How nurse practitioners can make a difference in correctional facilities

In the US, given both the record number of people seeking treatment for mental health issues and the highest incarceration rates in the Western world, it is no surprise there is constant demand for skilled mental health professionals in correctional facilities. Nurse practitioners (NPs), in particular, are highly sought-after, especially given the shortage of qualified psychiatrists and physicians in many institutions. But what kind of role do they typically play, and what kind of career path is typical of an NP who wants to work in this field?

In this article, we examine the typical tasks and duties of psychiatric mental health nurse practitioners (PMHNPs) who work in correctional facilities and the ways in which they can help provide vital support for the prison population. In addition, we also take a look at the kind of preparation needed to become an expert PMHNP, including higher education courses, workplace experience, and further opportunities for learning.

The demand for PMHNPs

Psychiatric support is crucial within correctional facilities, particularly given that a significant proportion of inmates suffer from both mental health issues and addiction disorders, often concurrently. There is also a general shortage of health professionals seeking employment in these kinds of areas, which means the demand for qualified individuals is extremely high. In addition to physicians and registered nurses (RNs), nurse practitioners often also play a vital supporting role for inmates.

Although they often work in conjunction with a physician, in most states in the US, psychiatric-mental health nurse practitioners are able to perform comprehensive examinations, make diagnoses, draw up treatment plans, and prescribe medication. They can operate in a range of different correctional facilities, from youth offender institutes and centers for people on parole (halfway houses), to maximum security prisons. They may even work with inmates on death row. So, how are PMHNPs able to provide assistance?

Providing counseling and evaluations

One of the main duties of a PMHNP is to provide counseling to inmates. Generally speaking, inmates will be offered the opportunity to speak to a psychiatrist, counselor, or PMHNP to discuss any issues or concerns they may have. Though the counseling duties are similar to any other mental health position, a certain level of expertise is required to deal with specific psychological, safety, and legal issues related to people who have committed criminal offenses.

PMHNPs may also be asked to complete evaluations of prisoners. This might be in relation to a parole hearing, a court case, or as part of general evaluations required by the correctional facility in question. Often, this kind of evaluation can have a significant impact on the life of the prisoner, and must therefore be extremely carefully considered and carried out with the highest degree of professional expertise.

Crisis management and other duties

In addition, PMHNPs may also be required to assist in crisis situations, where an inmate experiences an acute mental health situation, such as severe depression, suicidal thoughts, drug withdrawal, or psychosis. In each case, the nurse practitioner may be required to provide rapid diagnosis, present and administer treatment options, or even be required to help subdue the patient. Additional duties for nurse practitioners working in correctional facilities may include providing general healthcare for prisoners, prescribing, dispensing, and administering medication, and consulting with physicians over treatment plans and further options for referral.

In each of the above examples, serious preparation is required. This is true for all kinds of mental health professions, of course, but is particularly vital for people working in correctional facilities, who are tasked with helping people who not only have an above-average tendency toward violent or antisocial behavior but who also typically come from more socioeconomically disadvantaged backgrounds. And, as we mentioned above, they often suffer from severe psychological issues and/or substance abuse disorders. So, how can prospective NPs who are already qualified as registered nurses prepare for this kind of challenging position?

The best preparation

Usually, the first step is to complete a postgraduate course in the field of mental health. Probably the most comprehensive mode of preparation is to complete a Doctor of Nursing Practice – Psychiatric Mental Health Nurse Practitioner program, otherwise known as a DNP-PMHNP, which can be completed online or in person. A DNP-PMHNP arguably offers the best pathway for registered nurses who would like to qualify as nurse practitioners involved in mental health. With an online DNP-PMHNP from an accredited institution such as Baylor University, graduates will emerge with a detailed understanding of fields such as psychiatric mental health NP management; theoretical, conceptual, and clinical models of mental healthcare; and complex psychiatric management. Students also complete at least one clinical placement, something that can provide them with valuable insight and experience regarding the duties and tasks of a nurse practitioner in the field of mental health.

Though graduates should then be able to obtain a position at a correctional facility, naturally, all mental health nurse practitioners will continue to build their level of knowledge and experience throughout their careers. Outside of work itself, many PMHNPs also find peer-to-peer conversations, mentoring assistance, and training courses to be valuable learning experiences. In addition, lifelong learning through private reading, attending conferences, or other forms of exploration is also essential.

A huge challenge

Overall, psychiatric-mental health nurse practitioners employed in correctional facilities can be called upon to perform a wide range of duties, from offering counseling, emotional support, and general medical care to inmates to helping to manage crisis situations and performing mental health evaluations of the prison population.

There is no question that this is a hugely challenging position that requires not only determination, resilience, and even bravery, but also a high degree of preparation and detailed knowledge of a range of different areas. At the same time, professionals who work in this area often enjoy the demanding nature of the job, particularly as they have the opportunity to help a section of the population that is often dismissed or neglected, and where genuine assistance is not only much appreciated but also sorely needed.