Clinician Corner: Meet Courtney Bearden, PMHNP

Iris clinicians are at the heart of what makes our organization such a special place to work. That’s why we’re turning the spotlight on the amazing work they’re doing every day. This month, we’re sitting down to talk with Courtney Bearden.

Q. How did you find Iris and decide you wanted to be an Iris provider?

A: I found Iris by going on a nurse practitioner’s social media board. I searched “telepsych” because I knew that’s what I wanted to do. Of all the negative reviews and bad experiences people had with other companies, Iris was the only one that had universally good responses from my peers. I ended up meeting with several telehealth companies, and having done that background work, Iris was the clear-cut winner.

Q. What does a typical day as an Iris Telehealth provider look like for you?

A: Right now, I’m working with our on-demand services and doing a combination of night and day shifts. My day looks different day-to-day, but a typical day shift allows me to get up and take my kids to school in the morning, which is wonderful. Then, I have time to get back and make a cup of coffee. I see patients for the bulk of that day. It’s a combination of calling and doing doc-to-doc reports, seeing the patients, documenting, and some collateral phone calls.

Then, I’m done in time to go pick up my kids from school in the afternoon, which again is another really wonderful thing to be able to do. If I’ve got any leftover work, it’s mostly just answering emails, nothing major. I don’t spend after-work time doing charting because I do it as I see patents. With the nature of consult-liaison work, you can’t leave it until the next day. So, I’m always done when my shift is done, which is a really nice and big change of pace.

Q. How do you foster connection with patients virtually?

A: Connecting virtually is something I thought would be more difficult. I have done bits and pieces of telepsychiatry for the past ten years. So, it’s not a new platform, but many patients became first acquainted with it during the COVID-19 pandemic. While there were certainly patients who were concerned about it, I found that I could connect just as well with a patient in person versus over telepsychiatry. There are things you can do as a provider that make a difference. The way you have your screen set up is important. For example, my camera is attached to the screen that I do my charting on. I’m looking at the patient while I’m charting, so I can continue having that eye contact and constant connection.

I will say that I feel like I’m better able to connect with certain age groups over a screen than in person, especially younger generations. That’s how they’re used to socializing and connecting. I do find that teenagers, in particular, tend to open up more over a screen, and I think it’s a generational thing. Still, it certainly surprised me when I found I was getting more from patients through telepsychiatry than in person, when patients tend to be a little more closed off.

Q. As a healthcare professional, how do you manage work-life balance?

A: A big part of managing work-life balance is finding the right company to work for. There are certainly healthcare organizations that do not prioritize clinician health. They do not prioritize clinician work-life balance. That’s obvious when you see schedules with 10-minute follow-ups, no charting time, and 30-minute initial evaluations. When you see something like that, it’s a very clear indicator that the priority for that organization is their bottom line. It’s profit. It’s seeing as many patients as quickly as you possibly can. The priority is not client care, and it’s certainly not clinician care. So, finding the right organization to work with makes a huge difference.

I can have a fairly easy work-life balance because I don’t have to see patients quickly, right after another. I have 30-minutes for follow-ups and 60-minutes for initial evaluations. I can see my patients, do any collateral calls, and do my charting within that time block. Then, at the end of the day, I’m done.

Q. What are your biggest learnings from your time at Iris?

A: The thing I’ve learned the most about is that there isn’t one way for a company to support their clinicians and their patients. We’re raised as healthcare professionals in the idea that you have to do things fast and only worry about if you can bill for it. We’re taught that this approach is normal and it’s not. Working for an organization that prioritizes patient care and prioritizes their clinicians was eye-opening. I came from a background in community mental health. It wasn’t a for-profit, private practice environment that I came from – it was from public health. So even with that background, learning that there was a different way it could be done was eye-opening for me.

Q. What is the most rewarding part of your job?

A: The most rewarding part of my job is when I see a patient, and at the end of our appointment, they say, “thank you, that was the first time anyone has really listened,” or “you’ve asked more questions than anyone ever has before.” That’s reassuring to know that we’re doing something right. Then, when our clinic partners, the ER physicians, or social workers thank you for coming in and taking that piece of the patient care. If they wanted to be psychiatrists, they would have been psychiatrists. There’s a reason why they’re consulting with us. It’s because we’re specialists and have a passion for something that they don’t. That is rewarding when you get appreciation from your colleagues and certainly from patients.

