Allowing nurse practitioners to practice independently emerged as an issue of interest during a recent workshop regarding the diocese’s 2011-12 public-policy focus on improving access to mental health care, particularly for children and teens.
The nurse practitioner issue was raised during a Jan. 11 workshop discussing the petition, which parishioners throughout the diocese will be asked to sign during Public Policy Weekend Feb. 11-12, explained Ruth Putnam Marchetti, justice-and-peace coordinator for Catholic Charities in Livingston, Wayne and the Finger Lakes counties. The workshop, "In the Image of God: Access to Mental Health Care," was led by Marchetti and Bridget Hurley, chairwoman of the Public Policy Committee’s mental health care subcommittee. Other speakers were Deacon Brian McNulty, chaplain of the Rochester Psychiatric Center, and Bettina Davison and Lynda Avery Blake, advocates from Finger Lakes Parent Network. More than 60 people attended the event, which was held at St. Patrick Church in Victor, Marchetti said. A similar workshop was held at Catholic Charities in Elmira at the end of last month.
Nurse practitioners in New York state cannot practice unless they have a collaborative agreement with a physician, Marchetti said. Additionally, if said physician does not accept Medicaid, the nurse practitioner cannot either, she added.
"A nurse practitioner is more likely than a physician to set up practice in a rural, underserved area," Marchetti explained, noting that mental health care is so limited in the Rochester Diocese’s outlying areas that some counties do not even have a practicing psychiatrist. "And with all the restrictions, that’s harder to do."
That is why the diocesan Public Policy Committee included support of the Nurse Practitioner Modernization Act — which would remove those restrictions — in the petition that parishioners will be asked to sign, according to a report created by Hurley. Public Policy Committee members and Catholic Charities agencies staff will present the petition to Gov. Andrew Cuomo and state legislators this spring.
"The (committee) is very concerned about the widely acknowledged shortage of care providers for children with mental illnesses," Hurley wrote in the report. "Although nurse practitioners cannot provide everything that a psychiatrist does, they can diagnose, make referrals, and take care of many issues that arise in between psychiatric visits. An independent psychiatric NP would supplement, not replace, a psychiatrist’s care."
The diocesan Public Policy Committee’s 2011-12 agenda is focusing on the issue of mental health care — particularly for children — because of the disparity in serving the needs of people throughout the diocese who suffer from depression, anxiety and other mental and emotional disorders, according to information at www.dor.org/index.cfm/catholic-charities/public-policy. Human trafficking and adherence to the common good also were identified by the diocese as areas of education.
The petition drafted by the diocesan committee urges state lawmakers to improve access to mental health services for children and adolescents and maintain resources for family support and early intervention programs. The results of a shortage of mental health care providers include lower salaries for child psychiatrists compared to other medical specialties, low health insurance reimbursement rates and stigma for youths, according to diocesan officials. Dr. Rachel Bryant, a licensed psychologist who served as a speaker for the Elmira workshop, even created a column for the local newspaper several years ago because she was unable to see all the children who needed her care and felt this was one way to get some advice and information out to parents.
This lack of resources and persistent stigma also may account for reasons why 80 percent of children and youths in the United States do not receive any mental-health services, according to information from the National Center for Children in Poverty at http://nccp.org/publications/pub_687.html. The problem is even greater for ethnic populations, with 88 percent of Latino children not receiving the mental-health services they need, information on the website states.