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Behavioral and mental health in clinical practice

Section Editor(s): Newland, Jamesetta A. PhD, FNP-BC, FAANP, DPNAP, FAAN

doi: 10.1097/01.NPR.0000580800.05098.5c
Department: Editor's Memo

Each day brings us closer to a reality in which no one or place is invulnerable to the effects of mental illness. Mental health disorders are present in people from all walks of life, and awareness and uncertainty create individual and collective concerns in a society.

We ask the same questions every time a devastating event occurs, trying to make sense of human behaviors we observe in our world. As healthcare providers, NPs routinely encounter patients with mental health challenges. How do we address behavioral and mental health in clinical practice regardless of the setting or population? Intervention starts with assessment.

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Mental Illness Awareness Week

Mental Illness Awareness Week (MIAW) is October 6-12 and October 12 is National Depression Screening Day; the sponsoring agency of both is the National Alliance on Mental Illness (NAMI).1 Even though NPs routinely include screening for mental health issues during patient encounters, this month presents an opportunity to do more by participating in special activities and events. The intent of MIAW is to increase public awareness of behavioral and mental health challenges and reduce stigma so individuals who cannot manage their emotions, feelings, thoughts, or behaviors will seek evaluation and treatment.

Guidance on how to access educational and/or screening activities at schools, universities, work sites, churches, or community or social media groups can be found on the NAMI website. The more people that engage and hear messages about mental health awareness, the better the impact will be on the overall wellness of those who participate.

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US adults and mental illness

According to the National Institute of Mental Health, 1 in 5 US adults live with mental illness, which is classified as any mental illness (AMI) or serious mental illness (SMI); the latter represents a smaller AMI subset. AMI encompasses any mental, behavioral, or emotional disorder, which can have wide variability of impairment, from mild to severe. SMI is any mental, behavioral, or emotional disorder that is severe enough to interfere with a person's functional capacity in one or more areas of daily living.

In 2017, 46.6 million people age 18 years and older, or 18.9% of the adult population, had AMI; of these, 11.2 million (4.5%) were classified with SMI. The prevalence of AMI was higher among women than men and higher among adults reporting two or more races than among Whites. Asians had the lowest prevalence. Among the 46.6 million adults with AMI, 19.8 million or 42.6% received mental health services in 2017. Of those with SMI, 7.5 million or 66.7% received treatment in that past year. In both AMI and SMI, more women than men were treated, and adults ages 18 to 25 years represented the lowest percentage who received mental health services.2

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Intervention starts with assessment

These numbers indicate that over 50% of individuals with AMI are not receiving treatment. The shortage of behavioral and mental health providers places limitations on access to treatment and contributes to the large numbers of untreated individuals. Intervention, however, starts with assessment. Screening patients for AMI is the first step and is something every NP can do; referral to a mental health professional is important. NAMI can also offer a variety of services for families living with someone who has AMI. This grassroots organization is dedicated to helping better the lives of those affected by mental illness.



Jamesetta A. Newland, PhD, FNP-BC, FAANP, DPNAP, FAAN


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1. National Alliance on Mental Illness. Mental Illness Awareness Week. 2019.
2. National Institute of Mental Health. Mental illness. 2019.
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