Influencing public policy
DNP student advocates for mental health policy
(October 30, 2020) Lisa Anderson learned through her Doctor of Nursing Practice (DNP) studies at Cizik School of Nursing at UTHealth that sometimes finding the best solution for patients means walking out the clinic doors and up the capitol steps.
Anderson, a psychiatric/mental health nurse practitioner (NP) in San Antonio, received this year’s Texas Nurse Practitioners Policy Fellowship. She will use the opportunity to develop a policy brief to make a compelling case to state legislators about the importance of expanding NPs’ prescription-writing authority to Schedule II drugs. These controlled substances include a class of medications that are used to manage pain and other serious conditions, and most importantly to Anderson’s practice, stimulants used to treat attention deficit hyperactivity disorder (ADHD).
“My niche is ADHD,” said Anderson, MSN, RN, who expects to earn her DNP in the spring. “I love that population, and my number one barrier to adequately treating ADHD patients is the inability to prescribe stimulants.”
Anderson gained important policy experience this year as COVID-19 forced students and faculty to get creative in fulfilling required clinical hours.
Students at the DNP level usually come to the program with plenty of direct patient experience, explained Assistant Professor Kathleen Siders, DNP, APRN, FNP, coordinator for the DNP Advanced Practice Track. As an alternative, five students opted to assist the efforts by Professor Laura J. Benjamins, MD, and the Memorial Hermann Health System to address human trafficking. Benjamins, MD, MPH, is director of the MD/MPH dual degree program at McGovern Medical School.
Houston holds the dubious distinction of being the top city in the nation for human trafficking, with Texas in second place among states. The DNP students took on various aspects of the issue. They developed a resource handbook, an educational presentation for health care professionals, and a poster with a hotline number and QR code to be hung in public places such as bathroom stalls and hotel rooms.
“The victims will end up in emergency departments and clinics for health care,” Siders explained. “They are very tightly controlled and groomed to the point that they don’t always even recognize what’s happening to themselves.”
Anderson lives and works in San Antonio and selected Cizik School of Nursing’s DNP program in part because of its hybrid online/on-campus approach. Since she doesn’t spend as much time in Houston as the other students, she decided to assess needs related to human trafficking along the I-10 corridor from El Paso to San Antonio. The resulting policy brief advocates for age-appropriate curriculum for high-school students and mandatory postings in hotels and motels, like the notice her classmates designed.
“Parents think, ‘That’s not a problem. That’s not going on in my school or in my neighborhood,’” Anderson said. “But the fact is that it is happening everywhere, and it’s something that nobody wants to talk about.”
Texas Nurse Practitioners (TNP) advocates for NPs across the state, and Anderson impressed its fellowship selection committee not only with her previous policy work but with her psychiatric/mental health specialization.
“I think the psychiatric NP role is not as well known by the public,” said Erin Cusack, the association’s director of government affairs. “I think this is a great opportunity to educate policymakers about that role and the critical piece that it plays in meeting Texas’ mental health challenges and shortages.”
TNP began offering the policy fellowship last year, and Anderson was chosen as the second recipient among more than 40 applicants from around the state. She will have the advantage of serving the six-month fellowship while the Texas Legislature is in session this spring. She will learn about the policymaking process, participate in coalition meetings, and – COVID-19 permitting – attend some high-level meetings and hearings in Austin.
Public policy is an important part of the DNP curriculum, and to make progress on structural and systemic health care challenges, nurses must understand the larger issues at play, Cusack said.
“The more we can educate NPs on the broader system, the bigger impact they can have not only on their profession but on their patients,” she stressed.