The Significance of the Limited Access to Mental and Psychiatry Health Services in Underserved Communities: Implications for the Nursing Profession

 

The Significance of the Limited Access to Mental and Psychiatry Health Services in Underserved Communities: Implications for the Nursing Profession

Nursing has played a significant role in ensuring that individuals with limited access to psychiatry and mental health services receive timely and comprehensive care. The unique health needs of these individuals must be met by the healthcare professionals so that they may enjoy healthy and fulfilling lives, and the impact of this problem has a tremendous effect on their practice. This paper aims to identify the significance of the problem identified by the PICOT question on the nursing profession. It will compare the impact of community-based interventions and those undertaken in primary healthcare settings on the access of individuals to psychiatric and mental health services. Insight on the role of the nurses and the promotion of comprehensive care in underserved communities can be understood. The essay will explore different impacts of the problem on the nursing profession while providing credible evidence to support each point.

The limited access to psychiatric and mental health services in underserved communities has affected the nursing workforce. Nurses working in the community face a heightened number of mental health cases and an increased workload due to limited healthcare resources. The decreased availability of resources forces nurses to experience increased rates of burnout and work-related stress. Studies by Shah et al. (2021) concluded that nurses grappling with limited resources would likely suffer from emotional exhaustion and experience increased dissatisfaction with their work. The decreased availability of nursing staff forces the existing number of nurses to compensate for the reduced access to specialized care. In the long run, the quality of healthcare services accorded to these individuals dramatically decreases, and the ability of nurses to deliver evidence-based care is hampered (Jun et al., 2021). Therefore, to ensure that these challenges are overcome, the healthcare sector should provide adequate resources to these disadvantaged communities, and a sufficient number of healthcare workers should be allocated to meet the health needs of the populations.

The limited access to psychiatric and mental health services in underserved communities negatively affects the health outcomes of the individuals, consequently affecting the reputation of the nursing sector. A delay in access to mental health services has been shown to contribute significantly to poor health outcomes for individuals suffering from mental health conditions (Carbonell et al., 2020). In underserved communities, people will have to wait for a more extended period to receive care, and there is reduced access to specialized services and comprehensive care (Carbonell et al., 2020). This can significantly influence the development of adverse health outcomes, leading to increased hospitalizations, a decrease in general well-being, and the development of complications. The availability of resources and the accessibility of mental health services influences the role nurses play in providing holistic care and timely interventions. The significance of the problem to the nursing profession is reflected in the adverse health outcomes achieved by the patients. Nurses have played a considerable role in ensuring individuals access mental health services. However, the inaccessibility of the services hinders their interventions in ensuring that the individuals receive services, ultimately influencing their well-being.

Lack of access for individuals in underserved communities to mental health services underscores the essence of reduction of the gap in the education of nurses on mental health. Nurses in underserved communities who grapple with limited resources to provide specialized and comprehensive care must possess the skills and knowledge essential to addressing the unique health needs of the individuals (Coombs et al., 2021). Mental health literacy should therefore be prioritized in the nursing curricula so that graduating nurses can comprehensively understand the diverse mental health conditions, cultural considerations to accommodate, and the therapeutic interventions they are required to undertake (Coombs et al., 2021).

With this education, the nurses will be empowered to recognize the signs and symptoms associated with the conditions, intervene timely, and ensure that they provide the individuals with adequate support or referral for their needs to be managed effectively. This education can also stress the importance of incorporating community-based interventions and strategies that they can employ and how to collaboratively work with the other healthcare members to ensure that they improve the accessibility of mental health services in these underserved communities (Eales, 2019). Overall, educating the nurses on mental health will ensure that they are confident and competent with essential skills to address the mental health concerns of these communities.

The limited access to mental health services challenges the nursing profession in providing holistic care to individuals in disadvantaged communities. Holistic care considers the patients’ social, physical, and psychological needs (Kinchen, 2019). When individuals in underserved communities do not have access to care, they cannot receive holistic care, which is the primary goal of the nursing profession. Mental and physical health conditions often occur concurrently, and if nurses address these problems in isolation, the health outcomes will be substandard. However, if the nurses adopt community-based interventions and strategies, the accessibility to holistic care in the communities can increase dramatically. This challenge necessitates that nurses understand the social determinants of health (SDOH), collaborate with other healthcare providers and organizations, and address the barriers that decrease the accessibility of mental and psychiatric services by these populations (Coombs et al., 2021). Adopting a holistic approach to providing mental health services can help the nurses address the underlying disparities in healthcare and ensure that individualized patient care plans are used to address each patient’s unique needs.