Q. What do you love about working with Iris?

A: The thing I love most about working with Iris is that it does feel like a team approach, and you’re not just an interchangeable peg that can plug into any situation. When they place you with a clinic or a partner, it’s a very long process. When you’re first starting, you can feel like, “Oh my gosh, why does this take so long?” It’s because they’re finding the right fit. It’s not a locum’s company where they’re not making intentional matches.

When you’re with Iris, it’s an intentional placement. And they don’t hire everyone who applies. It’s less than 10%. You know that you’ve been selected for a placement that will be a good fit for you.

Q. How does telepsychiatry open up access to care?

A: When COVID was forcing many people into working remotely or in a telehealth situation for the first time, there was a lot of hesitancy from both providers and patients. I think having been exposed now to that technology and the ability to have care delivered that way; there’s no going back. I don’t think we can close the floodgates. Even as a patient, I don’t think I ever want to go into a primary care office in person again unless I have to.

It’s really convenient to have access to care at home and to care for patients who don’t have transportation, which was always a barrier – especially in rural health care. Not having to find a ride two hours into a town where the clinic is located is great. It has opened care to people who weren’t getting it before. This is how we’ll continue to provide care to people who need care. This is how we will do things from here on out.

Q. Why do you think telepsychiatry is important to the future of mental healthcare?

A: Telepsychiatry is going to be integral and continues to be integral for mental health care because there are not enough mental health clinicians. There certainly aren’t enough to have one provider in every single rural role and underserved community in America. We’re able to see patients in many different settings and spread that expertise and spread that knowledge to people who may not otherwise have any access to care.

A good example is the work I do with consult liaison. In a consult liaison role, I see patients in eight states and many different settings. There can’t be a psychiatric nurse practitioner or a psychiatrist on site in every one of those hospitals, 24/7. But, with Iris and with our on-demand services, there is. There’s essentially a mental health specialist in every clinic and hospital, 24/7, 365. There’s no way to do it without the use of telehealth. And, it’s a real disservice to patients not to have access to that level of specialized care.

At Iris, we believe our providers should be respected, valued, and applauded for the work they do, and we couldn’t be more proud to say, “thank you” to our very own Courtney Bearden. If you’d like to learn more about working for Iris Telehealth, contact us today.

How a PMHNP Telehealth Strategy Can Benefit Your Healthcare Organization

Over the past few years, the number of Psychiatric Mental Health Nurse Practitioners (PMHNPs) has been steadily increasing — passing the 12,000 mark in 2016.

In many states, PMHNPs can evaluate, diagnose, and prescribe medication to patients — just like their psychiatric counterparts. That means organizations can incorporate PMHNPs into their overarching strategies to help address provider shortages, meet patient needs, and decrease wait times.

Healthcare organizations looking to expand access to behavioral health services may be wondering which provider type is best for their community. Here is all the information needed to make an informed decision about hiring a PMHNP.

PMHNPs are highly-trained psychiatric care providers who can provide comparable treatment to psychiatrists

Due to the nationwide provider shortage, finding psychiatrists for your care team might not be an option. Thankfully, PMHNPs are just as equipped to provide the high-quality care patients need. While PMHNPs and psychiatrists have different training and education requirements, the treatment they can provide is very similar.

  • PMHNPs and psychiatrists have graduate-level education. PMHNPs are required to have either a Master’s or Doctorate in nursing to sit for the PMHNP certification exam.
  • Once a PMHNP is certified, they can practice across the patient lifespan. This ability means they can treat children, adolescents, adults, and geriatric populations.
  • Psychiatrists can also treat patients across their lifespan. However, PMHNPs often opt to undergo further fellowship training that equips them to treat specialized patient populations.
  • Both PMHNPs and psychiatrists are eligible to earn an X-waiver, which allows them to prescribe buprenorphine to treat patients with substance use disorders.

PMHNPs receive training around holistic care — which makes them a good provider fit for CMHCs and FQHCs

PMHNPs can significantly benefit your organization, especially if you serve patients from vulnerable populations, like Community Mental Health Centers (CMHCs), Certified Community Behavioral Health Clinic (CCBHCs) and Federally Qualified Health Centers (FQHCs).

Recent studies have found that the quality of PMHNP care is similar or equal to that of psychiatrists. Additionally, much of the training they receive works well for the kinds of patient populations CMHCs and FQHCs often see.

Like psychiatrists, all PMHNPs receive training around assessing, diagnosing, and treating patients with mental health needs. However, PMHNPs also focus on holistic care, and they have skills and experience in treating the whole patient.

