APA , Nursing

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Planning this change project has opened my eyes to several things regarding my chosen topic. One of the things that surprised me is that the view of behavioral health treatment in other developed nations tends to mirror that of the U.S.-as Dalton-Locke et al pointed out in their study, inpatient psychiatric care is seen as unpopular and expensive (Dalton-Locke et al, 2022) across the board; I have to admit I was somewhat naive regarding this, and expected other countries, especially European nations with socialized medicine, to have a different, perhaps softer view on behavioral health treatment and patients seeking psychiatric care. I learned that on average the compliance rate for psychiatric medications is less than 50% and that compliance with follow-up outpatient care after an ED visit with a referral is even lower, at roughly 37%, regardless of the patient’s insurance or social medicine status (Walker et al., 2021). On a positive note, I learned that proactive follow-up by the referring organization can double the rate of patient referral follow-up, regardless of the size of the community or organization in question (Maremmani et al., 2022). This tells me that a designated role for providing proactive follow-up for behavioral health patients discharged with outpatient referrals is indeed crucial in helping those patients actually receive the help that they came to the emergency department seeking…

I have learned that we all do indeed face the same issues in providing quality care to our patients, regardless of where we practice nursing. I have actually decided to take on a new role in my organization in which I can help develop a role of this nature for our community. Prior to going through this program, and this project, I really did not know that my interests in emergency nursing would turn to focus on this particular population, and I am surprised at this, but part of the point of advancing your education is to gain greater self awareness. This program has been challenging, for many of the same reasons that I am guessing it has been challenging for most of my colleagues-increased demands and fewer nurses working together to push us harder, changing societal demands on the healthcare system in uncertain times, and evolving family/work/school balance issues for us as working professionals. It has been challenging, yes, but worth it. Good luck to all of you, and congratulations!


Dalton-Locke, C., Johnson, S., Harju-Seppänen, J., Lyons, N., Sheridan Rains, L., Stuart, R., Campbell, A., Clark, J., Clifford, A., Courtney, L., Dare, C., Kelly, K., Lynch, C., McCrone, P., Nairi, S., Newbigging, K., Nyikavaranda, P., Osborn, D., Persaud, K., & Stefan, M. (2021). Emerging models and trends in mental health crisis care in England: a national investigation of crisis care systemsBMC Health Services Research, 21(1), 1–12

Maremmani, A. G. I., Aglietti, M., Intaschi, G., & Bacciardi, S. (2022). Substance Use/Dependence in Psychiatric Emergency Setting Leading to Hospitalization: Predictors of Continuity of Care. International Journal of Environmental Research and Public Health, 19(2).

Walker, E. R., Fukuda, J., McMonigle, M., Nguyen, J., & Druss, B. G. (2021). A Qualitative Study of Barriers and Facilitators to Transitions From the Emergency Department to Outpatient Mental Health Care. Psychiatric Services, 72(11), 1311–1319. 

Walker, E. R., Fukuda, J., McMonigle, M., Nguyen, J., & Druss, B. G. (2021). A Qualitative Study of Barriers and Facilitators to Transitions From the Emergency Department to Outpatient Mental Health Care. Psychiatric Services, 72(11), 1311–1319. 

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