Patricia Cunningham, DNSc, APN PMHNP/CNS-BC, FNP-BC
2011 APNA Award for Excellence in Practice ~ APRN-PMH

What Pat Cunningham loves most about being a psychiatric mental health advanced practice nurse and what she finds most challenging are two sides of the same coin: She loves “helping someone discover that they don’t have to suffer anymore and that there are ways that they can feel better.” The most challenging aspect is “getting people to accept that mental health problems have solutions.” "Reducing stigma and letting people know that there’s research and answers” is hard work, but the moment that the breakthrough happens, whether it’s with a patient, a family, or a student, it all pays off. “As psych nurses,” she says, “sometimes we’re working in a vacuum. You don’t always get to see the outcome.” So when a former client, family member, or student reaches out to tell her that “through an interaction with me they learned something that helped them make a change,” she says “there is absolutely nothing better.”

Dr. Cunningham is an Associate Professor at the University of Tennessee Health Sciences Center (UTHSC) and its DNP Psychiatric Mental Health Coordinator. A strong advocate for the integration of mental health care into primary care, she practices once a week as an APRN/PMHNP seeing patients with an internal medicine practice. “Mental health is HEALTH,” she says firmly. 15 years ago while working as a Behavior/Community Coordinator at UTHSC’s Department of Family Medicine, she came to a realization: “In almost every encounter, it felt like there were subsyndromal mental health problems and illnesses.” One particular day stands out. She walked out of a patient’s room and said to a nurse colleague, “This feels like psych nursing!” and the nurse replied, “Welcome to my world.” “That’s when I really became aware of the mental health needs in primary care,” Dr. Cunningham says. “Mental health care was too foreign, too stigmatized for many primary care patients to consider.  Their mental illnesses and mental health problems were sabotaging patients’ abilities to recover from their physical illnesses.”  She has been working to change those perceptions ever since – through practice, teaching, articles, and even the creation of a “mood disorder suite” to teach effective care of mental health disorders in a primary care setting.

As a volunteer with the Tennessee Public Safety Network in Critical Incident Stress Debriefing, Dr. Cunningham surmounts the mental health stigma prevalent in law enforcement. The network supports police officers, dispatchers, highway patrol, and others. “We do debriefings in small groups to deal with trauma and increase law enforcement resiliency throughout their careers,” she explains. “It’s about teaching them to reach out and break the culture of silence, to react normally to the horror they see – to see emotional reactions as normal.” It is education that is sorely needed. “More law enforcement officials experience cardiac disease, substance abuse, and suicide than get shot,” she says.

The other cause that Dr. Cunningham strongly champions is that of advanced practice nurses. “I’m tired of being forgotten and hidden. As an advanced practice nurse I will no longer be forgotten or hidden, period,” she says emphatically. “We are to use every opportunity to use our voices in responsible and accountable ways.” As for psychiatric nursing profession itself she says, “It’s important to recognize that psychiatric mental health nursing is a living thing…that’s why we continue to change through education and certification.” She cites the example of how she got her FNP in order to do the work she wanted at the UTHSC’s College of Nursing. It was not her first choice, but “it was a case of I bloomed where I was planted.” “Sometimes I’m uncomfortable with the change,” she acknowledges. “Evolving to the next thing is not always linear nor anticipated.  We adapt. "