Discussion: The Substance Abuse

Discussion: The Substance Abuse

when the collaborative psychiatrist decided to close his practice and abruptly discontinued the collaborative agreement. In order to prevent discontinuity in care, the APRN-PMHNP needed to establish a collaborative agreement with another psychiatrist and develop a practice agreement (Form 4NP) based on protocols established by the State of New York. This time-consuming process resulted in a disruption in treatment for several patients. The APRN- PMHNP managing this case reported a major incident by a high-risk patient that occurred as a result of this disruption in continuity of care. This case vignette highlights the potential negative consequences related to statutory

collaborative agreements as well as the ability of an APRN-PMHNP to provide effective, safe, and consistent care.

Introduction Several national initiatives in the past

decade have identified mental healthcare indicators that address system issues and the efficiency of access to mental health treatment by consumers within the community. Healthy People 2010, Healthy People 2020, and the National Consensus Statement on Mental Health Recovery are only a few of the national initiatives that recognize the lack of access and need for more mental health

Heather Muxworthy is a psychiatric/mental health r^urse practitioner at Wegman s School of Nursing. St. ¡ohn Fisher College in Rochester. NY. Nancy Bowllan is a clinical nurse specialist track coordinator and associate professor at Wegmans School of Nursing. St. ¡ohn Fisher College in Rochester. NY.

Journal ot the New York State Nurses Association, Volume 42, Numbers 1 & 2
Batriers to Practice and Impact on Care

providers. The National Business Croup on Health is a health non-profit membership organization that includes 60 Fortune 100 companies, and employs 55 million workers. This organization recognized a need and set a goal to improve delivery of behavioral health care in general medical and mental health sectors (U.S. Department of Health and Human Services, 2007). In addition to the above, the Substance Abuse and Mental Health Services fldministration (SAMHSA) (2003) recognized the need to provide more mental health research and to place more providers trained in evidence-based practice into the community. SAMHSA is the largest supporter of mental health grant opportunities for mental health innovation and demonstration programs (SAMHSA. 2003).

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