The significance of the decreased accessibility of individuals in underserved communities to psychiatric and mental health services identifies the need for why nurses should enhance their cultural competencies. Individuals in these communities often have different treatment preferences, diverse mental health perceptions, and different cultural backgrounds, which inform their health-seeking behaviors (Sarikhani et al., 2020). For nurses to provide culturally competent care, they must be informed about the cultural backgrounds of these individuals and provide care that addresses and respects the unique needs and beliefs of the communities (Sharifi et al., 2019).

Lack of access to high-quality mental health services can increase marginalized communities’ health disparities. When the social and cultural factors that influence the health outcomes of the individuals are understood, nurses can tailor their interventions to ensure that they provide inclusive, respective, and patient-centered healthcare services that effectively meet the diverse needs of the unique individuals. The cultural competence of the nurses can help to ensure trust between the individuals and the healthcare workers, enhanced communication, and increased engagement of the communities in the healthcare services (Sharifi et al., 2019). Cultural competence is essential in providing adequate healthcare services to meet the unique needs of underserved populations.

The critical role of nurses as advocates for their patients is highlighted by limited access to mental and psychiatric health services for underserved populations. Nurses are the primary point of contact for persons seeking mental and psychiatric health services in the communities. For nurses to effectively play their role as nurse advocates, they need to identify barriers facing the communities in accessing healthcare services and see that these individuals access high-quality mental health services. Social inequities and health disparities can be perpetuated by inaccessibility to mental health services and the failure of nurses to advocate for the needs of the patients (Sharifi et al., 2019). Nurses, the majority of healthcare workers, are well positioned to advocate for new policies ensuring that individuals from all walks of life and socioeconomic backgrounds have equitable access to high-quality healthcare services.

Their interactions with the patients also enable them to collect firsthand information about the challenges that individuals in underserved communities face and communicate the findings to higher authorities for consideration during policy-making (Nsiah et al., 2019). They can also increase awareness about mental health, engagement in public health campaigns, and collaborate with other community stakeholders in developing effective community-based interventions and strategies to increase the accessibility of individuals to mental health services. Therefore, for underserved communities to have equitable access to mental and psychiatric health services, nurses must proactively play their crucial roles as patient advocates.

Limited access to psychiatric and mental health services in underserved communities immensely affects nursing. The role of nurses as patient advocates, its impact on the workforce, its effects on patient outcomes, and the need to reduce gaps in the education of nurses on mental health are the key aspects of the implications of the problem. It is vital to address all the barriers that influence the access of individuals in underserved communities for nurses to provide comprehensive healthcare services. Understanding the significance posed by this problem can help the nurses to implement community-based interventions and strategies that can help to increase access to healthcare services to underserved communities, ultimately enhancing the achievement of positive healthcare outcomes by these individuals.

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References

Carbonell, Á., Navarro‐Pérez, J., & Mestre, M. (2020). Challenges and barriers in mental healthcare systems and their impact on the family: A systematic integrative review. Health & Social Care in the Community, 28(5), 1366–1379. https://doi.org/10.1111/hsc.12968

Coombs, N. C., Meriwether, W. E., Caringi, J., & Newcomer, S. R. (2021). Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study. SSM – Population Health, 15(PMC8214217), 100847. https://doi.org/10.1016/j.ssmph.2021.100847

Eales, S. (2019). A focus on mental health. British Journal of Nursing, 28(18), 1213–1213. https://doi.org/10.12968/bjon.2019.28.18.1213

Jun, J., Ojemeni, M. M., Kalamani, R., Tong, J., & Crecelius, M. L. (2021). Relationship between nurse burnout, patient and organizational outcomes: Systematic review. International Journal of Nursing Studies, 119(103933), 103933. https://doi.org/10.1016/j.ijnurstu.2021.103933

