Geropsychiatric Nursing: Preparing Nurses to Meet Mental Health Needs

Nate Hinkel

As life spans continue to increase, the UAMS College of Nursing is responding to a fresh challenge by preparing the next generation of nurses to meet the needs of older adults with mental health conditions.

“There is a whole side to aging that people don’t think about. People are living longer, but we need to know how their mental health care will transition,” said Melodee Harris, Ph.D., R.N., assistant professor and specialty coordinator of the adult gerontology nurse practitioner program in the College of Nursing.

“It’s imperative that we train more nurses to respond to mental health care needs of seniors.”
About one in five adults over 65 in the United States are diagnosed with at least one mental health or substance abuse condition. And with the number of older adults projected to soar to 72.1 million by 2030, the answer is clear. “We must train more health care providers with the expertise to care for older adults,” Harris said.

Less than 1 percent of the nation’s 2.2 million registered nurses are certified in gerontology.  Few undergraduate and graduate nursing programs focus on geropsychiatric nursing.

UAMS graduate nursing students are exposed to geropsychiatric nursing through a required course called Adult-Gerontology Primary Care Psychiatric Nursing for Advanced Practice Nursing students.

“It’s a great introduction to pique the interest of students and hopefully set them in a direction that will be a rewarding career path for them,” said Harris, who teaches the course.

Harris also is leading development of three geropsychiatric nursing online learning opportunities in master’s, doctor of nursing practice and Ph.D. programs through the Geropsychiatric Nursing Initiative.

The project is in partnership with the National Hartford Centers of Gerontological Nursing Excellence, Hartford Institute for Geriatric Nursing and the American Association of Colleges of Nursing.

Harris is responsible for developing content and producing online learning tools, identifying and contracting authors and reviewers, and overseeing the implementation of the continuing education programs.

“Many people may not realize the mental health and substance use challenges associated with the aging population,” Harris said. “They might think as long as they’ve been treated or have their conditions under control at middle age, what could change as they age?”

Undiagnosed and untreated geropsychiatric conditions  have a wide range of negative effects, including emotional distress, functional disability, reduced physical health, increased mortality, suicide, and high rates of hospitalization and nursing home placement, all of which equal higher health care costs.

In 2012, the Institute of Medicine (IOM) formed a committee to study geropsychiatric workforce issues. The IOM Committee on Mental Health Workforce for Geriatric Populations identified 27 mental health conditions that can have substantial negative effects on a person’s emotional well-being, functional and self-care abilities, and quality of life.

“Depressive disorders and dementia-related behavioral and psychiatric symptoms are the most common,” Harris said. “Serious mental illness such as schizophrenia and bipolar disorder are less common but have significant implications for caregivers.”

Health care providers must understand the way alcohol and prescription drugs are metabolized differently as people age.  Even people who have used alcohol and taken medications at the same dose and frequency for many years may be at risk for serious side effects as they age. In addition, seniors experience significant losses including loss of loved ones, as well as loss of independence.

“It’s imperative that we train more nurses to respond to mental health care needs of seniors,” Harris said.