Q and A: Kelsey Holstein, Psych-Mental Health NP

Working as a bedside nurse and seeing patients who couldn’t manage their physical health because of their mental health inspired Kelsey Holstein to return to school. She graduated in 2022 from UC’s Doctor of Nursing Practice in Psych-Mental Health NP program and now works for a private practice, offering mental health services via telehealth to patients in Colorado and Massachusetts.

Here's what Holstein had to say about the psych-mental health specialty, UC’s program and her current role.

I graduated with my Bachelor of Science in Nursing in 2014 and began working as a new graduate nurse at Fairview Hospital, which is associated with the Cleveland Clinic in
Cleveland, Ohio. I worked on a heavily surgical unit taking care of patients before orthopedic and gastrointestinal surgeries. After about a year, I left Ohio for a community hospital bedside nurse job in San Diego, California. There, I worked on a unit focused on illnesses such as uncontrolled diabetes and various infections.

I always had an interest in psychology and psychiatry and considered pursuing the pre-med program during my undergraduate education with the goal of becoming a psychiatrist, but I knew I could work as a nurse practitioner specializing in psychiatry, so I stuck with nursing and obtained a minor in psychology. However, it was really my job as a hospital bedside nurse that solidified my focus on psychiatry, as I often saw that patients were unable to manage their physical health because of undiagnosed or mismanaged mental health issues. It’s hard to learn about and manage diabetes or high blood pressure when there are voices in your head or you’re so depressed you physically can’t get out of bed. We can’t see mental illness — it’s not tangible in the same way that physical illness is — so the perception surrounding mental illness is vastly different. There’s still stigma surrounding mental illness, significant access issues and other barriers. If I can affect even a small number of people or reduce stigma and barriers, my career will be purposeful and meaningful for me.

From the start to the end of my program, I had nothing but great classes and professors. When COVID hit, I didn’t know what to expect (like most of the world), but UC faculty and administrators made sure we were supported as we navigated the pandemic. One of my most influential professors was Dr. Susan Brammer, who chaired my doctoral project. She guided me through my entire project (with many ups and downs) and through my application to present at the American Psychiatric Nurses Association’s annual conference in 2022. Through UC, I learned how to be a high-quality Psych-Mental Health NP and also how to be a nursing leader.

I accepted a telehealth position within a private practice as a Psych-Mental Health NP, serving patients in a variety of areas in Colorado and Massachusetts. There will be a significant degree of diversity in this population, and I’m excited to be challenged in new ways.

As a Psych-Mental Health NP, I assess, diagnose and treat patients with a variety of mental illnesses. As Psych-Mental Health NPs, we can prescribe medication, but when working to improve mental health, medication is only one part of the recovery plan. Some level of therapy or counseling is typically beneficial to most clients. It’s hard to build up coping mechanisms and other stress-reduction tools during times of crisis, so taking the time to learn and grow these skills during the recovery process is important. Another huge aspect of the Psych-Mental Health NP role is psychoeducation. I’m responsible for educating my clients about their diagnoses, as well as various treatment options and the risks/benefits of those options. Some of the long-term responsibilities include advocacy for clients, as well as mental health care as a whole, working to change outdated policies and acting as a mentor for other Psych-Mental Health NPs.

One of the most rewarding aspects is seeing clients move through recovery. In psychiatry, recovery doesn’t mean cure, but more so that symptoms are better managed and the quality of life of the client is improved. Mental health exists on a spectrum, so recovery is a lifelong process with inevitable ups and downs, but ideally the downturns are less severe as the client moves through treatment. It’s also very satisfying to see clients apply what they’ve learned; they get better at identifying triggers as well as coping mechanisms and this helps them develop some autonomy within the recovery process. Some of the challenges include funding and access to mental health care. We need improved access to care and improved funding for programs to reach more people.