History is the foundation of the future. If one is not to repeat the errors of the past, one must be knowledgeable about the historical developments that have led to the current modern-day state of affairs. The history of epidemiology has been influenced by many historic leaders from a diverse background of professions and disciplines. These historic leaders shared the purposeful mission to prevent and control health-related events with the desire to promote health among populations. This chapter focuses on historic leaders and events that have shaped modern day epidemiology.

Working with clients is dynamic and challenging. Although there are many variations of psychiatric-mental health problems, there are specific core issues to be considered for all clients. These include the overall purpose of treatment, theory base and resources, client’s perspective and resources, and stages of treatment. This chapter discusses the concepts to be considered for all clients and all types of psychiatric-mental health treatment. The foundation is the development of a therapeutic relationship. The resources of the advanced practice registered nurse as well as the client are identified as necessary to bring about change including increased self-awareness, broader perspective, increased functioning, and neurobiological shifts during psychotherapy. The stages of treatment across the process of therapy are based upon Peplau’s Interpersonal Therapy and the sections of each individual session are also presented. The chapter provides the groundwork for the chapters focusing upon treatment of specific symptom clusters later in the book.

Occupational health and safety is considered a branch of public health focusing on diseases, health alterations, and injuries within the working population. Occupational health and safety programs implement strategies and regulations that are designed to prevent or reduce the occurrence of occupational disease and injury among the working population. Occupational health exists at the intersection of government regulation, management, and labor relations. Occupational epidemiology is a branch of epidemiology concerned with the determination of the distribution and determinants of health, illness, and risk factors within the occupational environment. It supports healthcare practice in several areas. Occupational health nursing is a specialized area of community and public health nursing practice. Nurses have the knowledge, skills, and ability to integrate nursing knowledge with occupational health knowledge to develop, plan, implement, and evaluate the effectiveness of occupational health programs on employee health outcomes.

Complementary approaches to treatment are considered nonconventional (in a specific culture) and used together to complement conventional, “Western” treatments. Alternative approaches are nonconventional, nonallopathic interventions used in place of conventional treatment approaches. These approaches form the basis of the thriving treatment category known as complementary and alternative medicine (CAM). Naturopathic, or “Eastern medicine,” are terms used to describe these more “natural” CAM approaches which have evolved, mostly from Asia, over thousands of years. Integrative approaches seek to treat the whole person, not just their illness or disease, and are often referred to as a “holistic,” mind, body, and spiritual care approach. Integrative approaches to treatment combine conventional and nonconventional practices, holistically addressing all aspects of a person’s well-being. Lack of understanding of the background and philosophies underlying a complementary, alternative, or integrative technique may be a missed opportunity to treat a client holistically and offer additional therapeutic benefits and modalities.

Epidemiologic research studies are conducted to describe the burden of disease in a population, the presence of risk factors, health behaviors, or other characteristics of a population that influence health alterations or disease processes. Epidemiologic studies can determine risk factors associated with disease, causal inferences, and effectiveness of health-related interventions. This chapter differentiates observational research designs and sampling methods and also describes the components of a research proposal, contrasting it with a research report. Epidemiologic research relies on primary and secondary data collection methods: Primary data collection is when the epidemiologist collects the data, such as from medical examinations and direct observations. Secondary data collection is where the data have been collected by others such as medical records, census data, and vital statistics data. Nurse epidemiologists or nurses who engage in epidemiologic research use both primary and secondary data sources to answer the proposed research question.

Nurses have the unique task of caring for both the perpetrators of other-directed violence as well as their victims, while also finding themselves at an increased risk of experiencing work-related violence. The American Nurses Association website states that one in four nurses have been assaulted at work, and their likelihood to be exposed to violence at work is higher than that of prison guards or police officers. The World Health Organization proclaims violence to be the leading worldwide health problem and is the fourth-leading cause of death worldwide. This chapter focuses upon the other-directed violence that psychiatric-mental health advanced practice registered nurses are likely to encounter in the workplace and suggests how to identify and treat both the victim and the perpetrators of violence, while staying safe.

Testing consists of screening and diagnostic testing. Both screening and diagnostic testing are secondary prevention measures. The actual test used for screening and diagnostic testing is often the same. However, the differentiation is the context and purpose for which the test is conducted. Screening and diagnostic testing are essential components of surveillance systems. Screening is the presumptive identification of an unrecognized disease or health condition in a population by the application of a test, examination, or other procedure. This chapter differentiates between screening and diagnostic testing. It helps the reader calculate sensitivity and specificity rate. The chapter calculates positive predictive value and negative predictive value measures; and differentiates the types of reliability measures.

This chapter discusses the mental health needs of sexual and gender minority (SGM) people. An historical and cultural context as well as the Minority Stress Model provide a framework for understanding the challenges and health disparities SGM people face. Learners are urged to view this content through a lens of strengths and resilience, observing how the SGM community itself has led the changes that have resulted in reductions in stress and mental health sequelae. The chapter reviews the issues and challenges for SGM people across the life span, and presents considerations for the diagnosis and management of mental health disorders including trauma-informed care. It provides a framework in which to understand mental health conditions for SGM people and considerations for the psychiatric-mental health advanced practice registered nurse when providing affirming care and working against stigma and discrimination.

This chapter focuses on the principles that support the fundamental models of psychotherapy. It describes the principles of therapy models, focusing on how the techniques of the therapy are purported to relieve the patient’s distress. Within each model, the chapter explores the implicit or explicit assumptions around the cause of a client’s distress, the rationale for why a method should relieve it, and the techniques used to put the intervention in motion. Psychodynamic therapies cover a range of approaches from the traditional psychoanalytic models to supportive psychotherapy. Recent meta-analysis of manual driven psychodynamic therapies demonstrated equivalence in efficacy of dynamic therapy to established therapies. In contrast to the interpretive psychoanalytic approaches, cognitive interventions seem accessible to even the beginning therapist. The client–therapist relationship is a critical component of cognitive therapy and intentionally structured to build a sense of teamwork.

It is estimated that over 50% of people with mental health disorders and serious mental illness (SMI) also have a co-occurring substance use disorder (SUD). With concerning numbers of co-occurring psychiatric and substance use disorders (CODs), exacerbated by repercussions of the global COVID-19 pandemic, it is imperative that mental health clinicians are aware of an intensifying dual diagnosis epidemic. Knowledge of treatment, barriers, and referral options, integrating facets of mental and medical healthcare with substance abuse recovery, is critical for achieving sustainable results with this client population. Twenty percent of individuals with a severe mental illness will develop a SUD during their lifetime. Estimates are that only 7.4% of these individuals receive treatment for both disorders, and 55% receive no treatment at all. This chapter discusses factors in the development of SUDs and CODs, epidemiology, theory of addiction, diagnosis, levels of care, clinical manifestations, and diagnostic criteria.