April 2016
Barbara
Peterson
University of Minnesota School of Nursing
Minneapolis
,
MN
United States

 

 

 

Dr. Peterson's dissertation research focused on the impact of trauma on adolescents and the subsequent nightmares they experience.
I nominated Dr. Barbara Peterson for the DAISY Award of Commitment to the Understanding of Social Determinants in Health and I will address the award criteria below:

Commitment to the Understanding of Social Determinants in Health-
An understanding of the social determinants of health goes beyond the biomedical model of disease. The social determinants of health include, among other factors, class, race, gender, dignity confirming or dignity denying experiences, and a sense of autonomy and effective agency. This award is intended to recognize a faculty member committed to integrating the understanding and redress of these factors through their teaching and/or scholarship.

As a faculty member Dr. Peterson challenges students to recognize, define, and understand the impact of social determinants on an individual's mental health, the delivery of mental health care by psychiatric/mental health nurse practitioners, and the leadership needed by doctorally prepared PMHNPs to improve the mental health of all people. In her role as a PMH advanced practice nurse at Community University Health Care Center (CUHCC), she chooses to work interprofessionally with a clinical team that "wraps around" children and their families to support their resilience in light of poverty, mental illness, and trauma.

Our PMH program received a 3-year HRSA grant in 2013 and one of the major goals was to develop curricular content and clinical experiences for PMHNP, Pharm.D, and OT students to learn about social determinants of health and their impact on mental health. Dr. Peterson challenged faculty and students to think beyond just identifying mental health symptoms, but to think deeper about the impact of social determinants on the daily life of someone who has a mental health problem-to understand the individual's health story by giving space and time to hearing his/her voice.

Dr. Peterson said: "I feel like it's important to challenge students to think beyond the 'problem' that brings the patient into health care systems. It's important that students are grounded in considering the context of the patient's health story. We have taught for many years that health is a state of complete physical, social, and mental well-being and not merely the absence of disease or infirmity. But what does that really mean? How is health determined in the community, where the patient lives, works, raises a family, and interacts with others in his/her community? What are the social, economic, and environmental factors that influence their health status as well as the individual behaviors and biology that impact their health?”

Let me give you an example of how Dr. Peterson brings this personal understanding of the social determinants of health and clinical experience to her teaching. In the first core PMHNP course (N6604). Dr. Peterson created an assignment where the PMHNP students and Pharm.D students watch 2 video vignettes, one of a young boy (J) from an immigrant Hmong family and another of an adult woman (E) with bipolar illness going through cancer. The interprofessional assignment requires that student teams learn about each other as professionals on a health care team, as a team creates mind maps based on the analysis of social determinants of health that have the potential to impact E and J's mental health and the mental health care they receive, and finally design interview questions for a holistic assessment (See attached assignment description.) During this assignment, Dr. Peterson guided the online discussions by asking challenging questions to help students think 'upstream' when considering the impact of culture, family, social support, social exclusion, socioeconomic status, stress and trauma, food insecurity, education, family education, and family stressors. Students share the mind maps with each other for a deeper discussion and understanding of the students' own beliefs and values about mental health. By presenting these mind maps to classmates, the students became both learners and teachers.

Dr. Peterson's dissertation research focused on the impact of trauma on adolescents and the subsequent nightmares they experience. In her clinical practice at CUHCC, Dr. Peterson "walks the talk" about recognizing the impact of trauma on children's mental health as she works with a team to support children and their families who have experienced multiple, complex trauma events. Dr. Peterson says, "My choice of joining the team of providers at CUHCC was very personal for me. I am committed to a population of patients who are underserved, who may not be insured, may be undocumented, may be unable to pay, or for one reason or another are barred from other agencies (sometimes due to inequitably enforcing late and no-show policies). Some of the children I work with are disruptive, loud, unpleasant, disrespectful, bouncy, destructive, angry, and unpredictable. Some of them don't have stable places to live, stable parents to raise them, safe places to play, enough to eat, or clean clothes to wear. Some of them misbehave in school, are violent to peers and teachers, get suspended, and expelled or drop out. I am amazed at their resilience and ability to survive, but I'm also sad by their precarious futures. When I think of all the influences on a child's life, I recognize my influence is somewhat limited. Yet at the same time, I can be really instrumental in helping the kid get through childhood with fewer bumps and bruises (emotionally speaking). I love being part of the CUHCC clinical team that is truly interprofessional in 'wrapping around' kids and their families. The CUHCC team practices and teaches about cultural humility and other social determinants of health because it is woven into the fabric of what we do. Recognizing that most (if not all) of the youth we see at CUHCC have trauma exposure, we have recently been working on a children's mental health initiative to incorporate strategies that target trauma responses in youth, such as Yoga Calm. I love being in a team that has always been trauma-informed at its foundation.”

I am so pleased and honored to have Dr. Barbara Peterson on our PMH NP DNP faculty. As you can see she brings experience, passion, and compassion to her teaching and clinical practice and is committed to integrating the understanding and redress of the social determinants of health in mental health care.