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NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

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    NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

    Student Name

    Capella University

    NURS-FPX 6026 Biopsychosocial Concepts for Advanced Nursing Practice 2

    Prof. Name

    Date

    Analysis of Position Papers for Vulnerable Population

    Adolescent depression is a major public health concern due to its significant impact on academic performance, social interactions, and an increased risk of suicide. Addressing this issue requires a comprehensive, evidence-based, and patient-centered approach that leverages the expertise of an interprofessional team and ensures the effective use of available resources. This assessment presents a position with regard to health outcomes for depression in adolescents, explicates the role of the interprofessional team, evaluates supporting and contrary evidence, and identifies knowledge gaps and areas of uncertainty.

    Position on Health Outcomes for Depression in Adolescents

    Depression remains a significant mental health challenge within the adolescent population, with evidence suggesting a rising prevalence in recent years (Keyes et al., 2019). The consequences of depression can be severe, leading to poorer academic performance, impaired social relationships, and a heightened risk of suicide. Based on the latest research, our position emphasizes that depression among adolescents is treatable, with early identification and appropriate intervention improving health outcomes significantly (Stein et al., 2022). This viewpoint underscores the vital importance of preventative measures and early intervention in mental healthcare.

    Assumptions of the Plan

    The proposed plan for the early detection and prompt treatment of depression among adolescents relies on several key assumptions. Firstly, there is the assumption of availability and accessibility of mental health resources. This premise is based on efforts in recent years to increase mental health service provision and accessibility, particularly for young people (Fuhr et al., 2020).

    Secondly, there is an assumption about the ability of stakeholders (such as mental health professionals, educators, parents, and adolescents themselves) to identify early signs of depression. This assumption aligns with recent findings that show the importance of early identification for successful depression intervention (De Los Reyes et al., 2022).

    The final assumption centers around the creation of a supportive environment, one that encourages adolescents to seek help without fear of stigma or judgment. Research indicates that societal stigma and self-stigma can significantly deter young people from accessing mental health services (Harvey & White, 2023). Therefore, it is crucial that efforts are made to foster an environment that destigmatizes mental health and encourages open dialogue and help-seeking behavior.

    Role of the Interprofessional Team in Managing Adolescent Depression

    Interprofessional collaboration has been widely recognized as a crucial element in managing depression among adolescents. This team-oriented approach is advantageous in several respects. Firstly, i/t facilitates the early detection of depression symptoms (Stein et al., 2022). Early identification can be enabled through various professionals including teachers, school counselors, and primary care physicians who interact with adolescents regularly and can therefore spot changes in behaviors which are indicative of potential mental health issues.

    Secondly, an interprofessional team provides timely, coordinated, and comprehensive care. Psychiatrists and psychologists often lead the diagnosis and treatment planning, working in tandem with nurses and social workers to ensure the delivery of these plans (De Los Reyes et al., 2022). Additionally, recent research suggests that coordinated and collaborative provision of care by healthcare professionals can assist in improving health outcomes for adolescents (Harvey & White, 2023).

    Thirdly, the team offers various therapeutic options for adolescents suffering from depression, including counseling, psychotherapy, and pharmacological treatments. These professionals cater to the diverse needs of adolescents, providing tailored interventions that are best suited to individual circumstances (Fuhr et al., 2020). Lastly, the interprofessional team plays a critical role in educating adolescents, their families, and communities about depression. This education helps in reducing stigma and promoting early help-seeking behavior (Harvey & White, 2023).

    Challenges in Interprofessional Collaboration

    Despite its significant benefits, interprofessional collaboration also faces several challenges. Stigma related to mental health remains a substantial barrier to care access and can affect the interprofessional team’s effectiveness. The team might also struggle with resource constraints, particularly in regions where mental health services are limited (Harvey & White, 2023; Slater et al., 2023). Inadequate training in mental health among some professionals can hinder accurate identification and appropriate referral of adolescents with depression. Furthermore, effective coordination and collaboration across different professional groups can be challenging, especially in settings with poor communication infrastructure or disparate healthcare systems (De Los Reyes et al., 2022). Addressing these barriers will be crucial in optimizing the impact of interprofessional teams in managing adolescent depression.

    Evaluation of Supporting Evidence and Identification of Knowledge Gaps

    The body of evidence that supports a team-based approach to improve outcomes in adolescent depression is expansive. A comprehensive review of recent literature would support our approach. For instance, studies consistently demonstrate the efficacy of psychotherapy, especially cognitive-behavioral therapy and interpersonal therapy, in treating adolescent depression (Do et al., 2021). Furthermore, systematic reviews and meta-analyses have suggested the effectiveness of pharmacological interventions, particularly selective serotonin reuptake inhibitors (SSRIs), in conjunction with psychotherapy (Cooper et al., 2019).

