Michael Terry, DNP, FNP, PMHNP
2011 Award for Innovation – Individual

“Whenever I’m frustrated by a situation and find my way blocked so that I can’t provide the services I’m there for, I get restless and determined to make this work – for the patients, for the clinicians I support, or for the students I teach.” Michael Terry, DNP, FNP, PMHNP, recipient of this year’s APNA Award for Innovation – Individual, says. “I learned years ago that these obstacles, these problems, are typically system issues, that most people and organizations actually want to grow, to heal, to learn.” He speaks of his innovative work in terms of paths and maps. “I see it sort of like a topographical map. The terrain and the pathways or routes used are all there, and so are the obstacles, workarounds, hazards, etc. My job is to find a different path, with as little actual change as possible.”

Dr. Terry’s inventive solutions run the gamut from the use of technology to facilitate long distance learning, to creating the Trauma Support Services Program in Northwest Alaska, to overhauling a large HMO Urgent Care operation in Southern California to aid patient behavioral changes. All of his work centers around two goals: 1. Expanding the scope of basic emergency and primary care services to improve quality and accessibility and 2. Integrating behavioral health, especially for underserved populations, with a focus on the spectrum of trauma related disorders.  “So many times the system has become ideological or political and no longer works as well. It has created a map that no longer fits the territory,” says Terry. Finding the path to a viable solution “is a matter of strategy and creativity,” he explains. “Nothing is off the table…The path might be a bridge, a technological strategy, but it must be ‘off the shelf’ and somewhat simple or intuitive to use, even if it’s not well known.” Of course the technological innovations must be inexpensive and readily available – budgets are often tight and accessibility is a must.

Terry’s own path brought him to psychiatric mental health nursing 15 years into his career. “My career has been a series of efforts to refocus ‘upstream’ in order to provide better care,” he says. “I went from the streets and ER as a paramedic/ER nurse, to keeping folks out of the ER as an FNP in primary care, to prevention and health promotion as an educator.” He eventually realized that all of his efforts came down to one thing: behavior change. “I enrolled in a PMHNP program with the goal of becoming a psychiatric consultation-liaison nurse in primary care,” he remembers. “That was 24 years ago, and I’ve never looked back.”

Always focused on moving “upstream,” Terry is currently working on forging a path through the quickly changing landscape of American health services. “Primary care mental health services is a new path in this changing landscape and I want to train APRN-PMH nurses to help primary care providers who will be traveling this new path,” he says. He envisions a primary care APRN-PMH role to work “in direct care, consulting, program development, and education in primary care settings.” Additional coursework would be added to create a sort of “primary care mental health consultation service.” He is in the beginning stages of setting up a program like this at the University of San Diego, where he just joined the faculty as an Associate Clinical Professor.

Despite all that he has accomplished, Terry still sees so much more that needs to be done: “Remember Calvin and Hobbes, the comic strip, about a precocious and adventurous six-year-old boy and his sardonic stuffed tiger? Calvin once remarked to Hobbes, ‘God put me on earth to do a certain number of things. Right now, I’m so far behind, I can NEVER DIE!’ That pretty much sums it up.” His vision, dedication, and technical savvy will no doubt continue to propel him down paths which lead to more creative innovations and solutions in the psychiatric mental health arena.