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27.1 Effects of the COVID-19 Pandemic

The COVID-19 pandemic has had a profound and lasting effect on mental health and care delivery. Many people reported increased anxiety and depression during the pandemic, but had problems accessing services due to lockdowns and other issues causing problems with access to care. Nurses became crucial in assisting clients with accessing care by providing education and services to connect them with providers, including therapists, nurse practitioners, and physicians. Much of mental health care shifted to the virtual environment, and nurses helped connect clients to virtual care. Nurses also found themselves facing their own mental health issues exacerbated by the pandemic and client care. These stressors require nurses to pay special attention to their own mental health, emphasizing self-care and fighting the results of burnout and compassion fatigue.

27.2 Human and Sex Trafficking

Human trafficking is the illegal trade of vulnerable people, typically for forced labor or commercial sexual exploitation, using coercion, fraud, or force. It includes child soldiering, debt bondage, labor trafficking, and sex trafficking. There are numerous resources for prevention and awareness, both government and nonprofit, of which nurses should be aware. Nurses have a responsibility to adequately assess clients and be aware of potential signs of human trafficking, and to report suspected cases of human trafficking to the appropriate authorities.

27.3 PTSD and Veteran Trauma

Post-traumatic stress disorder is a mental health condition that can develop after a person experiences or witnesses a traumatic event. These events can include combat exposure, natural disasters, accidents, physical or sexual assault, and other life-threatening incidents. PTSD can be helped by a combination of psychotherapy, medication, and complementary therapies. When working with clients with PTSD, nurses must gather a thorough history, including a history of symptoms, provide education on therapies, evaluate for treatment responses, and tailor the treatment plan accordingly. Interventions include education, wellness coaching, stress management, and monitoring client safety. Trauma-informed care is especially important to the therapeutic relationship between the nurse and the client with PTSD. It creates a relationship of trust with an emphasis on safety, collaboration, choice, empowerment, and avoiding revictimization.

27.4 Mental Health in the LGBTQIA+ Community

Sexual orientation refers to an individual’s emotional, romantic, and sexual attraction to others. Gender identity refers to an individual’s deeply held sense of their gender, which may or may not align with the sex assigned to them at birth. Mental health concerns within LGBTQIA+ communities often include higher rates of depression, anxiety, and suicidal ideation due to the discrimination, stigma, and minority stress they may experience. Additionally, issues related to coming out, family acceptance, and societal pressures can contribute to these mental health disparities. Nurses play a crucial role in the mental health care of LGBTQIA+ clients by providing culturally competent, nonjudgmental, and inclusive support, addressing the unique mental health challenges they may face due to discrimination or identity-related stressors, and connecting them with appropriate resources and therapy that affirms their gender identity and sexual orientation.

27.5 Mental Health in the Homeless and Displaced Population

Unhoused and displaced persons often experience a range of complex mental health needs, including depression, anxiety, post-traumatic stress disorder (PTSD), and substance use disorders, stemming from the trauma of homelessness, social isolation, and exposure to violence or harsh living conditions. Addressing these mental health needs is essential for facilitating their stability, reintegration into society, and access to long-term housing solutions. Nurses can provide invaluable assistance to unhoused clients with mental health issues by offering compassionate care, mental health assessments, and connecting them to appropriate resources, including shelters, mental health services, and substance misuse treatment. Advocating for supportive housing initiatives and engaging in street nursing programs allows nurses to reach vulnerable populations directly.

27.6 Objectives for the Future

Objectives for the future of the nursing profession can be defined by nurses themselves. There are two major report/studies that have been issued to address the future of the nursing profession: The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity from the National Academy of Medicine (2021) and the American Academy of Nursing Consensus Recommendations to advance system level change for nurse well-being (2023).

The first emphasizes the importance of nurses in addressing health disparities and improving health-care access for underserved populations. The second recommends actions by key organizations to drive systemic changes in workplace safety, increase professional mobility, and advocate for policies that improve access to health-care resources. Inclusive strategies for nursing education involve creating culturally sensitive curricula and fostering diversity, equity, and inclusion. Creating a personal future career or service plan as a psychiatric-mental health nurse is essential for any professional in the field. Such a plan involves setting clear goals, such as further education or specialization, and defining the populations or mental health issues they are passionate about serving.


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