BACKGROUND: The mental health needs of children and adolescents are not being adequately addressed.
OBJECTIVES: To describe the roles of public health nurses in the care of children and adolescents with mental disabilities and to explore incentives and barriers to expansion of the role in the care of this population.
METHODS: Directors of nursing of public health agencies and executive directors of mental health agencies in Ohio responded to a mailed survey.
RESULTS: The majority of respondents reported that public health nurses currently work with youth with mental disabilities, primarily in the roles of referral and providing physical health care. Both groups of directors saw potential for increasing roles-provided public health nurses received education and consultation. Both groups reported that barriers to expanding public health nurses' roles were the organization and funding of mental and public health systems.
CONCLUSION: Although better utilization of public health nurses could improve children's health care and make more efficient use of scarce specialty mental health resources, financial and organizational barriers present significant challenges to collaboration.
Get full access to this article
View all access options for this article.
References
1.
Achenbach, T.M., & Howell, C.T. (1993). Are American children's problems getting worse? A 13-year comparison. journal of the American Academy of Child and Adolescent Psychiatry, 32, 1145-1154.
2.
Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA). (1990). National plan for research on child and adolescent mental disorders (DHHS Publication No. ADM 90-1683). Washington, DC: U.S. Government Printing Office.
3.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
4.
Center for Mental Health Services (1997). Mental health providers in rural and isolated areas. (DHHS Publication No. SMA-98-3166). Washington, DC: U.S. Government Printing Office.
5.
Cohen, P., Cohen, J., Kasen, S., Velez, C., Hartmark, C., Johnson, J., Rojas, M., Brook, J., & Streuning, E. (1993). An epidemiological study of disorders in late childhood and adolescence: I. Age and gender specific prevalence. Journal of Child Psychology and Psychiatry, 34, 851-867.
6.
Collins, A., & Reinke, E. (1997). Use of a family caregiving model to articulate the role of the public health nurse in infant mental health promotion. Issues in Comprehensive Pediatric Nursing, 20, 207-216.
7.
Costello, E., Costello, A., Edelbrock, C., Burns, B., Dulcan, M., Brent, D., & Janiszewski, S. (1988). Psychiatric disorders in pediatric primary care. Archives of General Psychiatry, 45, 1107-1116.
8.
Dillman, D. A. (1978). Mail and telephone surveys: The total design method. New York: Wiley.
9.
Finke, L. (1994). Child psychiatric nursing: Moving into the 21st century. Nursing Clinics of North America, 29, 43-48.
10.
Friedman, R., Katz-Levy, J., Manderscheid, R., & Sondheimer, D. (1996). Prevalence of serious emotional disturbance in children and adolescents. In R.W. Manderscheid & M.A. Sonnenschein (Eds.), Mental health, United States, 1996 (DHHS Publications No. [SMA] 96-3098) (pp. 71-89). Rockville, MD: U.S. Government Printing Office.
11.
Friesed, B., & Koroloff, N. (1990). Family centered services: Implications for mental health administration and research. Journal of Mental Health Administration, 17, 13-25.
12.
Gortmaker, S., Walker, D., Weitzman, M., & Sobaol, A. (1990). Chronic conditions, socioeconomic risks, and behavioral problems in children and adolescents. Pediatrics, 85, 267-277.
13.
Health Resources and Services Administration. (1992). Mental health providers: Supply and distribution. Rural health professions facts. Washington, DC: Author.
14.
Kennedy, C., Polivka, B., & Chaudry, R. (1997). Public health nurses' role in the care of adults with mental disabilities. Psychiatric Services, 48, 514-517.
15.
Krauss, J. (1993). Health care reform: Essential mental health services. Washington, DC: American Nurses Association.
16.
Leaf, P., Alegria, M., Cohen, P., Goodman, S., Horwitz, S., Hoven, C., Narrow, W., Vaden-Kiernan, M., & Reiger, D. (1996). Mental health service use in the community and schools: Results from the four-community MECA study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 889-897.
17.
Lewinsohn, P., Hops, H., Roberts, R., Seeley, J., & Andrews, J. (1993). Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. Journal of Abnormal Psychology, 102, 133-144.
18.
Morrissey, J., Johnson, M., & Calloway, M. (1997). Evaluating performance and change in mental health systems serving children and youth: An interorganizational network approach. Journal of Mental Health Administration, 24 (1), 4-21.
19.
Office of Rural Health Policy and Office of Rural Mental Health Research. (1994). Mental health and rural America: 1980-1993 (NIH Publication No. 94-3500). Washington, DC: U.S. Government Printing Office.
20.
Polivka, B., Kennedy, C., & Chaudry, R. (1997). Collaboration between local public health and community mental health agencies. Research in Nursing & Health, 20, 153-160.
21.
Reinherz, H., Giaconia, R., Lefkowitz, E., Pakiz, B., & Frost, A. (1993). Prevalence of psychiatric disorders in a community population of older adolescents. Journal of American Academy of Child and Adolescent Psychiatry, 32, 369-377.
22.
Richters, J., & Martinez, P. (1993). The NIMH community violence project: I. Children as victims of and witnesses to violence. Psychiatry, 56, 7-21.
23.
Segal, E., Brzuzy, S., Hodge, D., Lynd, C., Mahon, C., McCreight, M., & Sias, P. (1991). The state interdepartmental cluster's system of care initiative program evaluation. Final report. Columbus, OH: Ohio Department of Human Services, Division of Family, Children and Adult Services.
24.
Stroul, B.A. (1990). Child and adolescent service system program technical assistance research meeting: Summary of Proceedings. Presented at the: CASSP Technical Assistance Center, Georgetown University Child Development Center, Washington, DC.
25.
U.S. Department of Commerce, Bureau of the Census. (1990). County and city data book. Washington, DC: U.S. Government Printing Office.
26.
Valente, S.M. (1989). Adolescent suicide: Assessment and intervention. Journal of Child and Adolescent Psychiatric Mental Health Nursing, 2(1), 34-39.
27.
Volkmar, F. (1996). Childhood and adolescent psychosis: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 843-851.
28.
Whitaker, A., Johnson, J., Shaffer, D., Rapport, J., Kalikow, K., Walsh, B., Davies, M., Braiman, S., & Dolinsky, A. (1990). Uncommon troubles in young people: Prevalence estimates of selected psychiatric disorders in a nonreferred adolescent population. Archives of General Psychiatry47, 487-496.
