When I envision my future as a Psychiatric Mental Health Nurse Practitioner, I acknowledge the professional mentors who have ignited my desire to act as a change agent within the mental health field. I have observed and drawn inspiration from Nurse Practitioners who have progressively removed barriers to health care access for many populations including those with special healthcare needs, the elderly, veterans, BIPOC and LGBTQ+ individuals, and those exhibiting mental health concerns (while recognizing these groups are multi-faceted and not mutually exclusive). My reason for wanting to become a Psychiatric Mental Health Nurse Practitioner is so that I, too, may work collaboratively with like-minded individuals to dismantle systems of oppression preventing individuals from achieving optimal mental health outcomes. In my future career I will I strive to make an impact within the mental health field by working with urban Medicaid-insured BIPOC and LGBTQ+ youth in Washington State. My reason for pursuing this goal stems from my work in the mental health field over the past decade where I learned of the multitude of barriers families face when trying to access timely mental health care. In my previous employment role with Seattle Children’s Hospital, I was tasked with connecting youth and families to evidence-based mental health providers throughout Washington State. In this position, I became painfully aware of the severe lack of psychiatric medication prescribers needed to meet the complex and diverse psychiatric needs of patients throughout the state. While forming therapeutic relationships with individuals experiencing marginalization and stigmatization, I witnessed how systemic inequality contributes to these disparities. In Washington, socioeconomically disadvantaged families, and youth who identify as BIPOC and/or LGBTQ+ routinely experience restrictions in identity-affirming care. Thus, they are more likely to enter a mental health crisis before receiving necessary services such as therapy and medication management. Washington continues to rank among the last of all 50 states in mental health care access, particularly for the populations noted above. A trend which is deeply problematic and has prompted my decision to attend Vanderbilt University’s Psychiatric Mental Health Nurse Practitioner Program due to its focus on training students to provide quality care to diverse youth and families traditionally underserved by the U.S. mental health system. Above all, I aspire to be a clinician who actively participates in structural change by engaging in community advocacy efforts that ensure adequate resources and funding for mental health services. I believe as clinicians we must intently engage in macro-level initiatives that bring about systems-level changes if we are to truly achieve a more equitable mental health future for all. I would be honored to fulfill a much-needed psychiatric prescriber role in Washington State, to enhance youth mental health resiliency, recovery, and remission.

Throughout childhood, I struggled with severe social anxiety. My inability to speak among my peers and teachers in class was so strong and pervasive, that if I were a child now (versus in the ‘80s and ‘90s), I likely would be diagnosed with selective mutism and be eligible for therapeutic interventions and classroom support. Instead, I found myself struggling alone, and experiencing near constant panic and paralysis. Consequently, I always felt defective and deficient, and misunderstood by other children and adults. For example, in kindergarten, I remember painting a picture for my mom as a Mother’s Day gift. At some point, I ran out of green paint for the grass. Instead of asking the teacher for more paint, I just stopped painting and the grass was left unfinished. This may seem so inconsequential, but every time I look at the painting, it has become a metaphor for my childhood, and a reminder that so many children, due to mental health differences, are unable to communicate their needs, and thus, get left behind in the classroom. Even with advances in mental health treatments over the last 20+ years, the reaction to children with social phobia and/or selective mutism is often dismissed as, “oh they’re just shy” and it is assumed that the child’s behaviors will spontaneously resolve. However, the best interventions engage the child in progressive exposures to social interactions to build a sense of confidence and resiliency. Therapy may begin with something as simple as asking the child to approach a classmate and say “hi,” and advance to asking another child to play. Ultimately, my deeply personal journey has led me to want to become a psychiatric nurse practitioner, so that I may provide young children with therapeutic and pharmacological support for their unique, and often misunderstood mental health concerns. As a mental health provider, I promise to validate the diverse experiences of all children, regardless of how different they may be from my own.

If we all take a moment to listen and observe, we soon realize that mental health struggles are happening all around us. We all know someone experiencing mental health concerns – whether that be a family member, a colleague, a friend, a patient in our care, or in many cases – ourselves. Throughout much of my life, I struggled with crippling social anxiety, which often resulted in me feeling depressed and alone. It was not until others offered their support and validation, and I engaged in therapy, that I began to feel less isolated, and grew strong enough to face my fears. Knowing that mental health concerns are part of the collective human experience helps to normalize and validate our individual struggles so that we can be a support to others. Over the years, connecting with others’ unique personal experiences has allowed me to feel a greater purpose behind the work that I do in the mental health field. Ultimately, my personal and professional experiences have forever shaped my understanding of the world, my relationships with others, and my career aspiration to become a psychiatric mental health nurse practitioner. Several years ago, I worked on psychiatric inpatient units in a counseling role at the University of Minnesota Medical Center. In that position, one particular patient stood out to me. I will call her Brenda to protect anonymity. Brenda was an elderly woman diagnosed with schizoaffective bipolar disorder. Brenda was admitted while experiencing a manic psychotic episode, which made having productive dialogue and mutual understanding difficult. Throughout her long hospital admission, her behaviors proved challenging, but I also found her to be an immense joy. Brenda spoke tangentially, struggled to manage irritability symptoms, and her experience of reality was vastly different from my own. One day, she crafted what she believed to be a beautiful cascading waterfall out of her bathroom sink by placing a sheet over it and running water until the water overflowed to form a pool on the floor. Instead of becoming angry and accusatory, I found myself inconspicuously and delicately cleaning up her creation so as not to upset her. Through careful observation and compassion, I found ways to communicate with her using a gentle, calm, and reassuring tone. With patience and time, I established rapport with Brenda on her terms while showing her the dignity and care she deserved. During these moments I felt a calling to care for individuals experiencing psychosis in my future career as a psychiatric mental health nurse practitioner, understanding that we may not always see eye-to-eye with our patients, but for me, meeting patients wherever they are on their mental health journey equates to gratitude and fulfillment.