access through advocacy, research, and education, with condition information, self-screening tools, current advocacy efforts, an annual conference, and online education.
- CDC Support for Public Health Workers and Health Professionals shares guidance on mental wellness and stress management for providers, including material on compassion fatigue, burnout, and workplace mental health.
- National Alliance on Mental Illness provides support, education, a national hotline, and referrals to pro bono care for frontline providers, plus personal stories, support groups, infographics, and public-service videos.
- American Psychiatric Nurses Association (APNA) offers an online community, continuing education, an annual conference, and publications for psychiatric nurses, and advocates for both mental health care and the profession. Membership covers national and local chapters and is open to nurses at all levels.
- National Association of Psychiatric Mental Health Nurse Practitioners is open to NPs and students, with continuing education, school discounts, conference discounts, and scholarship and grant opportunities. It advocates for access to care and for psychiatric NPs.
- Healthy Nurse, Healthy Nation, part of the American Nurses Foundation, supports nurses' health, including mental well-being, with relaxation and mindfulness resources.
If a patient is in immediate danger or talking about suicide, connect them to the 988 Suicide and Crisis Lifeline (call or text 988), which is free, confidential, and available 24/7.
Frequently Asked Questions
How common are unmet mental health needs in the United States?
The need is large and often goes unmet. Mental Health America reports that nationally 29.7% of patients with a cognitive disability could not see a mental health provider because of cost, and the rate ranges from 18.5% in Rhode Island to 40.7% in Texas. Access gaps hit rural and lower-income patients hardest.
Which groups face the biggest disparities in mental health care?
Communities of color are affected disproportionately. African Americans are among the least likely of any racial group to receive treatment, and physicians are about 33% more likely to use patient-centered communication with white patients than with African American patients. Transgender adults report considering suicide at far higher rates than the general population.
What are the main barriers to mental health care?
Too few providers and poor access (especially rural and low-income areas), trouble finding in-network providers, high cost for the uninsured, stigma, cultural beliefs that dismiss mental illness, distrust of the medical system, limited public education, and a shortage of culturally competent or language-matched care.
How can a nurse provide better care for patients with mental health challenges?
Build cultural competence through education and mentoring, keep current through continuing education, educate patients to correct misconceptions, advocate for funding and access, and protect your own mental health so you can keep showing up for patients.
What should a nurse do when a patient is in crisis?
If a patient expresses thoughts of suicide or self-harm, stay with them, take it seriously, and connect them to emergency help. The 988 Suicide and Crisis Lifeline (call or text 988) is available around the clock, and on-site crisis or psychiatric services should be engaged per your facility's protocol.
Where can nurses find professional mental health resources?
Mental Health America, the National Alliance on Mental Illness, the American Psychiatric Nurses Association, the National Association of Psychiatric Mental Health Nurse Practitioners, and the American Nurses Foundation's Healthy Nurse, Healthy Nation all offer education, advocacy, and support for both patients and providers.