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Earlier this year, the American Association of Nurse Practitioners® (AANP) reported
that “158 million people live in Mental Health Care Health Professional Shortage Areas,” and added that “over the last 10 years, almost 100 new psychiatric mental health nurse practitioner (PMHNP) programs have been added to schools of nursing in the U.S.” Susanne Fogger, DNP, CRNP, PMHNP-BC, CARN-AP, FAANP, co-chair of AANP’s Psych and Mental Health Community has some important insights for those who are looking to join this growing workforce specializing in psychiatry and mental health.
When asked how she decided to specialize in psych and mental health, Fogger replied: “That part was easy, because I’ve always been a psychiatric nurse. I graduated from nursing school in 1978 and took my first job in a state hospital in Boston, Massachusetts — so I have a lot of experience working with those who are chronically mentally ill.” Fogger is also a U.S. Air Force veteran who has worked with veterans in a health care capacity and was also the nurse manager of an adolescent psychiatric unit. She has experience in home health nursing in a rural area, and then began the nurse practitioner (NP) program at the University of Alabama at Birmingham to become a psychiatric NP.
NPs interested in psych and mental health should know that this specialty is “actually much more complicated and complex than regular adult health because there are no true algorithms in psychiatry,” explains Fogger. Because psychiatry treats the mind, “it’s interesting in the sense that there’s so many different dynamics that get involved in taking care of people,” she says. “’It depends’ is the best answer I can often give people. How do you know if this medicine is going to work or not? Well, it depends on a lot of things, including the individual’s genetic makeup.”
Therapy and medication are two tools Fogger utilities in her practice, and she also recommends working with patients to help them navigate daily habits and behaviors that also have an impact on their mental health. “I would say to [patients], ‘Why don’t we work on doing some things that you’ve got control over? Tell me about how your sleep has been, and then we can focus on getting you to sleep better.’”
Fogger also has advice to NPs considering specializing in mental health or psych. She believes NPs should join organizations — like AANP’s Psych and Mental Health community — and attend local meetings. “Having a group process or having a community gives NPs a voice,” she says. “Psychiatry is not a field where an individual needs to be isolated — isolation is really a problem for folks, so communities allow people to have connectivity, and to feel like they’re part of something bigger.”
Fogger cautions psych/mental health NPs from attempting to solve problems a patient must choose to solve for themselves. “You’re coaching the patient to make changes in their life […] you can’t make changes for the patient. The patient has to make the changes themselves. You can talk about things they need to do, but the patient needs to do it. That’s the hardest thing for nurses to get used to — that you can’t do for other people and expect them to get well. It has to be their gas.”
If you are interested in increasing your knowledge about psych and mental health — all while earning continuing education (CE) credits — visit AANP’s CE center to browse activities related to these important subjects. “Attention Deficit Hyperactivity Disorder Across the Life Span; It’s More Than Stimulants” features Fogger and her Psych and Mental Health Community co-chair Dr. Lisa Anderson, DNP, APRN, PMHNP-BC, as faculty and offers 0.9 contact hours (CH) of CE, 0.45 CH of which may be applied towards pharmacology.
Join Anderson and Fogger in the Psych and Mental Health Community to discuss any of the questions you may have about this specialty, or the many topics Fogger addresses here — and to access a cutting-edge, online forum where you may share documents, engage in discussions and exchange knowledge with other NPs interested in this specialty.