Peggy Halter, PhD, PMHCNS
2012 Award for Excellence in Leadership ~ Advanced

“I wanted to know more.” In talking about her career as a PMH nurse, Peggy Halter, PhD, PMHCNS uses this phrase to explain the motivation behind pivotal career decisions she has made. She describes one of her first encounters with a gentleman who was certain that he was a car, when she was a PMH nursing undergrad at a state hospital:  “I thought, how could the human brain, this highly evolved structure that has been the source for the development of speech, navigating the globe, treating polio, and making calls on a cell phone, be degraded in such a fashion? How could this obviously bright young man in the bloom of life end up in a state institution rather than in graduate school? I wanted to know more.”

After graduation, she worked on a stress management unit for two years, but still found that she wanted “to know more” in order to better care for her patients. She enrolled in graduate school at Kent State University, where she met several professors for whom she credits her confidence and facility as a PMH nurse: “Anita O'Toole who knew and wrote a book with Hildegard Peplau; Susan Jones who mesmerized us with tales of family therapy and hooked me on genograms; and Vi Morofka, my clinical instructor whose on-spot evaluation of my clinical skills and lack thereof, brought me to tears on more than one occasion, yet helped me push the boundaries and expand my confidence as a psychiatric advanced practice clinician.” After school, her quest to know more continued: “They say that if you really want to know a topic, teach it,” she says. “I did and I did.” For 22 years she “taught psychiatric nursing, supervised clinical experiences, and ultimately taught graduate psychiatric nurse practitioners.”  

Today as a leader in the field, Halter wears many hats: teacher, associate dean, project coordinator, editor. She is an Associate Dean at Ashland University’s new College of Nursing and Health Sciences in Ohio. In this role, she has recently been working to ease the faculty’s transition from a single-purpose hospital-based nursing program into an academic model. Concurrently, she is also developing a Doctor of Nursing Practice program with a Family Nurse Practitioner focus, and aiming to offer it in fall of 2013.  On top of all of that, Halter is a textbook editor, having written for and edited the 6th and now upcoming 7th (to be published in fall 2013) editions of an undergraduate psychiatric nursing textbook you may have heard of or even used in school – Foundations of Psychiatric Mental Health Nursing.  As editor she recruits and cultivates contributors for the text, collaborating with them and supporting their work.

“In addition to psychiatric nursing, my background is in health policy,” Halter says. She has taught and researched health policy, as well as being involved with the ANA as a fellow of their Advocacy Institute, with the Ohio Nurses Association as a long-term member of their Health Policy Council, and as current co-chair of the APNA Institute for Mental Health Advocacy (IMHA). “My role as co-chair [of the IMHA] is evolving along with APNA, our profession, the national healthcare climate, and global initiatives,” she says. She has seen APNA make “great strides” in improving its national visibility over the past five years. “As an organization, we have provided the American Psychiatric Association with comments and suggestions for the new edition of the Diagnostic and Statistical Manual (DSM). A simple phone call was all it took for advanced practice psychiatric nurses to be involved in clinical field trials to test criteria in the DSM-5 that will be published in May 2013.” 

Halter shares a little bit of advice about advancing your PMH nursing career as well as the profession of PMH nursing in general:

What is an important lesson that you have learned during the course of your career?
One of the biggest lessons that I have learned over the course of my career is that if you have heroes and want to find out more about what they do email them or call them. It is that simple. People with knowledge, strength, and in the public eye are usually there because they are responsive. I remember asking Grayce Sills about pursuing an administrative position with APNA. She said, "How about you meet me in my room?" at a conference. I did. We talked for three hours as she shared the background of APNA.

When I was a PhD student at Duquesne University I was supposed to do a precepted clinical experience with a health policy expert. I happened to see a presentation by the Director of the Ohio Department of Mental Health at a National Institute of Mental Health conference. I asked him if he could recommend a preceptor. He said that he would be glad to be my preceptor. This meeting changed the course of my career. Michael Hogan, PhD, was poised to be named Director of the President's New Freedom Commission for Mental Health in 2003. Updates on the progress of the commission's work were highly influential on my subsequent work.

What are some of the important issues facing PMH nursing right now and in what direction do you see them going?
Psychiatric mental health nurses are in a key position to improve mental health care for society. With the addition of millions of insured people due to the Affordable Care Act, demand for mental health services will increase. As the understanding of the relationship between physical and mental health becomes more apparent, financial incentives will increase to prevent mental illness or its consequences.

Psychiatric mental health nurses need to recognize their expertise, their numbers, and their influence. Anytime an issue arises pertaining to psychiatric care and its delivery, psychiatric nurses need to be at the table and must have a voice.

Psychiatric nurses choose this profession to help others. Stepping back from the one patient at a time perspective and looking at the bigger picture is a wise investment of time and expertise. I believe that every psychiatric mental health nurse has an obligation not only to his/her practice, but to the improvement of mental health and mental health care overall.