The Role of Psychiatric Mental Health Nurse Practitioners in Crisis Intervention

Specialist professionals within mental health are in high demand due to their knowledge and skills which play an important role in day-to-day patient treatment as well as crisis management.

Healthcare’s understanding of issues surrounding mental health is improving, but there is a lot of work to be done within the field and a constantly growing need for more specialists to assist those in society who need help.

A Psychiatric Mental Health Nurse Practitioner (PMHNP) is an advanced practice registered nurse who specializes in caring for the mental health and wellbeing of their clients, providing assessment and management of mental health illnesses and diseases. They also implement strategies and treatments with the aim of helping their patients to achieve physical and psychological wellbeing and balance. In some settings, they may perform psychosocial and physical assessments as well as emergency psychiatric care.

In addition to performing the functions of general advanced-practice registered nurses, they also provide specific focus on the diagnosis and treatment of both common acute and chronic psychiatric issues and crisis.

What is a psychiatric crisis?

A crisis is defined as an overwhelming event such as exposure to violence, the passing of a loved one, the discovery of a serious illness, or divorce, for example.

Individuals who are affected by a crisis have the potential to harm both themselves and others, which is why crisis intervention is sometimes needed to mitigate those risks. Crisis intervention can be a short-term management technique that is designed to reduce the potential permanent damage to the individual who is affected by a crisis. In instances where damage is likely, psychological crisis intervention is needed to prevent traumatized victims from developing illnesses. If left unmanaged, a patient with a severe crisis could go through significant psychological stress, which can be linked to other mental health conditions. So, crisis intervention is an important factor in improving outcomes in psychiatric cases.

The role of crisis teams

The core characteristics of crisis teams will include 24-hour direct access, rapid response, a range of interventions, and multidisciplinary ways of working. Interventions could include medication that increases the patient’s resilience and reduces the possibility of relapse, plus practical everyday help with day-to-day tasks and support for carers and family.

The underlying principles of the team will focus on assessing and addressing the environmental and societal triggers that cause a mental health crisis. The team will understand how to enable people to develop coping skills in response to the triggers, as this will help to alleviate the impact of a future crisis or avoid reoccurrences completely. 

Crisis intervention helps teams assess and triage situations accurately as well as directing the attention of both medical and mental health professionals in both emergency and community care settings. Due to their multidisciplinary nature, they can also call upon extra services such as the local police to provide additional support.

Community mental health centers and local government agencies often have crisis intervention teams that provide support to the community when there is a mental health crisis. These teams are also helpful when there are manmade or natural disasters. When situations are not as urgent, they can provide resources to individuals that need support.

The role of nurses in dealing with a crisis

According to Registered Nursing, the first step is to identify the client in crisis, assessing them by collecting both primary and secondary data, as well as objective and subjective data about the patient. For example, some of the nursing diagnoses that may be appropriate for a client who is at risk of self-harm or suicide, may include assessing risks related to an unresolved crisis, depression, lack of resources and local of social support systems, or related to a previous trauma such as neglect or abuse.

Diagnoses that may be relevant for a client who is at risk of causing harm to others include assessing how the crisis is connected to a substance related or psychiatric mental health disorder, connected to poor impulse control, related to an unresolved past crisis, or due to a history of childhood abuse or neglect.

Once the initial assessment is complete and the patient’s safety is maintained, emotional and physical interventions are used to resolve the crisis. The nurse will begin by establishing trust then allowing the patient to ventilate their feelings in the therapeutic patient-nurse relationship. Other interventions may include:

• The development and enhancement of the patient’s coping mechanisms.
• The provision of positive reinforcements for appropriate behaviors.
• The engagement of the client’s family members and other parties in the care plan within an environment that is supportive of the patient and their choices.

Ongoing follow up care is necessary for clients who are recovering from a crisis, both to prevent a future crisis and to return them to their normal level of functioning. For clients adversely affected by self-harm, for example, goals may include employing coping strategies to deal with stressors, seeking help when they feel an urge to self-harm, and utilizing appropriate methods to express their anxiety and anger.

Attaining the right qualifications and skills

The importance of PMHNPs and their role within the community is crucial. To become a psychiatric mental health nurse practitioner to help those must vulnerable in society, it is vital to get the best qualifications and acquire the right skillset. The online MSN-PMHNP at Rockhurst University is available both on a full-time and part-time basis and has clinical placements built into the cost of the program. For healthcare professionals looking to break into the PMHNP role, the course covers essential topics such as advanced practice nursing and evidence-informed quality improvement.

The demand for dedicated practitioners is on the rise, and students who put in the work will not only be assured a successful career, but also a rewarding one.