Mental Health Issues and Substance Use in the United States: Pulling the Power Levers.

BACKGROUND: Promising treatment avenues have been developed and studied that align well with the skills of psychiatric-mental health (PMH) nurses. The treatments are relationship-driven, nimble and accessible, and recovery-guided. They emphasize a whole-person approach with care delivered by a team of experts working in a contextually coordinated way.

AIMS: To describe the challenges facing the United States with regard to mental illness and substance use disorders and the ways in which PMH nurses can use their skills to mitigate these challenges.

METHOD: Published research and government reports were reviewed to obtain current mental health and substance use data.

RESULTS: The number of people not being treated for mental illnesses-particularly serious mental illness, major depressive episode, and suicidal thoughts-has not improved since 2009. Although inroads have been made in reducing the rate of smoking in the United States, we are facing an opioid crisis. There are limited data on marijuana use, but it is apparent that many Americans use cannabis routinely. According to the Substance Abuse and Mental Health Administration, approximately 44.7 million people need mental health treatment and 20.1 million Americans need substance use treatment, but only 10% to 30% receive it.

CONCLUSIONS: PMH nurses must take a leading role in retooling the therapeutic relationship and partnering with clients, families, and caregivers to improve the quality of life and well-being of those dealing with mental illness and substance use disorders. To accomplish this essential task, the PMH nursing workforce must be robust and distributed throughout the United States.