NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

Name

Capella University

NURS-FPX 4900 Capstone project for Nursing

Prof. Name

Date

Problem Description and Impact

Oliver James, a 16-year-old high school student, has been hospitalizate to the hospital following a suicide attempt, highlighting a severe patient health problem of depression and anxiety in adolescents. His case exemplifies the critical issue of untreated mental health conditions escalating to life-threatening situations. Over the past six months, Oliver’s parents have noticed his withdrawal from social activities, a drop in academic performance, and excessive use of social media, which they believe has negatively impacted his self-esteem and mood. In the United States, prevalent mental health issues among children and adolescents include ADHD and anxiety, each affecting around 9.4% to 9.8% of this population. A significant depressive episode affects approximately one-fifth of teenagers between the ages of 12 and 17. Among young people, there are alarmingly high rates of ongoing melancholy, suicide thoughts, and restricted access to mental health services (Bitsko et al., 2022).

During my practicum, I will work closely with Oliver, his family, and mental health professionals to develop a personalized care plan integrating evidence-based practices such as cognitive-behavioral therapy (CBT) and mindfulness techniques to address his severe anxiety and depression. I also plan to utilize digital health technologies like telehealth and mobile apps for continuous monitoring and support beyond the hospital (Philippe et al., 2021). Adolescent mental health is a focal point in my nursing practice, extending beyond clinical care to advocacy for policy reforms and community outreach.

Collaborating with school counselors, pediatricians, and community organizations, I aim to establish a robust support network for adolescents like Oliver, enhancing health outcomes and addressing systemic challenges. This includes promoting programs like “Teen Mental Health First Aid” to increase student awareness and resilience (Childs et al., 2020). Addressing severe depression and anxiety in adolescents is critical for preventing suicide and other serious outcomes. As a nurse, I will leverage my assessment, intervention, and advocacy skills to promote mental health education and resilience-building programs and ensure ongoing support through local agencies. I aim to advance mental health care standards in nursing practice by implementing innovative, personalized interventions for Oliver and similar adolescents.

Evidence-Based Approach to Guide Nurses

Practical nursing actions for managing mental illness in patients like Oliver are firmly rooted in evidence from professional sources and peer-reviewed literature. Cognitive-behavioral therapy (CBT) is essential for Oliver’s mental health, and nurses play a crucial role in delivering structured sessions and monitoring progress. Collaboration with therapists ensures treatment effectiveness; however, limited availability of trained therapists in rural areas leads to delayed therapy initiation and continuity gaps (Philippe et al., 2021). Therapeutic communication in mental health nursing involves nurses using practical skills to assess needs, provide emotional support, and collaboratively set treatment goals.

Building trust with patients enhances engagement and adherence to treatment plans, facilitating comprehensive care tailored to mental health needs. However, time constraints from high patient caseloads hinder nurses’ ability to dedicate sufficient time to each patient, impacting the depth of therapeutic interactions (Xue & Heffernan, 2021). Nurses are critical in promoting patients’ mental health through education on mindfulness, physical activity, and healthy lifestyles, aiding in resilience and symptom management. Personalized routines are crafted to support immediate well-being and long-term mental health strategies. However, a lack of accessible community resources, like affordable fitness facilities and programs, poses a barrier to engaging Oliver and others in recommended self-care practices (Pinho, 2021).

NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

Recent peer-reviewed literature on nursing interventions for mental health management undergoes assessment using the CRAAP criteria: authority, relevancy, accuracy, purpose, and currency. These evidence-based resources, published within the past five years, offer reliable guidance crafted by healthcare professionals. They provide precise directives for managing type 2 diabetes effectively, ensuring accurate approaches to enhance metabolic health (Muis et al., 2022). Nurses are pivotal in policy-making, advocating for resources, and improving healthcare access for patients with mental health needs. By actively participating in policy development, nurses influence healthcare delivery and ensure that mental health services are accessible and effective for patients like Oliver.

Adherence to evidence-based nursing standards and policies ensures systematic, evidence-driven assessments and interventions, improving symptom management and patient safety. Integrating evidence-based practices into nursing care ensures systematic, effective interventions that enhance patient outcomes, including those for individuals like Oliver (Potter et al., 2020). The nursing theory or conceptual framework that frames and guides my actions during my practicum is the Roy Adaptation Model, which emphasizes holistic patient care and adaptation to health stressors. They promote continuity of care and collaborative healthcare efforts, enhancing overall patient outcomes, including those for patients like Oliver (Potter et al., 2020).

State Board Nursing Practice Standards/ Organizational or Governmental Policies

Governmental policies and State board nursing practice standards, particularly the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act (MHPAEA)play crucial roles in shaping mental health care delivery and outcomes for patients such as Oliver, who is dealing with severe depression. The State Nurse Practice Act (NPA) establishes the legal framework within which nurses practice, outlining the scope of practice, licensure requirements, and standards of care. These regulations ensure that nurses like those caring for Oliver are well-equipped and authorized to provide holistic mental health care aligned with best practices. By adhering to NPA guidelines, nurses uphold quality standards while advocating for policy changes that enhance the integration of mental health services, optimize patient outcomes, and foster a healthcare environment that effectively supports mental wellness (College et al., 2023).

