The pandemic has caused a huge impact in patients in accessing mental health treatment and substance use disorder treatment. When the pandemic started, the majority of in-person visits were suspended due to the fear of spread of the virus. There was no clear instruction or confirmed date when service can be resumed. The confusion chao is stressing out the patients, health care providers and the medical system. As alway, mental health care is placed at a non-urgent place when compared to acute medical care. These populations were strained with no answers on when and where the treatment will be available. The depressed have become more depressed and the anxious is crawling out of their skins. With the advocacy and leadership of PMHNPs, State mental health authorities play a critical role in creating and administering policies regarding COVID-19 in their state hospitals and community mental health clinics(Druss, 2020). According to Molfenter et al. (2021) , Clinicians including psychiatrists and PMHNP working with the Public Health Emergency of International Concern (PHEIC) expanded use of telehealth to deliver services safely while maintaining access, efficacy, and engagement. However, despite the promotion of telehealth and telemedicine, patients and PMHNP continue struggling in between.
The stigma of masks use—Patients with mental health illness with paranoid features are not comfortable with masks as they can see the clinician’s face(Moreno et al., 2020). With marks covering the faces, it is hard to build rapports and assess emotional changes.In addition, patients would opt out of appointments to avoid contracting the covid virus. When the state relaxed the in person visit requirement, patients can be evaluated without mask over video.
The 5 feet distance is too far.—One of the patients describing her personal AA meeting before converting to zoom. People were spreaded too far and had to yell out their feelings. What kills her the most is everyone is muffled by the mask and everyone has to yell a couple times to just repeat themselves. It was exhausting! The distance brings coldness to those who were already lonely and isolated. In addition, the 5 feet distance also limits the capacity of the clinic and availability(Carrión et al., 2020). Zoom meetings have been able to address the need of connecting with each other. However, the needs of physical closure are not able to be fulfilled.
The struggle of Telehealth—The care providers are struggling to assess the patients over glitching video or over the phone. Body language is an important door to reveal the patient’s mood and behavior. Meanwhile, patients are struggling to connect themselves into the tele appointment with either technology skills, stability of the internet and affordability of electronic devices(Weiss et al., 2021). The expansion of PMHNP independent practice enables the creativity of assessing the patients with user friendly tools. In addition, PMHNPs not only need to update themselves in technology but also teach the patients to utilize it.
The struggle of medication—There are many psychotropic medications that need periodic lab check for therapeutic level and potential side effects. With additional closures, online appointment booking and limited availability, it is difficult to get labs completed for drug screening and routing check out. PMHNPs ensure quality in care and being creative in medication regime switching to accommodate the need and preference of the patients.
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