Kinchen, E. (2019). Holistic nursing values in nurse practitioner education. International Journal of Nursing Education Scholarship, 16(1). https://doi.org/10.1515/ijnes-2018-0082

Nsiah, C., Siakwa, M., & Ninnoni, J. K. (2019). Registered nurses’ description of patient advocacy in the clinical setting. Nursing Open, 6(3), 1124–1132. https://doi.org/10.1002/nop2.307

Sarikhani, Y., Bastani, P., Rafiee, M., Kavosi, Z., & Ravangard, R. (2020). Key barriers to the provision and utilization of mental health services in low-and middle-income countries: a scope study. Community Mental Health Journal. https://doi.org/10.1007/s10597-020-00619-2

Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and factors associated with nurse burnout in the U.S. JAMA Network Open, 4(2), 1–11. https://doi.org/10.1001/jamanetworkopen.2020.36469

Sharifi, N., Adib-Hajbaghery, M., & Najafi, M. (2019). Cultural competence in nursing: A concept analysis. International Journal of Nursing Studies, 99, 103386. https://doi.org/10.1016/j.ijnurstu.2019.103386

Introduction

Communities with ethnic and racial disparities, low socioeconomic status, and isolated geographically often face barriers to accessing mental and psychiatric services. In clinical practice, healthcare workers have ensured that these communities are engaged and provided adequate mental health services. They have served as educators, providers of comprehensive services, and advocates of these communities. There is a collaboration between different healthcare workers in developing culturally sensitive interventions based in the communities to promote mental health in these individuals. In the future, nurses can rely on technology such as telehealth to help reduce the geographical gaps in access to high-quality mental health services. Suppose the access to mental health services for underserved communities is addressed. In that case, the overall mental wellness of these individuals will improve, and there will be equity in the access to services by all, regardless of geographical location or socioeconomic status.

General Problem

The general problem is that there are people still unable to access mental health services despite the increased awareness raised by healthcare workers. The situation necessitates that the nursing practice focuses on the advocacy and engagement of patients and communities unable to access mental and psychiatric health services (Kates et al., 2019). Healthcare workers must build trust and good therapeutic relationships with patients to provide culturally sensitive services. They also need to deeply understand these individuals’ challenges and tailor the interventions accordingly to meet their unique needs (Purtle et al., 2020). If the community members are engaged, the nurses can identify their challenges and increase awareness about mental health, helping to promote early prevention and diagnosis of mental health issues (Purtle et al., 2020). This approach can help to empower the communities to take charge of their health.

Communities and patients that do not have access to mental and psychiatric services often delay being diagnosed, receive inadequate treatment for their conditions, and do not have access to support for their health conditions. They are likely to experience severe symptoms of the illnesses, prolonged hospitalizations, and a reduction in overall well-being (Carbonell et al., 2020). Through timely, appropriate interventions, their health can be improved. The overall quality of life and a reduction in the relapse of mental health conditions can be achieved through coordination of care and patient education.

When individuals cannot access mental and psychiatric services, there is a rise in healthcare disparities, which can later burden healthcare organizations. When the conditions are not prevented and diagnosed early, individuals will seek healthcare services in the emergency departments or present to the other hospital departments with severe acute symptoms of the disease (Kates et al., 2019). The latter increases the healthcare workers’ workload, increases healthcare costs, and challenges the institution in providing high-quality services to the patients (Kates et al., 2019). Addressing this problem can help reduce unnecessary hospitalizations and decrease costs associated with care.

The Problem of Interest

The specific problem is limited access to and underutilization of mental and psychiatric health services in underserved communities. This problem has perpetuated disparities the communities face in access to healthcare services. The communities are unable to access holistic and equitable services. The current nursing practice focuses on providing individuals with care in traditional healthcare settings like hospitals and clinics. Even though most individuals can access services from these settings, those living in geographically isolated areas may fail to benefit from these services. Some barriers that increase the inaccessibility to healthcare services include stigmatization surrounding mental health services, lack of means of transportation and financial constraints these individuals face (Coombs et al., 2021). A culturally sensitive and comprehensive approach to address this problem is also lacking.