The MHPAEA ensures that insurance plans cover mental health with medical and surgical services. Studies have demonstrated that there has been a notable increase in access to mental health care services since its implementation, leading to improved treatment rates and reduced financial barriers for patients. For Oliver, this translates into better management of his depression through consistent access to psychiatric medications and therapy sessions, ultimately enhancing his quality of life and reducing the risk of severe mental health episodes (Block et al., 2020).

NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

Similarly, the ACA’s provisions, including Medicaid expansion and subsidies for insurance coverage, have significantly expanded access to mental health services for low-income individuals like Oliver. Research indicates that states that expanded Medicaid under the ACA have seen increased mental health treatment rates and reduced rates of untreated mental illness among the previously uninsured population. This comprehensive coverage ensures that Oliver can receive necessary mental health treatments without financial strain, thereby supporting his ongoing mental health stability and well-being (Preidler et al., 2020).

Nurses are pivotal in advocating for policy changes that improve mental health care delivery. Their involvement in policy discussions helps shape regulations and funding priorities to support comprehensive mental health services. By advocating for integrating mental health into primary care settings and promoting early intervention strategies, nurses contribute to improved patient outcomes and reduced healthcare disparities related to mental illness (Gabrielsson et al., 2020). Regarding the scope of nursing practice, MHPAEA and ACA influence nurses to deliver care in mental health settings. These policies define licensure requirements, reimbursement rates, and the availability of resources necessary for effective patient care. These policies guide nurses in providing patient-centered care and ensuring compliance with standards while advocating for enhanced mental health services within their communities (Preidler et al., 2020).

Leadership Strategies and Documentation of Practicum Hours

To enhance outcomes, patient-centered care, and Oliver’s overall experience while managing severe depression, strategic leadership initiatives are paramount. Implementing specialized programs tailored to Oliver’s needs ensures comprehensive support across various facets of mental health care. Leadership is essential in establishing a telepsychiatry program to enhance Oliver’s access to mental health services. This initiative enables him to have regular remote check-ins with psychiatrists or therapists, ensuring continuity of care and overcoming logistical barriers. Research highlights telepsychiatry’s effectiveness in boosting patient engagement and treatment adherence, which is crucial for managing Oliver’s severe depression.

Effective leadership entails advocating for resources, driving policy changes to support telehealth initiatives, and aligning the care team with organizational goals for remote mental health care (Smith et al., 2020). Leadership plays a crucial role in organizing Mental Health Awareness Workshops within the community to educate Oliver and his family on depression management strategies and available support resources. These workshops aim to reduce stigma, increase awareness, and strengthen community-based support systems. Engaging local stakeholders and organizations creates a supportive environment crucial for Oliver’s recovery. Leadership in this context involves advocating for policy changes to support mental health education and effectively driving efforts to engage and educate the community (Mongelli et al., 2020).

NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

Leadership must prioritize effective change management strategies to ensure smooth transitions, address resistance to new processes, and maximize the integration’s benefits. Strategies include stakeholder engagement to gain buy-in, comprehensive training programs such as the “Mental Health Integration Training Program” for staff to facilitate new workflows, and ongoing evaluation of program effectiveness (Gorry et al., 2022). This approach enables early detection of mental health concerns, timely interventions, and comprehensive management aligned with Oliver’s overall health needs. This evidence highlights the effectiveness of integrated care models in improving patient outcomes and treatment adherence, providing a robust framework for Oliver’s holistic care.

I spent over two and a half hours in thorough consultations with Oliver, a patient managing mental health challenges. I worked closely with Oliver’s consultant to devise and apply effective strategies for managing his mental health. These discussions encompassed various aspects, including Oliver’s lifestyle, complete medical history, and pertinent details about his condition. I diligently logged these hours in the CORE ELMS Volunteer Experience Form, ensuring meticulous documentation of our collaborative efforts in addressing Oliver’s mental health needs.

Part 2

For this practicum phase, I will focus on Oliver James, a 16-year-old high school student who recently attempted suicide due to severe depression and anxiety. Oliver’s case underscores the critical need to address untreated mental health conditions in adolescents, evident from his social withdrawal, academic decline, and excessive social media use impacting his mood and self-esteem. Choosing Oliver allows me to delve deeply into managing severe adolescent depression, integrating evidence-based practices like CBT and mindfulness techniques into his care plan. I aim to convey the significance of Oliver’s challenges to him and his family through clear, empathetic communication. Aligning clinical insights with current research and mental health policies will help build trust and cooperation.