    The value of collaborative care models in treating adolescent depression is also strongly supported by research. These models, which involve primary care providers, mental health specialists, and often case managers, have been found to significantly improve depressive symptoms, functioning, and quality of life in adolescents (Do et al., 2021). The data supporting early detection and intervention in the treatment of depression among adolescents is critical. Several studies show that early identification and treatment can lead to better health outcomes and perhaps avoid the escalation of depression symptoms. School-based mental health programmes, in particular, have demonstrated potential in promoting early detection, allowing for timely treatments (McGorry et al., 2022).

    NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

    Despite this supporting evidence, several knowledge gaps and unanswered questions persist. One significant area is the role of social determinants of health in adolescent depression. While research has established links between socioeconomic status and mental health outcomes, the exact pathways remain unclear and warrant further investigation (Fuhr et al., 2020). Moreover, the optimal strategies and tools for early identification of depression in adolescents remain underexplored. There is a need for validated and easy-to-use screening tools that can be used in diverse settings (schools, primary care clinics) to facilitate early detection (McGorry et al., 2022).

    Additionally, questions about the long-term effectiveness and safety of pharmacological treatments for adolescents remain. While SSRIs are generally considered safe, the long-term impact, especially in relation to physical development and potential dependency, is less clear (Cooper et al., 2019). While strategies for improving accessibility and reducing disparities in mental health care exist, their effectiveness in diverse cultural and socioeconomic contexts is an area of ongoing research. This information gap highlights the need for further studies on culturally sensitive and context-specific interventions for adolescent depression.

    Evaluation of Contrary Evidence and Response to Conflicting Data

    There exist positions and data that contravene our approach to adolescent depression management. Notably, some critics of the use of pharmacological treatments in adolescent’s point to potential side effects such as increased suicidal ideation, especially in the initial phases of treatment with SSRIs (Cooper et al., 2019). Others have voiced concerns about the potential for overdiagnosis and overmedication, arguing that the use of antidepressants may be prescribed in lieu of non-pharmacological interventions (Stein et al., 2022).

    There are also contrary views regarding the focus on early identification of depression in adolescents. Some argue that this could lead to overdiagnosis and overtreatment, with adolescents being labeled and medicated for transient emotional states or normal developmental transitions. Others raise questions about the benefits of early identification, contending that it might not always lead to better outcomes due to complexities such as the lack of resources or the difficulty of engaging adolescents in treatment (Beirão et al., 2020).

    Engagement with these contrary views is essential. It is crucial to underscore the importance of personalized treatment plans, which consider the unique needs, circumstances, and preferences of each adolescent. Personalized treatment plans are backed by evidence suggesting that patient-centered care contributes to improved health outcomes (Bierman et al., 2023). It is not a one-size-fits-all approach, and the decision to use pharmacological treatments should always involve careful consideration and discussion with the patient and their caregivers.

    NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

    Moreover, when pharmacological treatments are deemed necessary, rigorous follow-up and monitoring are crucial. The American Academy of Child and Adolescent Psychiatry guidelines (AACAP) recommend weekly monitoring for the first four weeks of treatment, with continued regular follow-ups. This serves to mitigate potential side effects and ensures any adverse reactions are quickly addressed (Harris et al., 2023). In addressing the reservations about early detection, it can be underscored that a wealth of evidence supports its advantages. Research findings suggest that swift recognition and appropriate intervention can avert the intensification of depressive symptoms, consequently leading to more favorable health outcomes in adolescents (McGorry et al., 2022).

    Concurrently, the legitimate worries about overdiagnosis and excessive treatment should be acknowledged, concurring that cautious, standardized screening processes and prudent application of diagnostic classifications are necessary to sidestep these potential complications (Beirão et al., 2020). Furthermore, contrary views highlight the potential ineffectiveness of some interventions due to lack of adolescent engagement. Evidence-based strategies, such as shared decision-making and motivational interviewing, can be utilized to foster engagement (Bierman et al., 2023). Adolescents should be involved in the decision-making about their treatment to ensure their concerns are heard, and their preferences are respected. This approach has been demonstrated to improve treatment adherence and health outcomes (Cooper et al., 2019). 

