4 min
Villanova Nursing Professor Addresses Overlooked Roles in Mental Health Care
Mental health crises, such as suicidal ideations or attempts, present profound challenges, not only for the individuals experiencing them, but also for the families and professionals who provide care. Parents, in particular, often find themselves stepping into the role of a primary healthcare provider when a child returns home from mental health inpatient treatment. Guy Weissinger, PhD, MPhil, RN, the Diane Foley Parrett Endowed Assistant Professor of Nursing at Villanova University’s M. Louise Fitzpatrick College of Nursing, explores the complex challenges parents face during these delicate situations and how the healthcare system can better prepare them for these responsibilities. Dr. Weissinger’s research also emphasizes the need to rethink how educators train and support healthcare providers involved in mental health care and suicide prevention. In a recent conversation, Dr. Weissinger shared insights into his research, the unique roles that parents and nurses have in managing mental health crises and the steps needed to create a more holistic and inclusive approach to care. Q: A large part of your research examines the parents of youth who are experiencing mental health crises. What challenges do parents face when tasked with providing ongoing healthcare for their children who might be facing these issues? Dr. Weissinger: There’s been a lot of recent work looking at how parents can be better supported in any kind of health crisis as their child is experiencing it. At the end of the day, a physician, therapist or nurse practitioner (NP) can support a patient with their clinical expertise in the hospital, but when those patients return home, the responsibility most often falls on the parent to continue that care. If we're then requiring parents to act as case managers and healthcare providers for their children, how can we best equip them to fill those roles? Q: How does a parent’s role in managing a child’s mental health crisis differ from the roles of a physician or therapist? Dr. Weissinger: I studied family intervention science, which looks at both the individual and family processes that may be related to adolescent suicide risk or any other mental health concern, so I like to ask the question: what is this person's role in their family system? Parents oftentimes have a particular role in the family system, and when there's any kind of mental health crisis, that role may have to change: how they act, what tasks they perform, etc. I’m studying the role transition of a parent during a suicide crisis—what are their struggles and what are parents identifying as their big needs? I’m finding that a lot of parents are feeling really alone or shameful in some way, and then they’re using their own money, time or social resources to try to provide care for their child. This often happens because they feel like the mental health system is not providing the support they need to take on that role, so they’re trying to figure out what to do on their own. Q: An additional part of your research surrounds the role of a nurse practitioner in suicide crises. What are some of the findings from your recent research with nurse practitioners (NPs) about their suicide prevention education? Dr. Weissinger: The findings, which will soon be published, are really interesting because they’re very mixed. I went out and asked NPs what they were taught about suicide prevention and when they were taught it as part of their education and training. Some said that their primary care education integrated suicide prevention as a focus of the curriculum. Others mentioned that they didn’t learn about it in their undergraduate or master’s programs, but they’re still expected to know about suicide prevention as part of their job responsibilities. It’s important to highlight these discrepancies and how we need to think about adapting nursing education to include these important topics. Q: What are some of the overlooked responsibilities and challenges of nurses in managing adolescent mental health? Dr. Weissinger: A large percentage of primary care visits are currently conducted by nurse practitioners, and now suicide screenings are expected to be a standard of practice in primary care visits, even though some NPs don't have that specific training. NPs are often left out of consideration and conversation around best practices related to suicide prevention, so we need to make sure that anyone who's conducting these screenings surrounding suicide has the training and the preparation to do so. It's a difficult conversation for NPs to have, especially when they’re working with kids and families. Q: Why is suicide prevention important to study from a nursing lens? Dr. Weissinger: So much mental health research lumps together groups or only studies psychologists and physicians, so a lot of people who provide mental health services or do suicide prevention screenings are left out of these studies. For example, nurses provide a majority of the discharge education on what parents are expected to do at home when a child leaves the hospital—whether that’s administering injections for a child with diabetes or making a house safer for preventing self-harm. Most of the time, a nurse is walking parents through next steps, answering questions and checking in on patient progress. It’s not the psychologists who evaluated the child, or the physicians who decided that the individual needed to be inpatient, it’s the nurses who are providing those points of contact. Q: What do you hope is the main takeaway from your work surrounding mental health and suicide crises? Dr. Weissinger: Suicide is a really complex thing to address, and it needs to be a conversation that isn’t looking for a silver bullet. It’s a conversation that asks the questions: how do we improve the mental health care system? How do we get primary care providers trained and involved in these discussions? How do we best prepare family members to support individuals who are struggling? Not all researchers need to work on every part of this, but it needs to be a total, all-encompassing effort.
