Psychiatric Mental Health Nurse Practitioners in Behavioral Health Access Centers: A Collaborative Staffing Model

Suicide is a leading cause of death worldwide (Miller et al., 2017). In general, hospital emergency departments (ED) are seeing increases in visits for behavioral health reasons (Cooke, 2017). To free up ED resources for more timely treatment of critical care patients, hospitals have begun opening behavioral health emergency departments, or behavioral health access centers (AC)(Castellucci, 2018; Southard, Neufeld, & Laws, 2014). A large urban hospital in northern Utah does not currently allow Psychiatric Mental Health Nurse Practitioners (PMHNPs) to practice in its AC. This project compared data from the local hospital's AC to ACs from external facilities of similar size that utilize PMHNPs for providing patient care. This comparative data was used to develop a collaborative staffing model (i.e., psychiatrists and PMHNPS) and both the data and the model were presented to local behavioral health AC administrators. The comparative data and collaborative staffing model proposal were used as the project intervention. Readiness for change in the administrators was measured using pre and post-intervention surveys to assess perceived need, appropriateness, efficacy, leadership, barriers, and motivation. Results from the comparison showed a statistically significant increase in readiness for change in adopting a collaborative staffing model. Using a 1-5 Likert scale (1 being "strongly disagree" and 5 being "strongly agree") the study was able to show an increase from 3.66/5 to 4.13/5 in readiness to change after the intervention. The survey questions were grouped into areas of: need for change, appropriateness, efficacy, leadership, barriers, and motivation for change. The greatest increases came in areas of "need for change" and "appropriateness". These results indicate that AC administrators see a need for change in the staffing model and are open to implementing a change. Further research in this area should focus on verifying PMHNP competency and possibly creating an objective competency list for treating patients in such a setting. It is hoped that this project will serve as a catalyst for change in the future of treating patients in the access center.