Their specialized training includes:

  • Psychotherapy and behavioral health conditions: PMHNPs receive extensive training in psychotherapy and can effectively treat common behavioral health conditions, including mood disorders, anxiety, substance use, depression, ADHD, and schizophrenia.
  • Crisis intervention and directing patient care planning: PMNHPs have experience in crisis intervention and can utilize de-escalation techniques to support patients who enter your health center in a state of distress. PMHNPs are also skilled at care coordination and can help provide consultations and referrals to psychiatrists and other specialists if a patient’s case requires it.
  • Collaborative care: PMHNPs are trained to work in collaborative care teams, where they may work with psychiatrists, social workers, community managers, or nurses to find a care plan that can treat a specific patient’s needs effectively.
  • Effective communication with patient families: PMHNPs are equipped to interact with patient families or caregivers — particularly when treating young patients or patients from vulnerable populations.

If these skills and experiences would benefit your organization, a PMHNP may be a good fit for you.

If you’re considering hiring a PMHNP, make sure you understand your state’s regulations

Unlike psychiatrists, PMHNPs are subject to state regulations that dictate the kind of care they can provide. For example, a PMHNP in Texas could see patients and provide assessment and diagnosis. However, they would not be able to prescribe without having an established Prescriptive Authority Agreement in place with a physician. However, in Oregon, a PMHNP can prescribe medication without a physician’s collaboration and can even practice independently.

States fall into three regulatory categories:

  1. Full practice: In full practice states, PMHNPs can evaluate, diagnose, and treat patients by prescribing medications without consulting with a physician. In these states, PMHNPs can also set up independent practices. There are currently 23 full practice states across the country.
  2. Reduced practice: Reduced practice states limit PMHNPs’ ability to practice fully and independently. Often, PMHNPs will be required to hold a collaborative agreement with a psychiatrist in order to provide full patient care and prescribe medications to treat their patients.
  3. Restricted practice: In restricted practice states, PMHNPs must work directly with a psychiatrist or other healthcare provider and cannot prescribe medications to patients without that psychiatrist’s supervision. There are currently 12 restricted practice states in the U.S.

When considering which provider type to hire, you should research what kinds of regulations exist in your state. If you live in a restrictive state, plan to have consulting psychiatrists available to prescribe medication in collaboration with your PMHNP. Telehealth can offer a better solution to connect patients with care while working in their scope of practice, regardless of where nurse practitioners practice.

Hiring PMHNPs can be a challenging task, so consider the recruitment resources available

If you’ve decided PMHNPs are a good fit for your organization, there are several recruitment options and partners you can consider:

Nurse practitioner associations: If you’re looking for a local PMHNP, you can research nurse practitioner associations at the regional and state level. These associations often have job boards where you can post potential openings and get your position in front of qualified candidates.

Local universities: Universities with nursing programs will often also have job boards and can be beneficial partners when looking for a PMHNP in your area.

Telepsychiatry: Telepsychiatry partners like Iris Telehealth can be valuable resources to help your organization source and vet potential PMHNPs utilizing telehealth before adding them to your team. Using a service like this will give you access to PMHNPs at a national level, opening up a network of qualified providers and helping to get them licensed in your state.

Provider matching: Finding the right provider for your organization is key to the success of your patients and your care team. That’s why at Iris, we help organizations find a provider who meets their organization’s needs and aligns with their team’s culture and values. This process, called provider matching, helps bring stability to organizations, providers, and the patients they serve.

Your decision to use a PMHNP should be all about your patients

Because psychiatrists’ availability is limited across the country, particularly in rural communities, it’s essential to consider how your organization can best serve your patient populations and provide high-quality care.

PMHNPs bring valuable experience dealing with sick patients and vulnerable populations, which can be a major benefit to your organization. This is particularly true for CMHCs and FQHCs, who often see a high volume of patients from vulnerable populations.

PMHNPs are also incredibly passionate about their work. In an interview with one of our own PMHNPs, Dale McQueeney, she says that one of the most rewarding parts of her job is seeing patients reduce use or achieve and maintain abstinence from substances.

Most importantly, PMHNPs can serve as key behavioral health providers. They can extend access to your services, meet patient needs, decrease wait times, and become long-term, collaborative team members.

To learn more about how Iris Telehealth can help you source PMHNPs for telehealth, contact us, and we’ll help you get started.