    Conclusion

    In conclusion, the management of adolescent depression is a complex but critical task that demands the coordinated efforts of an interprofessional team. We have presented our position and detailed the roles of this team in facilitating improvements for this target population. This is underpinned by a robust evaluation of evidence supporting our approach, as well as an impartial response to contrary evidence and positions. We have also identified knowledge gaps and areas of uncertainty, recognizing that our understanding and management strategies for adolescent depression must continually evolve as new evidence emerges. It is our belief that this comprehensive and balanced approach will lead to improved health outcomes for adolescents suffering from depression and contribute positively to their overall well-being.

    References

    Beirão, D., Monte, H., Amaral, M., Longras, A., Matos, C., & Villas-Boas, F. (2020). Depression in adolescence: A review. Middle East Current Psychiatry, 27(1). https://doi.org/10.1186/s43045-020-00050-z 

    Bierman, A. S., Burke, B. T., Comfort, L. N., Gerstein, M., Mueller, N. M., & Umscheid, C. A. (2023). From precision medicine to precision care: Choosing and using precision medicine in the context of multimorbidity. Cambridge Prisms: Precision Medicine, 1. https://doi.org/10.1017/pcm.2023.8 

    Cooper, M. C., Kilvert, H. S., Hodgkins, P., Roskell, N. S., & Eldar-Lissai, A. (2019). Using matching-adjusted indirect comparisons and network meta-analyses to compare efficacy of brexanolone injection with selective serotonin reuptake inhibitors for treating postpartum depression. CNS Drugs, 33(10), 1039–1052. https://doi.org/10.1007/s40263-019-00672-w 

    De Los Reyes, A., Talbott, E., Power, T. J., Michel, J. J., Cook, C. R., Racz, S. J., & Fitzpatrick, O. (2022). The needs-to-goals gap: How informant discrepancies in youth mental health assessments impact service delivery. Clinical Psychology Review, 92, 102114. https://doi.org/10.1016/j.cpr.2021.102114 

    NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

    Do, R., Lee, S., Kim, J.-S., Cho, M., Shin, H., Jang, M., & Shin, M.-S. (2021). Effectiveness and dissemination of computer-based cognitive behavioral therapy for depressed adolescents: Effective and accessible to whom? Journal of Affective Disorders, 282, 885–893. https://doi.org/10.1016/j.jad.2020.12.177 

    Fuhr, D. C., Acarturk, C., Sijbrandij, M., Brown, F. L., Jordans, M. J. D., Woodward, A., McGrath, M., Sondorp, E., Ventevogel, P., Ikkursun, Z., El Chammay, R., Cuijpers, P., & Roberts, B. (2020). Planning the scale up of brief psychological interventions using theory of change. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-05677-6 

    Harris, K., Amanda Aguila Gonzalez, Vuong, N., Singh, N., Brown, R., & Susanna Ciccolari Micaldi. (2023). Expert team in your back pocket: Recommendations from a pediatric mental health access program. Clinical Pediatrics, 000992282311541-000992282311541. https://doi.org/10.1177/00099228231154122 

    Harvey, L. J., & White, F. A. (2023). Emotion self‐stigma as a unique predictor of help‐seeking intentions: A comparative analysis of early adolescents and young adults. Psychology and Psychotherapy: Theory, Research and Practice. https://doi.org/10.1111/papt.12467 

    Keyes, K. M., Gary, D., O’Malley, P. M., Hamilton, A., & Schulenberg, J. (2019). Recent increases in depressive symptoms among US adolescents: Trends from 1991 to 2018. Social Psychiatry and Psychiatric Epidemiology, 54(8). https://doi.org/10.1007/s00127-019-01697-8 

    NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

    McGorry, P. D., Mei, C., Chanen, A., Hodges, C., Alvarez‐Jimenez, M., & Killackey, E. (2022). Designing and scaling up integrated youth mental health care. World Psychiatry, 21(1), 61–76. https://doi.org/10.1002/wps.20938 

    Slater, T. M., Rodney, T., & Finnell, D. S. (2023). Promoting the integration of peer support specialists into the healthcare team. Nursing, 53(2), 50–55. https://doi.org/10.1097/01.nurse.0000903972.32588.ad Stein, D. J., Shoptaw, S. J., Vigo, D. V., Lund, C., Cuijpers, P., Bantjes, J., Sartorius, N., & Maj, M. (2022). Psychiatric diagnosis and treatment in the 21st century: Paradigm shifts versus incremental integration. World Psychiatry, 21(3), 393–414. https://doi.org/10.1002/wps.20998