JNP: The Journal for Nurse PractitionersCharacteristics of Youth Treated by Nurses or Nurse Practitioners vs Psychiatrists for Mental Health–Related Visits During 2000-2019

🧠 Mental Health / Behavioral Sensitivity

A pooled analysis of 10,916 outpatient mental health visits among patients ages 12 to 26 found 93.6% involved psychiatrists and 6.4% nurses or NPs. Nurse/NP visits were more concentrated among older transition-age youth and patients with socioeconomic vulnerability, while substantial demographic and regional differences separated the provider groups. The observational analysis used MEPS data from 2000 through 2019 and did not establish that provider type caused differences in access or care patterns.

Clinical Considerations

• Younger patients were substantially less likely to have nurse/NP rather than psychiatrist visits, including ages 12–14 (aOR 0.07; 95% CI, 0.02–0.28).
• Nurse/NP visits were concentrated geographically: 50.07% originated in the Northeast, compared with 25.43% of psychiatrist visits.
• Hispanic and Black patients had lower adjusted odds of nurse/NP visits relative to psychiatrist visits, with aORs of 0.12 and 0.21, respectively.
• Provider identification is an important limitation: MEPS combined nurses and NPs and did not identify NP specialty, including whether clinicians were PMHNPs.
• The dataset ended in 2019, so the findings do not capture postpandemic youth mental health utilization or more recent PMHNP workforce growth.

Practice Applications

• Recognize NPs as part of the mental health care pathway for older and socioeconomically vulnerable young people.
• Interpret regional provider patterns cautiously because workforce distribution and practice environments may influence access.
• Avoid treating provider differences as evidence of comparative quality, effectiveness, or outcomes; those outcomes were not evaluated.
• Consider age, socioeconomic context, and provider availability when assessing mental health referral and continuity barriers for transition-age patients.
• Recognize that newer specialty-identifiable data are needed before extrapolating these 2000–2019 patterns to current practice.