Authors

  1. Vourakis, Christine PhD, RN, FIAAN, FAAN

Article Content

Nurses graduating from baccalaureate programs have traditionally been educated to view their patients as whole beings and as partners in care. Advanced practice nurses are further educated in creating, planning, developing and implementing care systems designed to meet the individual needs of patients recovering from chronic health problems in their own environments; so embracing Health Care Reform, ROSC and engaging in recovery management is in rhythm with the nursing discipline's practitioners education and focus.

  
No caption available... - Click to enlarge in new windowNo caption available.

The paradigmatic change occurring in health care as a result of ROSC and Health Care Reform will finally allow nurses to practice their profession to the fullest and not have to compromise their education and socialization to fit into a fractionalized health care environment. For many practitioners engaging the patient as a partner in recovery and sharing responsibility for managing their health in their home environments on an ongoing basis is a welcome change that will likely have a positive result not only for the patient but for the provider as well.

 

As noted by our Guest Editors, the majority of patients with psychiatric mental health and substance use disorders are being treated in prisons. The criminal justice system is lagging behind somewhat in the creation of models of ROSC and the following facts warrant major reform in this system.

 

* Drug arrest rates grew by over 90 percent between 1980 and 2014.

 

* Over 50 percent of the incarcerated have mental health problems, while approximately 70 percent were regular drug users and 65 percent regularly used alcohol prior to being incarcerated.

 

* Emerging research finds that longer spells of incarceration increase recidivism. A recent study finds that each additional sanction year causes an average increase in future offending of 4 to 7 percentage points (Executive Office of the President of the United States, April 2016, p. 4)

 

 

Encouraging a comprehensive approach within the criminal justice system that includes incarceration prevention strategies and improved community policing practices, the Obama "[horizontal ellipsis]Administration is committed to a holistic approach to criminal justice reform that creates a fairer and smarter system in the community, the cell block and the courtroom. Fixing the conditions in the cell block and offering more employment skill training for inmates can reduce barriers to reentry and decrease recidivism (Executive Office of the President of the United States (April 2016, p. 6)." For example, in prevention, the Administration is promoting, changes that limit school suspensions for youth and incorporation of best practices in community police departments. For the incarcerated population the Administration encourages, enhanced gateways to housing and health care, the elimination of selected criminal record employment restrictions, reforms in how sentences are imposed and job training (Executive Office of the President of the United States, April 2016).

 

The development of Recovery Support Services in the form of Recovery Community Organizations (Substance Abuse and Mental Health Services Administration, 2010), specifically for the needs of those released from prison are important for ongoing recovery support. These organizations are non-profit. They are started by interested citizens, based in local communities and are commonly comprised of recovering individuals and interested others. They offer a variety of educational and community programs. One of their major contributions is offering peer-based recovery support services (White, 2008).

 

Our two Guest Editors for this special topic issue, Katherine Fornili, MPH, RN, CARN and Mary Moller, DNP, ARNP, PMHCNS-BC, CPRP, FAAN are outstanding nurse scholars and clinicians with extensive backgrounds in both psychiatric-mental health (PMHD) and substance use (SUD) disorders. Their knowledge and clinical expertise in Recovery and Recovery-Oriented Systems of Care (ROSC) is evident in this special issue of the Journal. The contributions of the Co-Editors along with the papers they have assembled for this issue are a testament to how nurses and their interdisciplinary partners have embraced recovery and ROSC to foster holistic care approaches in their communities.

 

Katherine Fornili, has been a public health nurse for over 30 years, and a certified addictions registered nurse (CARN) since 1999. She is Assistant Professor in the School of Nursing, University of Maryland.

 

Her areas of expertise include program planning and evaluation; grant writing; co-occurring communicable diseases and substance use disorders; integration of primary care and behavioral health services; screening and brief intervention SBIRT (screening, brief intervention, referral to treatment) services; and pharmacological therapies (specifically buprenorphine initiatives).

