Mind the Gap! Filling Gaps in Psychiatric-Mental Health Nursing Workforce Data to Drive Change
The psychiatric-mental health nursing workforce is a driving force for innovation, equity, and meaningful mental health system transformation. Psychiatric-mental health nurses must be recognized as key players in expanding access to care, delivering high-quality care, and advancing health equity.
No one believes this more firmly than Kathleen Delaney, PhD, APRN, PMH-NP, FAAN.
Delaney, Professor Emeritus at Rush College of Nursing, is an expert in the psychiatric-mental health nursing workforce. Beyond her numerous publications and presentations on the topic, she was a key player in the inaugural APNA Psychiatric-Mental Health Nursing Workforce Survey. And, at recent Substance Abuse and Mental Health Services Administration and National Academies of Sciences, Engineering, and Medicine meetings focused on the behavioral health workforce, she represented APNA and helped shape critical conversations on optimizing the psychiatric-mental health workforce through interprofessional collaboration and innovative new models of care.
“There are many issues hindering accurate identification of the size, scope, and practice of the psychiatric-mental health nursing workforce,” Delaney says. “This results in non-mentions, misrepresentations, and underreporting of the PMHRN and APRN workforce in current federal and state reports and workforce research.”
The Gap
Psychiatric-mental health nurses are often misclassified or omitted in federal data systems and reports. This gap in data limits visibility for PMH nurses in critical decisions for PMH services and policies. According to Delaney, this data gap makes it almost impossible to accurately:
- Assess the adequacy of each state’s PMH workforce
- Measure health systems’ capacity to provide PMH services
- Fully evaluate quality and outcomes of PMH nursing care
- Show how PMH nurses expand access in critical settings such as Federally Qualified Health Centers (FQHCs) and community health centers
“For instance, each year all FQHCs report their patient visits and staffing via a Uniform Data System (UDS) and the federal government compiles the data,” explains Delaney. “However, PMH APRNs are not counted in a unique category in the UDS but grouped together with select licensed mental health providers (e.g. Marriage and Family therapists) in an ‘other’ designation.
“In the 2023 UDS report, this line of ‘other’ licensed providers performed nearly five times the clinic visits delivered by psychiatrists and twice the number of virtual visits. But because of the way this information is recorded, there is no sense of how many PMH APRNs are providing these services, the type of patients seen, or the quality of care they are providing.”
Driving Data-Driven Solutions
In a major step forward: the 2024 HRSA Behavioral Health Workforce report correctly listed an accurate count of PMH-APRNs. This correction was in large part due to the availability of the APNA 2022 Psychiatric-Mental Health Nursing Workforce Report, which was referenced in the report. To capitalize on this progress, Delaney and a group of APNA member experts are developing an APNA PMH nursing workforce sourcebook which will offer accurate, up-to-date workforce data to inform policy, education, and research.
“This resource will inform both the federal government and APNA membership of workforce size and activities, gather data useful for PMH workforce researchers, inform educational community of workforce distribution and areas of need, and establish APNA as the primary source of PMH nursing information,” says Delaney.
APNA is also taking steps to launch the next APNA Workforce Survey, which will update APNA workforce reports and shine a light on the vital contributions of psychiatric-mental health nurses!
Published May 2025
