Midlevel Practitioners Help Workforce Shortage: Nurse Practitioners, Physician Assistants and Other Midlevel Providers Can Help Expand the Availability of Psychiatric Services

By Albright, Brian | Behavioral Healthcare Executive, Summer 2017 | Go to article overview

Midlevel Practitioners Help Workforce Shortage: Nurse Practitioners, Physician Assistants and Other Midlevel Providers Can Help Expand the Availability of Psychiatric Services


Albright, Brian, Behavioral Healthcare Executive


As the gap widens between the need for mental services and the availability of psychiatrists, consequently, demand for "physician extenders" has increased significantly. Across the country, nurse practitioners (NPs), advanced practice registered nurses (APRNs), and in some cases, physician assistants (PAs), are taking on more of the psychiatric case load.

The availability of these midlevel providers can be invaluable, says Joe Parks, MD, medical director at the National Council for Behavioral Health.

Parks also practices psychiatry at the Family Health Center, a federally funded community health center (CMHC) in central Missouri, where an advanced practice psychiatric nurse and three behavioral healthcare consultants have allowed him to serve roughly eight times as many people than he could if he were treating them himself.

"We will never meet everybody's needs seeing all of the patients ourselves," Parks says.

By utilizing the advanced practice nurse, he can spend less time doing routine medication refills, for example, and spend more time with patients who require an in-person consultation. Before, patients waited months to see a psychiatrist.

"In this way I'm always operating much closer to the top of my credentials," Parks says. "It's a different kind of work for me. I work harder. I'm able to see many more people and it has really changed my practice."

Nurse practitioners are playing a key role in extending access to mental health and substance use treatment services, but how they are utilized varies by state. According to the National Council, 21 states and the District of Columbia give NPs full practice authority so that they can diagnose, treat, order diagnostic tests and prescribe to patients without physician oversight. In other states, NPs must work in collaborative practices under the direction of a supervising psychiatrist. Other states restrict NPs ability to prescribe certain medications.

Physician assistants are also emerging as a potential source of help for psychiatric practices. In a paper published in March, titled "The Psychiatric Shortage: Causes and Solutions," the National Council wrote that "PAs with specialty psychiatric training are a relatively new development that has tremendous potential for expansion. Since their duration of training is the shortest of the psychiatric prescribers, they represent one of the most cost-effective solutions to the shortage of psychiatric workforce."

TALENT SEARCH

Demand is increasing for midlevels. According to data from healthcare job matching site Health eCareers, there was a 17% increase in psychiatric nurse practitioner job opportunities between 2014 and 2015, making the field one of the fastest growing non-physician specialties.

Regulations are starting to shift to make it easier to integrate midlevel providers into these practices. In 2016, federal officials announced the expansion of the ability to prescribe buprenorphine to NPs and PAs with specialized training. The Veterans Administration has also extended full practice authority to NPs across the United States.

Other efforts to leverage midlevel providers to extend psychiatric care are also underway. Several national PA organizations convened a mental health summit earlier this year to identify ways that they can help address the psychiatrist shortage. The groups acknowledge that more work needs to be done to establish a framework to help train PAs for mental health and addiction treatment.

"That's not downplaying the importance of physicians," says Tari Dilks, PhD, associate professor of nursing at McNeese State University in Lake Charles, La. "If you can't find a psychiatrist to collaborate with, you can't practice in many states."

Dilks is co-coordinator of McNeese's Master of Science in Nursing programs and director of the psychiatric/mental health track for the Intercollegiate Consortium for a Master of Science in Nursing partnership and has an active private practice. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Midlevel Practitioners Help Workforce Shortage: Nurse Practitioners, Physician Assistants and Other Midlevel Providers Can Help Expand the Availability of Psychiatric Services
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.