‘If the community has a problem with mental health, the community has a huge problem’
On a foggy September morning, Gail Godwin sat at a table in the common room at Daybreak, chatting with a visitor. Godwin is training to be a psychiatric mental health nurse practitioner, and she came to the resource center that day to offer behavioral health assessments for anyone in need of mental health care.
She wasn’t just there to prescribe medication or offer a referral, though. Sometimes, she said, people just want to talk.
“When you come here, and you talk with the people that visit here, you get a appreciation for what they’re going through and how you might be able to help,” Godwin said. “I think every person will be different, but it’s just nice to be able to come and to help and to see what we can do.”
Daybreak, a resource center for the homeless, doesn’t have a formal mental health care program. It lacks the resources to hire a full-time mental health practitioner. But once a month, nursing students volunteer at the center, filling the need for mental health care as best they can.
By the time Godwin earns her psychiatric nursing certification in May, she’ll have spent 500 hours working with mentally ill patients at Daybreak and other mental health care facilities throughout Georgia. Godwin is an assistant professor of nursing and has been a nurse since 1983, but now she’s training to specialize in psychiatric care through a new online master’s program at the Georgia College School of Nursing in Milledgeville.
The Psychiatric Mental Health Advanced Practice Registered Nurse (PMH-APRN) program, launched in the summer of 2016, teaches nurses how to cater specifically to the needs of patients with mental disorders through six semesters of full-time or nine semesters of part-time study.
Associate professor and co-director of the program Carol Dean Baker said the nursing school decided to develop the academic program a few years ago to meet the growing demand for mental health care providers in the state. Baker said the need for psychiatric nurse practitioners is so great that she could work every day of the year if she wanted.
“We started this program because there were so few advanced practice psychiatric nurses, and we knew there was a need for this in the state of Georgia,” Baker said.
Researchers expect the U.S. to face a shortage of 193,000 nurses by 2020, according to a 2015 Georgetown University study. Of the 50 states and the District of Columbia, Georgia had the second-lowest concentration of nursing professionals per 1,000 residents, the report found.
The shortage is especially pronounced among psychiatric nurses, Baker said. Nearly every county in the state faces a dearth of mental health care providers, and in Georgia, 205 more mental health care professionals would need to start practicing in the state to adequately meet the needs of its more than 10 million residents, the Kaiser Family Foundation reports. The shortage impacts each tier of the medical field, from psychiatrists to school psychologists to nurse practitioners.
A shortage of psychiatric mental health nurses means not only that there aren’t enough nurse practitioners to provide care for those in need, but there also aren’t enough professors qualified to train more nursing students to enter the field. Godwin said there was a big push for more psychiatric nurses in the 1960s and 1970s, but many of those practitioners have since retired, leaving a void in the sector.
“It’s hard to teach and produce nurses if you really don’t even have enough nurses as faculty to meet all the certifications to be able to teach psych nursing,” she said.
That’s part of the reason why Godwin decided to study for her psychiatric nursing certification. She hopes to bring what she’s learned to her undergraduates students at Georgia College and encourage them to pursue mental health care as well.
“I guess the young nurses like to choose the glamorous places like ER and ICU and that sort of thing,” she said. “So, I’m kind of am think(ing) of ways that will make psych nursing more — or mental health nursing more — something that undergraduates would want to do.”
Godwin said she’s having some trouble fulfilling her 500-hour preceptorship requirements. There are so few psychiatric care providers in Middle Georgia that she’s had to seek out opportunities in more populous parts of the state.
“This semester I’m traveling to Atlanta to get my clinical hours in. So that’s difficult,” she said. “But I’m just going to do what I need to do to get the certification.”
Bridging the gap
Baker said Georgia College is committed to training more nurses like Godwin to earn their psychiatric nurse practitioner’s certification and use it to fill the gap in mental health care that has plagued the state for years. All of the nurses who have graduated from the program or are pursuing their certification now worked in the state beforehand, and Baker thinks they’ll stay.
“It is an online program, and we could accept someone from out of the state. However, all the students have been in Georgia, and they are staying in the state of Georgia,” she said, adding that all of the students who graduated in the first cohort in May immediately were hired at psychiatric offices and facilities within the state.
“Everyone’s telling us, just keep sending them,” Baker said. “We just don’t have enough to cover — to cover the weekends, to cover the call schedules.”
Nursing students at Georgia College also can apply for a grant that will cover their tuition, books and fees if they pledge to work in an underserved community in Georgia for at least two years.
“If they plan to stay in the state of Georgia, pretty much every county in the state of Georgia is underserved,” Baker said.
Getting back on track
In Macon, Daybreak serves as a hub for locals suffering with mental health disorders who have struggled to get the treatment they need. There are only 17 psychiatrists to care for Bibb County’s population of over 150,000, and the shortage of mental health care providers takes a particularly hard toll on the homeless population and those without insurance.
Wesley Merritt is one of the regular visitors at Daybreak who suffers from mental illness. The 25-year-old was first diagnosed with attention deficit hyperactivity disorder, known as ADHD, when he was 8 years old and has struggled with bipolar disorder and anxiety since he was 21. Merritt has been homeless for about three months, and he said his mental health issues have impacted his relationship with his family and his ability to hold down a job or lead a normal life.
“My family, they disowned me. And they will not help me,” Merritt said. “I’ve tried to ask them to help me, but they won’t.”
Resources like Daybreak and River Edge Behavioral Health have provided Merritt with the guidance he needs to get his life back on track. Merritt said Daybreak staff were helping him to get a copy of his birth certificate, so he could start applying to jobs. And later that day, Merritt had a counseling appointment at River Edge, where he said a case management team was working with him to secure an apartment in Milledgeville.
Without mental health care, Merritt said he’d be a mess. Now, he’s focused on finding some stability.
“I’m tired of being out here in this hot heat. I mean, I couldn’t stand it. I’ve been out here for a while,” he said. “But I’m just ready to get my life together.”
Samantha Max is a Report for America corps member and reports for The Telegraph with support from the News/CoLab at Arizona State University. Follow her on Facebook at facebook.com/samantha.max.9 and on Twitter @samanthaellimax. Learn more about Report for America at www.reportforamerica.org.