The healthcare workers have not understood the unique economic, social, and cultural challenges facing underserved communities, which is essential to tailoring interventions to meet their healthcare needs. The current allocation of resources to the healthcare systems does not help bridge the gap in access to healthcare services. The current practice has overlooked community-based preventive approaches to mental health conditions. People have to rely on emergency departments to manage their conditions and when seeking follow-up services, which places a burden on the healthcare system and impedes the provision of high-quality services.

Identification of the Problem of Interest

A needs assessment, objective analysis of data, and evaluation of different outcomes relating to the quality, allocation of resources, and satisfaction of the patients were carried out. A needs assessment is essential to understand the needs of the individuals in the underserved communities. Quantitative and qualitative data is gathered from different healthcare providers, community members, and relevant organizations in the communities. Some barriers to access to healthcare services identified include lack of transportation, financial constraints, geographical isolation of the communities, and cultural stigmatization. Health utilization patterns, epidemiological reports, and data on health disparities were utilized in objective data analysis to provide a quantitative image of the disparities in access to mental health services. There was an apparent disproportionate representation of the communities regarding the high frequency of emergency department visits for individuals with mental health issues, delayed diagnoses, and limited follow-up care.

Incident reports and staff survey analysis were used to assess the impact of limited access to mental health services on the satisfaction and safety of the patients. There were higher frequencies of adverse events, reduced morale of the healthcare workers, and high dissatisfaction among the patients in the underserved communities. The current practice and allocation of resources were assessed to ascertain if it is evidence-based and if the resources are utilized effectively. Literature was reviewed to provide more information on addressing the problem. There is a need for culturally sensitive services, community-based interventions, and telehealth to enhance community access to healthcare services (Cleary et al., 2019). Financial analysis to assess the impact of the limited access to services indicated that potential financial savings could be achieved if the access to mental health services in underserved communities is increased.

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Parameters of the Problem

The parameters of the limited access to mental health services in underserved communities entail the population impacted and the healthcare system. Healthcare workers are affected as they try to ensure that they provide patients with holistic and equitable care to all individuals. They have to ensure that they use the limited resources efficiently, address the issues of stigmatization and develop strategies that increase the engagement of the affected communities (Cleary et al., 2019). Patients in underserved communities directly face the effects of limited access to mental health services. They face a delay in diagnosing their conditions, difficulty getting support in managing their condition, and limited treatment options (Kassam et al., 2021). They are likely to face severe symptoms, a reduction in overall well-being, and an increase in readmission rates.

The support systems and families of the patients may face burdens in ensuring that their loved needs get the essential care they need; they may be drained emotionally and financially while doing this (Carbonell et al., 2020). Healthcare institutions are forced to deal with the workforce shortage, limited allocation of resources, and the development of essential interventions to address the disparities in accessing healthcare services. The financial constraints make it challenging for these institutions to provide high-quality, comprehensive care to the communities.

Conclusion and Transition

Limited access to mental and psychiatric health services in underserved communities negatively impacts the safety of the patients. A delay in access to health services can lead to severe symptoms of the condition, increase the risk of self-harm and make the patients vulnerable to crises. If the individuals in these communities do not receive timely interventions, they will likely face poor mental health outcomes and develop adverse events. The quality of care provided to these communities is likely to be affected. Lack of culturally sensitive approaches, inadequate follow-up care, and insufficient treatment options contribute to poor health outcomes (Cleary et al., 2019).

Patients with mental health conditions suffer for an extended time, have decreased overall well-being, and face reduced functionality. More resources will be required to provide sophisticated care when patients present with severe conditions at the hospitals. The healthcare system is burdened, the available resources are strained, and the financial costs associated with care increase. Limited access to services has physical, emotional, and spiritual effects on the community members. The impact of the mental health condition on their well-being and self-care can ultimately affect their physical health, making them less functional.

The significant effects of the limited access to healthcare services in underserved communities necessitate an evidence-based practice and quality improvement project. This project can help to improve the safety of the patients, increase the quality of care, promote the overall well-being of the individuals, and decrease the costs associated with care. By addressing the barriers to access to mental and psychiatry health services, implementing evidence-based interventions, and ensuring that the services are culturally sensitive, the EBP/QI project can increase the satisfaction of the patients, improve their overall health and ensure that there is equitable access of healthcare services to all individuals regardless of the geolocation or socioeconomic status.