 

She is currently completing her doctor of nursing practice (DNP) program in community/public health nursing, almost exclusively focused on addictions nursing, and is implementing a nurse-led SBIRT project at a university-affiliated internal medicine clinic.

 

Ms. Fornili has worked for and provided consultation to several states, developed curricula and conducted educational programs for nurses, physicians, dentists, insurance case managers, addictions counselors and staff of state agencies. She is co-developer of and co-course faculty for a popular undergraduate elective at the University of Maryland called Addiction, Society and the Role of the Nurse.

 

Her many peer reviewed publications focus on substance use disorders and she has developed a model for recovery-oriented primary care. Ms. Fornili's activities and publications in the areas of research and evaluation are numerous. Her research interests vary and include identification and outcomes of substance use disorders in primary care.

 

Dr. Mary D. Moller is an advanced registered nurse practitioner who is dually certified as a clinical specialist in adult psychiatric-mental health nursing and as a practitioner in psychiatric rehabilitation. She is Associate Professor and Track Coordinator of the Psychiatric-Mental Health Nurse Practitioner Doctor of Nursing Practice Program at Pacific Lutheran University, School of Nursing, Tacoma, Washington.

 

She is also the Director of Psychiatric Services for Northwest Center for Integrated Health in Tacoma, WA where she is in practice as a psychiatric ARNP treating patients in a triple integration agency: substance abuse, mental illness, and primary care. She is implementing psychiatric wellness protocols for relapse prevention across the three disciplines.

 

She has published over 100 peer-reviewed articles, book chapters, policy statements, conference proceedings, newsletter articles, training manuals, and professional videotapes.

 

Her research interests include psychological adjustment to and symptom management in recovery from schizophrenia, a wellness approach to symptom management of recovery from trauma and abuse, and most recently identification of motivational strategies for nurse recruitment and retention based on self-determination theory. She is the co-developer of the Murphy-Moller Wellness Model that serves as the centerpiece of the Three R's Psychiatric Rehabilitation Recovery Program. Re-hospitalization rates for participants with serious mental illness enrolled in the program are reduced by 93.5%. These results have been replicated nationally and internationally.

 

On another note, we are sorry to announce the retirement of Ruby Martinez, RN, PhD, from the Editorial Board. We are very thankful to Dr. Martinez who served on the Board for over 13 years. She will be missed along with her thoughtful and scholarly contributions.

 

We are pleased to announce the addition of two new members to the Editorial Board, Susanne Astrab Fogger, DNP, PMHNP-BC, CARN-AP, FAANP, School of Nursing, University of Alabama at Birmingham and Ann M. Mitchell, PhD, RN, FIAAN, FAAN, University of Pittsburgh, School of Nursing, Pittsburgh, PA. We are looking forward to their participation with the rest of the Board in advancing the mission, goals and objectives of the Journal.

 

We have updated our Instructions for Authors and now require all accepted manuscripts to use non-stigmatizing language, to avoid bias and labeling and to use Person-First language. Please see Instructions for Authors (http://edmgr.ovid.com/jan/accounts/ifauth.htm) for further detail on manuscript submission requirements.

 

REFERENCES

 

Executive Office of the President of the United States. (April 2016). Economic perspectives on incarceration and the criminal justice systemhttps://www.whitehouse.gov/sites/default/files/page/files/20160423_cea_incarcera. Retrieved April 20, 2016. [Context Link]

 

Substance Abuse and Mental Health Services Administration (2010). Recovery-Oriented Systems of Care Resource Guide. Retrieved from http://www.samhsa.gov/sites/default/files/rosc_resource_guide_book.pdf. Retrieved April 20, 2016. [Context Link]

 

White W. L. (2008). Recovery management and recovery-oriented systems of care: Scientific rationale and promising practices. http://homeless.samhsa.gov/ResourceFiles/White.2008.pdf. Retrieved April 20, 2016. [Context Link]