How to Treat Geriatric Populations in Health Systems

According to the World Health Organization, approximately 15% of adults aged 60 and over have a mental health condition. However, less than 3% of older adults receive treatment from mental health professionals. In some cases, this lack of care is due to inadequate access to mental health services, stigma, or other medical conditions that might need attention, too.

With the proportion of the world’s older adults estimated to almost double from about 12% to 22% between 2015 and 2050, it is more imperative than ever to start addressing both the physical and mental needs of this population.

Thankfully, telepsychiatry can connect older adults to quality mental health care, effective screening, evaluation, and treatment.

The state of mental health and aging

For older adults, there are several barriers that stand between them and getting the mental health care they need. These barriers might include access challenges, unnoticed behavioral health conditions, or co-occurring physical conditions that require treatment. Additionally, according to Mental Health America, 58% believe depression is a normal part of getting older, and only 42% of older adults would seek help from a health professional for depression.

This population can also be vulnerable to other mental health challenges like trauma and anxiety. Unfortunately, many of these conditions go untreated or undiagnosed, resulting in frequent doctor visits, emergency department visits, higher use of medication, and extended hospital stays.

While this population faces unique challenges, there is still great opportunity for them to get the mental health care they need.

How organizations can help effectively treat geriatric populations

As an organization, you can help support the geriatric population in your community by providing access to mental health care through telepsychiatry. Telepsychiatry is an essential tool that helps this population virtually connect with providers without having to navigate through waiting rooms or receive unnecessary exposure to outside elements. When patients connect with a provider from the comfort of their own home, it allows them to receive the care they need from wherever they are.

Whether your organization is seeing a large influx of older adults needing mental health care or you’ve just started integrating telepsychiatry, here are a few tips you can leverage to better serve this population.

Here’s how organizations can take action to offer a more effective and comfortable experience for older adults:

  1. Promote collaboration: The ED can be a costly and high-risk endeavor for older adults. That’s why having support for caregivers and providers can be essential. Before older adults need emergency department (ED) intervention, leveraging telepsychiatry can be a great way to de-escalate situations. Collaborating with caregivers and specialty care providers through telepsychiatry can allow older adults to receive mental health care from anywhere in the country.
  2. Empower caregivers: Caregivers may be juggling the care of their loved ones with their own full-time jobs, families, and even their personal health. As a solution, telehealth offers a new way to bring training to caregivers on their own time. Sharing strategies with caregivers about home safety and medical care through telehealth allows for a better quality of life for the older adults they provide care for at home. Equipping them with the right skills and techniques to care for their loved ones can be a beneficial resource for keeping older adults healthy at home.
  3. Intervene early: Having decision trees or care pathways in place for your providers to follow can keep older adult patients healthy between appointments. Rather than waiting, it’s better to intervene early by starting with screening. Leveraging the expertise of specialty mental health providers can relieve stress on care teams and take the pressure off primary care providers through collaborative care.
  4. Establish memory care units or dementia care: Memory care units or dementia care units can provide older adults with individualized services if diagnosed with Alzheimer’s or dementia. It can also provide a safe environment for easy monitoring while promoting independence.
  5. Take a holistic approach: Provider collaboration leads to a holistic approach to patient care. While addressing the physical health of this population is essential, it’s important to screen them for mental health conditions as well. Telepsychiatry can offer an easier way to diagnose older adults and mitigate emergency intervention. Additionally, integrating a virtual care option can support your on-site team by allowing them to collaborate with other providers.

Promoting access to geriatric mental health through telepsychiatry

Providing telepsychiatry to older adults increases their access to the specialty mental health care they need. While this population may face a stigma that says they’re not tech-savvy, it isn’t true.

Technology usage among older adults has increased during the pandemic. The American Association of Retired Persons (AARP) reports that 44% of older adults view technology as a positive way to stay connected. In addition, the American Psychiatric Association (APA) says that telepsychiatry has helped treat many behavioral health conditions like dementia, anxiety, and others since the late 1900s.

Telepsychiatry for the geriatric population provides patients with a sense of autonomy while extending services to those who cannot leave their homes. As technology usage increases, older adults can feel at ease knowing they have options to take care of their health.

Where Iris Telehealth fits in

At Iris, we believe that everyone should have access to mental health services in their community. If you’re an organization looking to incorporate telepsychiatry for your geriatric population, we can help. Contact us today if you would like to learn more about how telepsychiatry can help provide behavioral health services and increase access for older adults in your community.