PICOT Question

In underserved communities facing limited access to mental and psychiatry health services (P), what is the effect of community-based strategies and interventions (I), compared to the provision of healthcare services in traditional hospital settings (C), on access to comprehensive and timely mental and psychiatry health services (O) within one year (T).

 

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References

Carbonell, Á., Navarro‐Pérez, J., & Mestre, M. (2020). Challenges and barriers in mental healthcare systems and their impact on the family: A systematic integrative review. Health & Social Care in the Community, 28(5), 1366–1379. https://doi.org/10.1111/hsc.12968

Cleary, M., West, S., Arthur, D., & Kornhaber, R. (2019). Change management in health care and mental health nursing. Issues in Mental Health Nursing, 40(11), 1–7. https://doi.org/10.1080/01612840.2019.1609633

Coombs, N. C., Meriwether, W. E., Caringi, J., & Newcomer, S. R. (2021). Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study. SSM – Population Health, 15, 100847. https://doi.org/10.1016/j.ssmph.2021.100847

Hartley, S., Raphael, J., Lovell, K., & Berry, K. (2020). Effective nurse-patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance. International Journal of Nursing Studies, 102(1). https://doi.org/10.1016/j.ijnurstu.2019.103490

Kassam, S., Serrano-Lomelin, J., Hicks, A., Crawford, S., Bakal, J. A., & Ospina, M. B. (2021). Geography as a determinant of health: health services utilization of pediatric respiratory illness in a Canadian province. International Journal of Environmental Research and Public Health, 18(16), 8347. https://doi.org/10.3390/ijerph18168347

Kates, N., Arroll, B., Currie, E., Hanlon, C., Gask, L., Klasen, H., Meadows, G., Rukundo, G., Sunderji, N., Ruud, T., & Williams, M. (2019). Improving collaboration between primary care and mental health services. The World Journal of Biological Psychiatry, 1–18. https://doi.org/10.1080/15622975.2018.1471218

Purtle, J., Nelson, K. L., Counts, N. Z., & Yudell, M. (2020). Population-based approaches to mental health: history, strategies, and evidence. Annual Review of Public Health, 41(1), 201–221. https://doi.org/10.1146/annurev-publhealth-040119-094247

 

 

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	Novice	Competent	Proficient
APA 7th Formatting	Points: 15 (15.00%) Proper APA 7th formatting is absent or is incorrect for the majority of citations and reference page resources are accurately written.	Points: 20 (20.00%) Proper APA 7th formatting for some to most of the citations and reference page resources are accurately written.	Points: 25 (25.00%) Proper APA 7th Ed formatting for all citations and reference page resources are accurately written.
Organization & Coherence of Thought	Points: 15 (15.00%) Assignment is disorganized, sections are difficult to find (no headings), and assignment illustrates a disorganized written document. Coherence of thought is not evident.	Points: 20 (20.00%) Assignment is somewhat organized, some sections are difficult to find (not enough headings), and assignment illustrates a somewhat disorganized written document. Coherence of thought is somewhat evident.	Points: 25 (25.00%) Assignment is clearly organized, sections are easy to find (headings used) and assignment illustrates an organized written document. Coherence of thought is clearly evident.
Grammar & Spelling	Points: 15 (15.00%) Multiple grammar and spelling errors noted. Preponderance of inappropriate use of passive voice or clarity-limiting words is evident.	Points: 20 (20.00%) Few to several grammar or spelling errors noted. Some inappropriate use of passive voice or clarity-limiting words is evident.	Points: 25 (25.00%) No grammar or spelling errors noted. Appropriate use of passive voice or clarity-limiting words is evident.
Professional Writing	Points: 15 (15.00%) Evidence of unprofessional style of writing throughout, e.g., use of first person, familiar tone, colloquial language.	Points: 20 (20.00%) Evidence of unprofessional style of writing in some places, e.g., use of first person, familiar tone, colloquial language.	Points: 25 (25.00%) No evidence of unprofessional style of writing throughout.

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