California Has a Shortage in Mental Health Providers. How UC’s Bold New Initiative Will Address It.

January 2021Milenko Martinovich

More than half of Californians suffering from mental health issues are not receiving the psychiatric care they need. Within the next decade, the state is expected to see the number of psychiatrists decline by 34 percent.  

A bold initiative to solve this growing crisis began this month as the UCSF School of Nursing, in partnership with the UC Davis and UCLA Schools of Nursing, launched a remote-learning Post-Master’s Certificate Program that will train 300 new psychiatric mental health nurse practitioners (PMNHPs) within the next five years. The initiative, supported by a $1.4 million grant from the California Health Care Foundation, is an expansion of the existing Post-Master’s Certificate Program at UCSF that is projected to nearly double the state’s current pipeline of PMHNPs.

“We’re seeing a downtrend in the number of psychiatrists and that’s contributing to incredible workforce needs,” said Co-Director Rosalind de Lisser, associate professor at the UCSF Rosalind de Lisser School of Nursing. “This certificate will help us build a new pipeline for California’s mental health workforce.”

"Many Californians in need of behavioral health support seek care where these NPs are already in practice. Preparing the NPs to address the mental health needs of their patients improves care and avoids further burdening an understaffed mental health system,” added UCSF School of Nursing Dean Catherine Gilliss, whose clinical credentials included preparation as a specialist in psychiatric mental health nursing and as a primary care NP. “Not only are we preparing additional providers but we are working to distribute them more widely within the state.”

The first of its kind in California, the UC Multi-Campus Psychiatric Mental Health Nurse Practitioner Post-Master’s Certificate will greatly expand the state’s current PMHNP workforce of about 1,200.

The one-year program combines remote-learning education with in-person clinical training. The flexibility of the program allows students to remain working in their communities, including rural areas where access to mental health care is even more difficult. Many applicants have been recruited from these underserved areas, with the goal that they will be able to apply their newfound skills and expertise in their communities.

“The curriculum was designed to develop health care citizens, responsive to structural barriers to mental health care while also supporting clinician well-being,” de Lisser said. 

Kara Zertuche Family nurse practitioner Kara Zertuche, who began the program this month, lives in Humboldt County where she worked at a federally funded rural health clinic for seven years, serving patients with MediCal or no insurance.

“The vast majority had substance use or mental health issues or both,” she said. “So often I wanted to help them, but those issues were out of my scope. That experience really motivated me to want to specialize in the psychiatric aspect of a nurse practitioner.”

Upon certification in one year, Zertuche plans to apply her new skills in a primary care setting where she strongly believes mental health care should be integrated. A more holistic approach — caring for mind and body — could help stem this mental health crisis, she said.

“We can’t just focus on people’s physical health without the mental health component. It’s hard to make progress that way,” she said. “There are legacies of trauma and abuse that run through underserved populations. I feel passionate about health care justice. Everyone has a right to health care, and I want to be a part of that.”

Tonia Jones knows the gravity of California’s mental health crisis. As a nursing supervisor within the Los Angeles County Department of Mental Health, she assists the administration in Tonia Jones providing oversight to 48 county-wide facilities. For Jones, who has a PhD in nursing from UCLA and more than 30 years of nursing experience, the new certificate program offers the opportunity to enhance her expertise.

“This program aligns with my philosophical viewpoint as it emphasizes the importance of promoting awareness of mental health conditions, self-care and wellness,” said Jones, who was named the 2020 Outstanding Nurse of the Year for LA County’s Department of Mental Health.

The program’s significance has increased with the COVID-19 pandemic, Jones said. The pandemic has resulted in depression, anxiety, job loss, food insecurity and other challenges that are taxing Americans’ mental health.

“This program is very much forward thinking,” Jones said. “There is going to be a lot of fallout from COVID for years to come and finding coping strategies is very timely.”

Deborah Johnson Applications from well-qualified nurse practitioners far exceeded the number of available seats in the program’s first year, reflecting the demand for programs of this kind. The program will increase admissions for the January 2022 cohort, with the application cycle now open through March 1.

“There has been a groundswell of interest,” said Co-Director Deborah Johnson, associate professor at the School. “Applicants are drawn by the reputation and proven success of our MS program and the accessibility of this model. This will help meet the needs of the state."