Effective leadership, collaboration, communication, and change management skills will be essential. I must build rapport with Oliver and his family, collaborate closely with mental health professionals, and advocate for comprehensive care. Overcoming potential barriers, such as stigma and initial resistance to therapy, will require persistence and data-supported arguments demonstrating intervention efficacy. By applying these strategies, I aim to positively impact Oliver’s mental health journey, ensuring he receives the necessary support to navigate challenges effectively and prevent future crises. This approach contributes to immediate clinical care and broader advocacy for improved mental health services in Oliver’s community and beyond.

Conclusion

Focusing on Oliver James’s case provides a critical opportunity to address severe adolescent depression and anxiety, highlighted by his recent suicide attempt. I aim to build trust and cooperation with Oliver and his family by emphasizing evidence-based practices and clear communication. Applying leadership and collaboration skills will be essential in advocating for comprehensive care and navigating potential barriers like stigma. Through these efforts, I seek to positively impact Oliver’s mental health journey and contribute to broader advocacy for improved mental health services and awareness in his community.

References

Bitsko, R. H., Claussen, A. H., Lichstein, J., Black, L. I., Jones, S. E., Danielson, M. L., Hoenig, J. M., Davis Jack, S. P., Brody, D. J., Gyawali, S., Maenner, M. J., Warner, M., Holland, K. M., Perou, R., Crosby, A. E., Blumberg, S. J., Avenevoli, S., Kaminski, J. W., Ghandour, R. M., & Meyer, L. N. (2022). Mental health surveillance among children — United States, 2013–2019. MMWR Supplements, 71(2), 1–42. https://doi.org/10.15585/mmwr.su7102a1

Block, E. P., Xu, H., Azocar, F., & Ettner, S. L. (2020). The mental health parity and addiction equity act evaluation study: Child and adolescent behavioral health service expenditures and utilization. Health Economics, 29(12), 1533–1548. https://doi.org/10.1002/hec.4153

Childs, K. K., Gryglewicz, K., & Elligson, R. (2020). An assessment of the utility of the youth mental health first aid training: Effectiveness, satisfaction, and universality. Community Mental Health Journal. https://doi.org/10.1007/s10597-020-00612-9

College, C. V. T., Egert, A., Lee, K., & Gill, M. (2023). Nursing fundamentals. Ecampusontario.pressbooks.pub. https://ecampusontario.pressbooks.pub/mohawkcollegenursingpharmacology/chapter/nursing-fundamentals/

Gabrielsson, S., Tuvesson, H., Gustin, L. W., & Jormfeldt, H. (2020). Positioning psychiatric and mental health nursing as a transformative force in health care. Issues in Mental Health Nursing, 41(11), 976–984. https://doi.org/10.1080/01612840.2020.1756009

Gorry, P. D. M., Mei, C., Chanen, A., Hodges, C., Jimenez, M. A., & Killackey, E. (2022). Designing and scaling up integrated youth mental health care. World Psychiatry, 21(1), 61–76. https://doi.org/10.1002/wps.20938

Mongelli, F., Georgakopoulos, P., & Pato, M. T. (2020). Challenges and opportunities to meet the mental health needs of underserved and disenfranchised populations in the United States. Focus, 18(1), 16–24. https://doi.org/10.1176/appi.focus.20190028

Muis, K. R., Denton, C., & Dubé, A. (2022). Identifying CRAAP on the Internet: A source evaluation intervention. Advances in Social Sciences Research Journal, 9(7), 239–265. https://doi.org/10.14738/assrj.97.12670

NURS FPX 4900 Assessment 1 Assessing the Problem Leadership Collaboration Communication Change Management and Policy Considerations

Philippe, T. J., Sikder, N., Jackson, A., Koblanski, M. E., Liow, E., Pilarinos, A., & Vasarhelyi, K. (2021). Digital health interventions for delivery of mental health care: Systematic and comprehensive meta-review (Preprint). JMIR Mental Health, 9(5). https://doi.org/10.2196/35159

Pinho, L. (2021). The use of mental health promotion strategies by nurses to reduce anxiety, stress, and depression during the COVID-19 outbreak: A prospective cohort study. Environmental Research, 195, 110828. https://doi.org/10.1016/j.envres.2021.110828

Potter, D., Jayne, D., & Britt, S. (2020). Financial anxiety among college students: The role of generational status. Journal of Financial Counseling and Planning, 31(2), JFCP-17-00033. https://doi.org/10.1891/jfcp-17-00033

Preidler, J. R., Trachsel, M., Johnson, T., & Andorno, N. B. (2020). The affordable care act and recent reforms: Policy implications for equitable mental health care delivery. Health Care Analysis, 28(3). https://doi.org/10.1007/s10728-020-00391-0

Smith, K., Ostinelli, E., Macdonald, O., & Cipriani, A. (2020). COVID-19 and telepsychiatry: Development of evidence-based guidance for clinicians. JMIR Mental Health, 7(8). https://doi.org/10.2196/21108

Xue, W., & Heffernan, C. (2021). Therapeutic communication within the nurse–patient relationship: A concept analysis. International Journal of Nursing Practice, 27(6). https://doi.org/10.1111/ijn.12938