Addressing children's mental health needs: educational preparation of advanced practice nurses.

I n 1999, the President’s New Freedom Commission Report reported that nearly 14 million children were in need of mental health services, but the vast majority of these youth did not receive care. One underlying cause of the system failure was the shortage of providers for children with mental health needs, a shortage that continues, particularly among clinicians who prescribe psychiatric medications (Koppelman, 2004). Of concern to ACAPN is training advanced practice nurses (APNs) to deliver what science informs is the best mental health care available for children. In the coming months ACAPN along with the ISPN’s Education Chair will be examining how nursing educational programs are training APNs to provide mental health care to children and adolescents. There are five avenues for training of APNs who can address the needs of children with mental health issues. These educational options are listed in Box 1. The programs vary in the breadth of content devoted to child and adolescent mental health pathologies and therapies. The Child and Adolescent (C/A) Clinical Nurse Specialists (CNS) programs have been preparing APNs since the 1950s. Currently, approximately 900 APNs are certified C/A Psychiatric Mental Health (PMH)-CNSs. These programs have grown out of the traditional CNS emphasis on the nurse therapy role but have expanded in recent years to include pharmacotherapies. Vanya Hamrin, the interim coordinator of the C/A PMH-CNS program at Yale University, comments on the role distinctions of graduates of programs such as Yale: