Journal of the American Psychiatric Nurses Association

This discussion paper explores the intersection of cultural factors and Black women’s experiences with chronic pain and suicidality. It aims to inform the continued development of tailored pain interventions and culturally responsive psychiatric nursing care.

Using existing literature, we identified six domains of cultural factors potentially influencing Black women’s pain experiences and suicide risk. The six domains were conceptually organized into two categories: culturally specific risk factors and culturally specific protective factors.

In terms of risk factors, the endorsement of the superwoman schema, intersectionality, and history of medical mistrust were identified. For protective factors, spirituality, culture, and reliance on social support were identified.

Drawing on the disciplines of African American Studies, Black Psychology, and Clinical Health Psychology, we provide clear recommendations for the development of culturally tailored interventions that can uniquely address Black women’s pain and suicide-related experiences while receiving psychiatric nursing care.

Enhancing adolescents’ willingness to seek professional psychological help is essential for improving mental health service utilization. Previous research suggests that depression literacy, stigma, depressive symptoms, and family factors—particularly caregivers’ perspectives—play important roles in shaping help-seeking attitudes. However, few studies have simultaneously examined these factors from both adolescents’ and caregivers’ viewpoints.

This study aimed to examine how depression literacy, stigma, depressive symptoms, and caregivers’ attitudes toward professional psychological help influence adolescents’ help-seeking attitudes, while controlling for relevant sociodemographic variables.

A cross-sectional study was conducted with adolescents and their primary caregivers recruited from public and private high schools in northern Taiwan. Participants completed questionnaires on demographics, depression literacy, stigma, depressive symptoms, and attitudes toward professional psychological help. Hierarchical regression analyses were performed, adjusting for key sociodemographic variables.

After controlling for caregivers’ religious beliefs, marital status, and education, as well as adolescents’ prior use of mental health services, academic satisfaction, and interpersonal difficulties, the strongest predictors of adolescents’ help-seeking attitudes were their depressive symptoms, personal stigma, and caregivers’ attitudes toward professional psychological help.

Adolescents’ help-seeking attitudes are shaped by both their own psychological experiences and their caregivers’ perspectives. Targeted interventions should prioritize stigma reduction, symptom recognition and management, and caregiver engagement to foster timely and effective help-seeking among adolescents.

Tobacco use increases morbidity and mortality among its users. The rate of tobacco use is declining in the general adult population yet is two to three times higher for those experiencing mental health disorders, specifically those with serious mental illness (SMI). Psychiatric mental health nurse practitioners (PMHNPs) are well-positioned to treat tobacco use in patients with SMI, yet tobacco training during nursing education, both in amount of time spent and content delivered, is not well understood and can leave PMHNPs ill-prepared to intervene.

A cross-sectional descriptive survey design was used to assess PMHNP programs nationwide to determine where tobacco treatment is located in the curriculum, the amount of time spent on tobacco treatment throughout the program, and program directors’ general attitude and beliefs about the importance of tobacco treatment related to the scope of practice and impact.

Program directors or their representatives responded (N = 34) across all program types. Respondents reported either agreement or strong agreement with the importance of tobacco treatment in PMHNP programs. Most spent less than 1 hour or between 1 and 3 hours on tobacco treatment, primarily in psychiatric assessment and psychopharmacology courses. Most agreed or strongly agreed that this was within the scope of practice, yet agreement was less when asked about impact on outcomes.

PMHNP programs have an opportunity to improve perspectives on the impact psychiatric nurse practitioners can have on tobacco treatment outcomes and integrate curricular strategies to robustly integrate tobacco competencies.

First-line treatment for major depressive disorders (MDDs) is often antidepressants. These medications are commonly trialed and discontinued due to side effects. Pharmacogenetic testing (PGx) allows psychiatric-mental health nurse practitioners to assess patient drug metabolism with the goal of reducing medication trials.

The purpose of this quality improvement project was to examine the impact of PGx on remission rates and clinical outcomes for MDD compared with the standard of care (SOC) in psychiatry.

Outcomes were measured using a problem status system within the site’s electronic health record based on patient self-reports and clinician interpretation. No validated scale was used which represents a methodological limitation to the study.

The SOC group had higher remission rates of MDD (38%) compared with PGx (9.8%). The PGx group had a higher occurrence of moderate (24.4%) and severe (17.1%) diagnosis of MDD compared with the SOC group (16% and 8%), respectively. The SOC group had a stable problem status (70%) compared with the PGx group (43.9%). The improving status of PGx was 12.2% compared with SOC at 8%, and the worsening problem status of standard care was 10% compared with PGx at 4.9%. Age did not significantly differ by problem status in the PGx group, F_{(3, 37)} = 0.592, p = .624.

PGx may offer clinical value for patients with severe depression. Results should be interpreted cautiously, and further studies using validated scales and controlled designs are needed.