Specialization within a specialty: Advanced practice psychiatric nursing pathways for the greatest good

Dr. Hildegard Peplau’s theory on the primacy of the therapeutic interpersonal relationship remains central to the role of the psychiatric–mental health advanced practice nurse (PMH APN). In 1989, Peplau published her thoughts on how World War II (WWII) shaped early PMH APN practice. Following WWII and the return of hundreds of thousands of previously mentally healthy service members with combat-related psychiatric symptoms and disorders, the prevailing societal beliefs about mental illness began to shift from an innate/inherited etiological perspective to a broader appreciation of the additional contributions of social and environmental factors to mental well-being. With that awareness came a decrease in stigma and a shift from housing patients in psychiatric hospitals to treating them in community settings. The coronavirus 2019 (COVID-19) pandemic has likewise affected societal beliefs through exposure to the mental toll of massive infection rates, loss of life, social isolation, and other downstream consequences. During these times of crises, psychiatric nurses and educators are challenged to provide innovative solutions to meet the increased demands for psychosocial care.