discussion reply

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional strategies your colleague could implement to bring about needed change in their community.use 3 reference each.

 1.    I am currently employed at a freestanding psychiatric hospital located on the south shore of Massachusetts.  We provide inpatient psychiatric services to adolescents, adults, and geriatric patients who suffer from mental illness.  Since the Covid-19 pandemic, we have seen an increase in the community’s need for mental health services.  A recent study conducted by Blue Cross Blue Shield of Massachusetts found that the need for services has increased exponentially due to the effects of the pandemic.  Currently,  “one in three Massachusetts residents over the age of 19 reported needing behavioral health care for themselves or a close relative; however, 26% percent said they were not able to get it” (Becker, 2022).  As an organization, we need to find a way to increase access to mental health services in our community.

How the Doctor of Nursing Practice (DNP) Prepared Nurse Can Increase Access to Mental Health Services

 As a DNP-prepared nurse, it is my goal to serve as an agent of positive change at the local level to the patients who are under my organization’s care as well as the community at large.  In order to reduce accessibility issues as a DNP-prepared nurse, it will be critical for me to consider the American Association of Colleges of Nursing essential number 8 and “conceptualize new care delivery models that are based in contemporary nursing science and that are feasible within current organizational, political, cultural, and economic perspectives” (American Association of Colleges of Nursing, 2006).  One thought I have for my organization would be to integrate outpatient services such as partial hospitalization programs so that we can increase accessibility to mental health services in the community.  One significant challenge, both nationally and for my organization, is the shortage of nursing staff.  In order to increase the services we provide, it will be imperative for my organization to build partnerships with local agencies.  Wegner et al. (2000) determined that “groups of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise in the area by interacting on an ongoing basis” will have more success.  In order to recruit nurses to my organization, I aim to partner with local universities and colleges to provide a site for their psychiatric clinical rotations.  If student nurses have a positive clinical experience at my organization, they will be more likely to consider employment with us in the future which will, in turn, allow us to expand the services we provide and increase accessibility to mental health care.


American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf

Becker, D. (2022). The pandemic has led to a surge in mental health need in Mass., survey finds. https://www.wbur.org/news/2022/02/08/massachusetts-pandemic-mental-healthLinks to an external site.

Wenger, E., McDermott, R., & Snyder, W. M. (2000). A guide to managing knowledge: Cultivating communities of practice. Harvard Business School.

2.There is a very large homeless population within my community, and with that unfortunately comes high rate of substance use disorders. The most recent census of this six hundred plus square mile county was approximately 170,000 individuals, ten percent of whom were living below the poverty level (United States Department of Commerce, 2023). Despite the known concerns for homelessness in Monroe County, there remains to be only three small shelters that are seasonally available to those in need, open between the hours of 7:00pm and 5:00am EST. As a very rural area, the lack of available resources leaves individuals living in homeless communities in wooded areas. Multiple individuals have been found to be passed away due to exposure in the winter months. While community members are also aware of the concern for substance use disorders, there have been very direct and disheartening efforts preventing the opening of treatment centers in the area. Signs have been posted in front yards with slogans such as ‘no drug addicts in our back yard.’

            Addressing socioeconomic determinants of health and the wellness of this community is one of many roles of the Doctor of Nursing Practice (DNP) (American Association of Colleges of Nursing, 2006). These two community health issues are very much related. The ongoing gap in access to substance use disorder treatment perpetuates the cycle of substance-related crime, associated health concerns treated in the local emergency department, and inability to treat the often-underlying mental health concerns leading to self-medication (Mitchell et al., 2023). As a social change agent, the DNP can not only research evidence-based interventions to provide community-based care to individuals in need but also educate community members on why this is important, and how their efforts to prevent this from happening harms not only those in need but the populace as a whole (American Association of Colleges of Nursing, 2006).

            The DNP acts as an expert support when advocating for health policy in local, state, or federal government. Meeting with members of local government to provide evidence-based testimony regarding the detrimental impact the blocking of substance use treatment facilities has on the community is one step in creating increased access to care. Individuals in need of substance use treatment often experience shame and ambivalence to seek the support they so greatly need; it is essential to educate lawmakers about how the additional stigma placed upon individuals by the formal supports who should be enabling their ability to access treatment severely impedes community wellness (Stewart et al., 2023).

            Engaging directly with the homeless shelters currently available to review current barriers to availability is the first step to increasing accessibility. Two of the three shelters are run by volunteer organizations, and the third is a locally funded organization that is a part of the community health department. As a DNP, gathering data and evidence to support the implementation of an intervention is essential to buy in from any stakeholder and can be achieved by evaluating the number of individuals who seek shelter at these resources, and those who are able to stay the night (McEwen & Wills, 2019). Presenting this data to local officials to along with evidence-based data regarding the benefits of this community initiative, such as reduction in deaths associated with exposure and the current use of law enforcement to relocate homeless individuals from areas deemed inappropriate for their inhabitation, can support approval for shelter expansions.


American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf

McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer.  

Mitchell, E., Waring, T., Ahern, E., O’Donovan, D., O’Reilly, D., & Bradley, D. T. (2023). Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review. BMC Public Health23(1), 1610. https://doi.org/10.1186/s12889-023-16503-z

Stewart, R. E., Cardamone, N. C., Schachter, A., Becker, C., McKay, J. R., & Becker-Haimes, E. M. (2023). A systematic review of brief, freely accessible, and valid self-report measures for substance use disorders and treatment. Drug and Alcohol Dependence243, 1–11. https://doi.org/10.1016/j.drugalcdep.2022.109729

United States Department of Commerce. (2023). QuickFacts: Monroe County Pennsylvania. https://www.census.gov/quickfacts/fact/table/monroecountypennsylvania/PST045222