Nan Chadwick, Ph.D., RN, is passionate about teaching psychiatric-mental health nursing at the University of West Georgia in Carrollton. She calls this the decade of the brain.

Here are some reasons why she says this is an exciting time for mental health nurses.

• Mind/body research has shown a connection between many physical and psychological diseases.
• Advances in radiology and nuclear medicine are revealing how the brain works.
• The Human Genome Project taught us more than ever about DNA.
• New anti-psychotic medications and behavioral therapies are helping patients with age-old disorders - such as schizophrenia, bipolar disorder and chemical depression - live better lives.
• Better understanding has removed some of the public stigma of mental illness.
• Advocacy groups, like the National Alliance for the Mentally Ill, have raised awareness and lobbied for funding to fight mental illness.

"Psychiatric nurses know so much more than they did, and they are constantly learning," said Monique Farill, CNS/PMH, who works in Grady Health System's department of psychiatry with inpatient and outpatient services.

The department functions as the Central Fulton Community Mental Health Center and runs the only 24-hour emergency psychiatric service in the region.

Farill earned her master's degree in psychiatric-mental health nursing in 1975 and was among a group of pioneering clinical nurse specialists who helped shape Grady's psychiatric programs.

"There weren't that many clinical nurse specialists in the beginning, so we had to carve our roles out. I feel so fortunate that Grady welcomed us, respected our skills and allowed us to make contributions," Farill said.

Today, many clinical nurse specialists carry their own caseloads and collaborate with doctors, residents and social workers in assessing, diagnosing and providing therapy for their patients.

Farill has seen the emphasis change from theory and institutionalization to the workings of the brain, the effects of new medications, and psychiatric services that support patients living at home.

"The caseloads keep growing, and although we've made great strides in mental health and helping people with substance abuse, we still have to address the homeless or incarcerated mentally ill patients," Farill said.

Nurses provide linkage between physical and psychological care when patients have multiple diagnoses, such as hypertension, diabetes and mental illness. They also push for wellness programs that address diet and exercise, so that patients with mental illness are healthier.

"Working in mental health at Grady has enriched my life. I've come into contact with patients who are near and dear to my heart, and it has been rewarding to be a part of their lives," Farill said.

Unfortunately, not enough students are choosing this specialty. Mental health inpatient facilities have some of the highest vacancy rates in nursing: 20 percent to 30 percent, according to a 2005 Health Resources and Services Administration report.

Practicing psychiatric nurses would like to see nursing schools spend more time in mental health training so that students graduate with greater confidence to practice in the field.

"The biggest change in psych nursing is that there are a lot more opportunities than there used to be," Farill said. "The field is wide open, and nurses are using their creativity to define their roles."

You can read about some of those roles in this month's issue.

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