Page 319 - Encyclopedia of Nursing Research

286 n MENTAL HEALTH SERVICES RESEARCH

are living with mental health conditions are most commonly managed in primary
(Camann, 2010). care and community-based settings.
M The second area of research opportunity
concerns evaluations of now rapidly evolv- Celia E. Wills
ing integrated health care roles for advanced Anna L.D. Villena
practice nursing, in which medical and men-
tal health skills are available in the same
geographic location and primary care pro-
vider (Delaney, 2009, 2010; National Panel for Mental health services
Psychiatric-Mental Health NP Competencies,
2003). Although integrated care models for research
management of physical and mental disor-
ders are not yet universally available, there is
a key role for advanced practice nurses who Mental health services research (MHSR)
effectively blend medical and mental health is a subset of health services research that
training and well positioned to manage the focuses mental disorders across the life span
holistic needs of the patients they see in pri- in diverse populations in terms of the organi-
mary care settings (Hogan & Shattell, 2007; zation and delivery of services, outcomes and
Manderscheid, Masi, Rossignol, & Masi, quality of care, clinical epidemiology, and
2007). This is an especially critical need for evidence-based practice dissemination and
populations in which there are complex co- implementation (National Institute of Mental
occurring physical and mental health dis- Health, 2010). The importance of MHSR to
orders that are associated with substantial inform improvements to public health ser-
morbidity, premature mortality, and dimin- vices has become increasing recognized in
ished quality of life (Weber, Cowan, Millikan, recent years, especially as mental disorders
& Niebuhr, 2009) and addresses the Institute are documented to be a leading and increas-
of Medicine recommendation to integrate ing cause of disability in the United States and
mental health and substance abuse care worldwide (U.S. Public Health Service Office
within primary care services (Committee of the Surgeon General, 1999; World Health
on Crossing the Quality Chasm: Adaptation Organization, 2008). MHSR generates new
to Mental Health and Addictive Disorders, knowledge directed to the transformation of
2006). There are some models of integrated mental health services to achieve high-qual-
nursing care for co-occurring disorders that ity, accessible, recovery-oriented care for all
have been developed and tested within the (The President’s New Freedom Commission
past decade. For example, Lyles et al. (2003) on Mental Health, 2003). In MHSR, the meth-
reported the results of an intervention that ods used to study general health services
used nurse practitioners trained to man- research are applied to examine a diverse
age the medical and mental health needs of range of topics such as reducing the morbid-
primary care patients with medically unex- ity and mortality of suicidality in at risk pop-
plained symptoms. McDevitt, Braun, Noyes, ulations, research on effective approaches to
Snyder, and Marion (2005) described the improving the dissemination and uptake of
evaluation of a nurse-managed integrated evidence-based practices, research on men-
primary and mental health care center for tal health care delivery in traditional and
persons with serious and persistent mental nontraditional service settings, economics
illness. These types of integrated roles need and financing of mental health services, and
additional research testing for various com- identification of innovations in mental health
binations of comorbid health conditions that service delivery models to address unmet