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NR 606 Week 2 Discussion; Preparing the Discussion

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NR 606 Week 2 Discussion; Preparing the Discussion

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Identify the appropriate screening tool for Natalie to complete during her first visit and discuss why
the selected tool is appropriate for the client.

The PHQ-9 is a reliable instrument designed for use in the perinatal population. Its benefits include
being self-administered, accessible in various languages, and straightforward. The PHQ-9 comprises
nine questions assessing the symptoms outlined in the DSM-IV diagnostic criteria. Specifically, women
are prompted to evaluate their experiences related to lack of interest, feelings of depression, sleep
issues, tiredness, changes in appetite, sentiments of guilt and worthlessness, challenges with focus,
psychomotor agitation or slowing, and thoughts of suicide. Participants are instructed to rate each
symptom according to its occurrence over the previous two weeks, using the following response
options: "not at all," "several days," "more than half the days," or "nearly every day." The scores for
each item are aggregated to yield a total score (Davis et al., 2013).



Natalie is diagnosed with peripartum depression. Identify the appropriate treatment for Natalie and
discuss why the selected treatment is appropriate for the client.

Preventing postpartum depression (PPD) in individuals at high risk can be effectively accomplished
through counseling, cognitive behavioral therapy, and interpersonal therapy. Healthcare providers
should recognize these high-risk patients and apply these therapeutic methods as preventive
strategies (Carlson et al., 2024).

For managing peripartum depression, psychotherapy, and antidepressant medications are regarded as
primary treatment options. Psychotherapy is the preferred approach for those with mild to moderate
peripartum depression. In cases of moderate to severe depression, a combination of therapy and
antidepressant medications is recommended. Additionally, referring patients to a behavioral health
resource may prove helpful. The American College of Obstetricians and Gynecologists (ACOG)
endorses the use of selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake
inhibitors (SNRIs), and tricyclic antidepressants for the treatment of PPD (Carlson et al., 2024).

Of these options, SSRIs are viewed as the first-line medications for PPD. If SSRIs are not effective, it
may be appropriate to transition to SNRIs or mirtazapine. Sertraline and escitalopram are considered
strong first-line options for medical treatment. Importantly, there is a significant amount of safety
research that supports the use of sertraline (Carlson et al., 2024).

Natalie has concerns about the stigma associated with seeking mental health care. Discuss at least
two
(2) strategies the PMHNP can use to address these concerns.

The stigma or negative perceptions associated with living with a mental health condition are often
viewed as more challenging than the illness itself. Public stigma refers to the adverse reactions that
society has towards individuals experiencing mental health issues, which can be analyzed through
stereotypes, prejudice, and discrimination. Widespread stereotypes about those with mental health
conditions include beliefs that they are dangerous, incapable, and lacking in integrity. Prejudice
involves accepting these stereotypes, while discrimination pertains to the actions that result from
these prejudices (Shahwan et al., 2022).

, Public stigma against individuals with mental health conditions occurs not only in personal interactions
but also through broader societal issues, such as biased institutional policies, practices, and cultural
norms. This type of bias, referred to as structural stigma, results in insufÏcient opportunities and
resources for those with mental health conditions. Consequently, they frequently encounter exclusion
from the workforce, reside in unstable and unsafe living conditions, face challenges in obtaining health
insurance, and are at risk of involuntary hospitalization and treatment (Shahwan et al., 2022).

The scarcity of opportunities and the low quality of available resources for individuals with mental
health conditions lead to severe outcomes. For instance, there is a significant overrepresentation of
people with mental health conditions within the criminal justice system and among those experiencing
poverty.
Moreover, individuals with mental health conditions have higher rates of illness and death, which,
when combined with these challenges, leads to a diminished quality of life compared to the general
population (Shahwan et al., 2022).

People dealing with mental health issues frequently encounter both societal and systemic stigma,
which may cause them to absorb these unfavorable perceptions. This phenomenon is known as self-
stigma (Shahwan et al., 2022).

A strategy utilized by the PMHNP to address mental health stigma involves using thoughtful language
and steering clear of negative or non-clinical terms, like "crazy," when talking about mental health.
Clearly, distinguishing between mental health and mental illness is crucial, as this aids in decreasing
stereotypes and biases related to mental illness. Another tactic is to present mental wellness as a
critical component of overall well-being. This method helps to normalize the act of seeking assistance
for mental health issues (Bergman & Rushton, 2023).

Identify at least two (2) specific resources from the website that are appropriate for Natalie and
discuss why the selected resources are appropriate for the client.

I believe informing Natalie about the services offered by Postpartum Support International (PSI) would
be beneficial. PSI aims to assist families and providers by providing the information and resources to
effectively screen, assess, refer, and follow up on postpartum issues.

I will share the HelpLine details with Natalie, as this resource could be beneficial for her. She will
gain access to support and resources, and she has the option to leave a private message. A
compassionate and trained volunteer will get back to her via call or text.

Another valuable resource for the client is a support group. She needs to know that she is not alone,
which can help reduce her fear of stigma and provide the adequate support she needs. Online support
groups led by trained PSI facilitators connect clients with other parents and offer helpful tools and
resources. These online groups allow the client to engage with other parents, share experiences, and
learn about valuable resources. The online format may also be more convenient for her, especially
since she has a newborn.

Screenings for maternal mental health disorders are under or ineffectively used. Discuss at least two
(2) strategies for collaborating with providers in your community to offer screenings and
appropriate referrals to mental health providers to promote better outcomes for maternal mental
health.

One of the most effective approaches to enhance maternal mental health outcomes is to offer
education and training for healthcare professionals. Providing workshops, seminars, brochures, and
videos can
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