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The landmark report by RWJF (Robert Wood Johnson Foundation) and the IOM (Institute of Medicine) calls nurses to be fulltime partners in shaping the future of nursing practice and the overall US health sector. At a time of rapidly increasing rates of adult, childhood, and adolescent mental disorders, the need for primary mental health nurse practitioners (PMHNPs) remains an important professional obligation. The World Health Organization highlights that, among children aged 24 years and younger, the estimated cost of mental disorders is $247 billion every year (Kumar et al., 2020). The overall costs are even higher and will continue to rise with the increasing prevalence of mental disorders. At a time when there are increasing rates of  ER visits  for  both fatal and non-fatal  self-inflicted harm  among adults, children, and adolescents, there is an urgent need for  increased acuity   of  mental health concerns. Besides, failure to adequately manage emotional, mental, and behavioral disorders has long term and devastating impacts on individuals, their families, and society. For these reasons, the author selected mental health as the specialty of choice. PMHNPs play a major role in decreasing the burden of mental health disorders on individuals, families, communities, and the society.

Mental Health as a Specialty

Mental health is a nursing specialty where nurses collaborate with   individuals, communities, and families with persons diagnosed with psychiatry disorders. Nurses who specialize in mental health can become PMHNPs or clinical mental nurse specialists and can further specialize in a patient population of interest such as pediatrics or gerontology. PMHNPs   must have completed a nursing diploma, Bachelor’s or Associate program and passed the RN licensing exam. After gaining an RN psychiatric experience, one can proceed further to obtain PMHN certification from the American Nurses Credentialing Center (ANCC). According to Kumar et al., (2020), the roles and responsibilities of PMHNPs are embedded in the therapeutic relationship and nursing process and include; to diagnose and manage acute and chronic mental disorders, to provide psychotherapy, to educate families and patients, to coordinate care, make referrals, order, perform, and interpret diagnostic tests. In most primary healthcare settings, PMHNPs offer video and telephone consultations, they coordinate resources, and collaborate with other healthcare providers. Moyo et al., (2020) add that, to a greater extent, PMHNPs are collaborators. They collaborate with other healthcare providers in specialties such as nutrition, neurology, psychology, social work, and even the criminal justice system.

Difficulties and Facilitators for Choice Selection

The most significant difficulty encountered while selecting my nursing specialty was choosing between mental health and gerontology.  I spent the better part of my life in high school caring for my aged maternal grandmother and interacting with her at old age brought new experiences on what nursing as a profession would be if I spent most time caring for this patient population. On the same note, I have been an advisor, a mentor, a carer and a support system to my elder sister after she was diagnosed with major depressive disorder (MDD) following a dramatic divorce with her husband, in a marriage that had lasted 14 years. To make a more informed decision, I considered factors such as my preferred working style, personality, work hours, work environment, job salary and outlook. Being and extrovert, I prefer working as part of a closely knit professional team in a  clinic or hospital setting  as opposed to  visiting patient  in their homes.  Mental health meets this criteria.

Professional Organization Affiliated to Mental Health

The American Psychiatry Association (APA)   is a leading psychiatry organization which   advances the practice of mental health. Its mission is to   promote access to care for mental health disorders, psychiatry researc


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