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Randolf Rasch, the dean of MSU’s College of Nursing, is glad that the current health care debate — ugly as it has been — is shining a light on many issues close to his heart, including mental health.
“We’re going through crazy stuff, but our elected officials realize they’ve got to do something that benefits the health of Americans,” Rasch said. “It’s heartening to hear people from different sides of the spectrum talking about mental health.”
On top of the growing number of patients whose primary need is for mental health care, there is a mental health side to nearly every diagnosis, especially chronic ones that call for wrenching lifestyle changes.
When Rasch, a family nurse practitioner, came to East Lansing in 2015, mental health was one of his top priorities.
“Almost any patient you see has behavioral mental health issues,” Rasch said. “They can be simple or very complex, the equivalent of a common cold all the way up to a serious problem.”
But the waiting time to see a psychiatric-mental health nurse practitioner, psychologist or psychiatrist can be as much as two months.
“We don’t have enough providers in mental health and that’s a huge problem,” Rasch said.
At about the same time, Rasch took the reins at MSU, Tom Mee, CEO of Mc- Laren Greater Lansing, was thinking about an endowment for MSU’s nursing school.
Last fall, McLaren took the plunge and made a $1.5 million gift to MSU’s College of Nursing to establish an endowed chair for behavioral mental health nursing education.
“He saw the great need for improving mental health outcomes at McLaren and saw this as a way of doing that,” Rasch said.
Mee said the endowment is “a commitment to work together to break down the single greatest barrier to mental health care services — access to providers.”
Rasch said the main goal of the endowment is to improve mental health patient outcomes at McLaren, but also to train registered nurses at the bachelor’s level and more advanced stages of training, such as clinical specialists, to help patients of all kinds who have behavioral mental health issues.
Rasch has a soft spot for Mee, and not just because of the generous endowment—the second largest gift ever given to the nursing college. Mee, also, is a registered nurse and proudly wears his nurse tag at work along with his CEO badge.
The endowment will boost a “gown and gown” partnership between McLaren and MSU that already folds learning and research into practice.
“The advantage of doing it with Mc- Laren is that when students go there for practice, they’re in an institution that is emphasizing mental health,” Rasch said.
Nurses have a wider range of skills than many people think.
“Often the public has a restricted idea of what nurses do, like passing medications and putting people in a bedpan,” Rasch said.
In most states, advanced nurses can do some diagnoses and prescribe medications for conditions such as diabetes or upper respiratory infections and track those patients.
However, Rasch considers every skill in which nurses are trained, from emptying bedpans to making diagnoses, as a means to an end.
“The goal isn’t to prescribe, or to do those technical skills,” he said. “It is to be with patients and families, to figure out who they are and how to adapt what they need to how they live.”
Mental health is an integral part of that job, no matter what the outward condition might be.
“If someone is being treated for a chronic disease like diabetes, it can be depressing,” Rasch said. “What nursing is about is about making sure you address the needs of the whole person.”
When treating a condition that requires lifestyle changes, as treating diabetes does, nurses trained in behavioral mental health meet people where they are.
“What we eat is quality of life,” Rasch said. “If you tell me I can’t eat what I normally eat, I’m not likely to follow it. If you tell how to eat what I normally eat and make it more healthy, you have greater success and a better outcome.”
The ties between mental and physical health are perhaps most obvious in one of society’s deadliest scourges, substance abuse.
Rasch approaches the problem with the compassion of a lifelong nurse practitioner. “We need to remember that most people who are abusing drugs or other substances are not getting adequate care for their behavioral and mental heath needs and they are self-medicating,” he said.
When Rasch’s students refer to a patient as a “drug-seeker,” he asks the student to think a little harder.“I think it’s important how we talk about these things,” he said.
Behavioral mental health specialists have long known that the obvious solution to the problem — cutting off the supply of the substance being abused — usually drives the patient to another source.
“The real care they need should address the underlying problem,” Rasch said. “We want to collaborate with the nurses at McLaren to increase everybody’s ability to recognize when there is a problem and figure out how to get those patients to the care that they need.”
It hasn’t escaped Rasch’s notice that many people have finally come around to supporting treatment, rather than mass incarceration, for substance abusers. Only when the drug of choice became opioids and heroin, and the people affected lived outside the big cities—and had lighter skin color.
“Yeah, but you know — whatever it takes for people to wake up and smell the coffee,” he said. “People are beginning to recognize that problems they normally associate with certain minority groups cross socio-economic status.
More people realize they know someone personally who has these issues.”
Rasch takes the ugly side of the health care debate philosophically, as a symptom of beneficial growing pains in society. The long view reflects his religious background. He planned to go to medical school but went into nursing at Andrews University in Berrien Springs, Michigan. He loved his time at the evangelical Christian college.
“It was one of the best decisions of my life,” he said.
He thinks the current epidemic of mental health problems, including substance abuse, are making a lot of people get religion — literally — and find the taproots of compassion that underlie the turbulence above ground.
“I can’t think of a religion, or a social practice like humanism or whatever, where the foundation isn’t concern about your fellow human beings,” he said.