Mental health awareness: Connecting with gratitude, by Dr. Susanne Fogger

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Susanne Fogger, DNP, CRNP, CARN-AP, PMHNP-BC, FAANP

Mental Health Awareness month is drawing to a close, but it remains important to consider the meaning. This months’ awareness means different things to different people.  However, if you feel that Mental Health Awareness is only about other peoples’ issues and other peoples’ mental illness, perhaps you could reconsider, as everyone has mental health needs. While some people have a wealth of positive thoughts and good energy which seems to come naturally, each of us has a responsibility to ourselves attend to our own mental health or inattention will mar our ability to enjoy life to the fullest.

Humans in the United States have thousands of decisions to make each day, with a variety of choices. While each day, everyone is faced with “choices,” some have fewer choices or struggle to make decisions. The degree in which we perceive our sense of control over our lives, environment and choices tends to influence our mental health by affecting how empowered we feel. The fewer choices we have, the less empowered and more helpless we become.

Mental Health Awareness Month is an opportunity to reflect with gratitude on the health one has, as well as consider choices that can move one toward a healthier physical and mental health, an appreciation for the past in shaping who we are today, and the potential for good health in the future.

This month, I also want to discuss the tie between nurses and mental health. Is it a coincidence that Nurse’s Week — a week in which nurses are recognized and their efforts appreciated — takes place during Mental Health Awareness month? For those who know nurses and see the time, energy and emotion it takes to care for others, this is a natural connection.

I believe nurses must celebrate their accomplishments in caring for others through caring for themselves. Many nurses struggle with the thoughts of, “How do I take care of myself when there is nothing left after caring for others?” or “At the end of a long shift or particularly stressful week, I have nothing left for me.”  Are the two activities possible at the same time? Can you be busy, stressed, fulfilled and happy?

In some ways, it depends on what you want to have happen. Positive mental health practices involve balancing care for self and care for others. Compassion for others requires compassion for self as well. Sometimes this is lost in the culture of nursing, where a bathroom break is considered a luxury and long, meal-less hours are typical. How often has a nurse said “I’ll get this one thing done, then I can…” This culture of putting one’s self last is erosive and can make nurses less capable of attending to others because they have not taken the time to take care of themselves. Superhuman, nurses are not.

This stressful environment also breeds feeling of inadequacy, anxiety and the perception of being judged or never enough, making it hard to do the best work. It can also affect mental health.  As nurses, the key is the choices we make to promote opportunities to renew and restore ourselves. Restoration of our ability to care for others comes through self-care. Self-care strengthens your ability to care for others. One cannot be healthy if one does not consider that mental health is integral to physical health, as there is no health without mental health. Self-care need not be complicate but planning to be successful works. Shift work is stressful, so getting enough sleep and eating well may mean forgoing the last episodes of your favorite TV show. Get out and take a walk in the forest or local park. Walking is beneficial in many ways and if you invite a friend, can be a social event as well.

At the UAB School of Nursing, our psychiatric nursing faculty are dedicated to developing nurses who not only take care of their own health but are able to assist others in their mental health needs. While all nurses must be part psychiatric nurse, the truth is, psychiatric nursing or care of individuals with underlying psychiatric conditions can be more challenging than other types of nursing. There are no definitive tests, MRIs, labs or biopsies that can confirm most psychiatric illness. Clinicians who care for individuals with behavioral health issues (both mental illness and substance use) must be detectives in many ways. They listen and work to make sense of the patient’s presenting symptoms in order to conclude what may be the cause. Some of the wealth that exists within the UAB SON are those very individuals who are psychiatric mental health nurses, nurses who have a significant history of treating individuals across the life span for underlying behavioral issues.

The psychiatric faculty who teach or lead within the SON are leaders in the state and nation. Current department chair, Dr. Teena McGuinness reinstated the MSN psychiatric nursing program (PMHNP track) and since 2008, this program has changed the face of psychiatric care in Alabama. While the state still has an extreme shortage of mental health providers, this program has educated nurse practitioners across Alabama and deep south to provide needed care. Since its inception, more than 350 psychiatric nurse practitioners have graduated from this program and are providing care throughout the state and U.S. In addition, Dr. McGuinness has written grants that have supported the program and PMHNP students in their education to continue its important efforts. She currently is the Co-Director of the Birmingham VA’s PHMNP resident program, where she has mentored over 5 classes of PMHNP residents.

One of the graduates of the PMHNP program, Simone Durand, currently leads the Psych NP track and is the Co-Director of the Psychiatric NP Residency at Children’s Hospital and the VA’s VANAP NP program. Simone Durand specializes in the care of children and adolescents and blended her previous master’s in counseling with her nursing degree. In addition to Ms. Durand, Dr. Karmie Johnson teaches in the Accelerated Master’s in Nursing Pathway in the pre-licensure track. She also has a clinical practice as a part of the PATH clinic, a UAB nurse managed clinic that has tremendous success in treating the uninsured population with chronic illness, and provides mental health care services to at-risk mothers in the Nurse-Family Partnership of Central Alabama, which works with low-income, first-time mothers. Jennifer Carpenter, a recent graduate of the partnership with the Birmingham Veteran’s Hospital psychiatric nurse practitioner residency, teaches in the pre-licensure and graduate program. In addition, she has a practice within the VA, treating veterans with mental illness such as PTSD. Dr. Yasmine Turkman, a researcher and mental health nurse, is conducting research on breast cancer survivors. She also teaches in the PMHNP track. Dr. Melanie Daniels has charge of the undergraduate psychiatric nursing course work, where she has taught many BSN nurses get in touch with being therapeutic. Lastly, I have taught psychiatric nursing at the graduate level at UAB for almost 10 years and have mentored DNP students with a focus on addictions nursing.  I also have a practice at the UAB 1917 infectious disease clinic, treating patients with behavioral health issues.  As faculty, these individuals work to improve mental health throughout the state. Their work includes direct patient care and teaching the next generation of nurses.

While Mental Health Awareness month draws to end, take a moment to reflect how the choices you make today, influences your performance tomorrow. We have a great deal of work to do to improve the access to mental health care for individuals in need, especially within the state of Alabama. The UAB SON is part of the solution to improve care for those who have mental illness and substance use issues. We are grateful to have cadre of strong leaders, educators and clinicians who lead a new generation of nurses to care for individuals with behaviors health need. Mental health awareness is about attending to the emotional and psychiatric needs of others while attending to your own.

Dr. Susanne Fogger writes a monthly blog post for the UAB School of Nursing blog. For her first post, “Thoughts on Addictions: Alcohol Awareness,” click here.

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