Practice Pearls for Optimizing MDD Treatment


Greg Mattingly, MD, and Jeremey Schreiber, MSN, PMHNP-BC, provide their practice pearls for community psychiatrists and psychiatric nurse practitioners who care for patients with major depressive disorder (MDD) to optimize their treatment and management.

Greg Mattingly, MD: Let me just ask you, what pearls do you have for community psychiatrists, community nurse practitioners about optimizing treatment for patients? I'll start with one and I'm going to throw it out there and I'm going to, I'll be a little provocative, maybe. Some clinicians, some older doctors like myself, made a little pushback about nurse practitioners in the field. “You're not a doctor, you didn't go to medical school. Now we're going to let you prescribe medicines?”What's your view of this and how do you kind of overcome maybe some of our own, once again, some of our own habits, some of our own stigma within our own healthcare field, about how we work together as a team, a group of people across mental healthcare, trying to promote brain health within the United States?

Jeremy Schreiber, MSN, PMHNP-BC: I think that's a great question. It's a 2-part thing. I think as NPs, as an NP myself, I try to be the best that I can be. I stay current on the research. I stay current on the literature. I evaluate what's coming down the pipe, so to speak. I'm always on top of everything and I try to make sure that I represent NPs well. I try to always make sure I do that with my own education and so forth. I think NPs across the country should do the same thing. We should be looking to further our education and so forth. At the same time, I think we should have a good relationship with the other members of the treatment team. In terms of relationship with psychiatrists, absolutely, just like relationships with case managers, with counselors, with therapists, with the front office staff. After all, what we're all trying to do is work together as a team to get our patients well. I don't know that necessarily the caste system is something that's very beneficial. I've been fortunate enough that I've called you Greg a couple of times today and I didn't hear you say, "Well, Jeremy, it's Dr Mattingly, and don't you say that on camera." That doesn't exist because we're looking at a cultural shift as well where physicians, nurse practitioners, physician associates, we are all working together for the common good of our patient. I think that's a philosophical underpinning that we should all have, develop, and intertwine with.

Greg Mattingly, MD: One hundred percent. It gets back to the treatment team. Who's the most important part of the treatment team?

Jeremy Schreiber, MSN, PMHNP-BC: The patient.

Greg Mattingly, MD: It is the patient. It may be the person who answers the phone when your patient has a question. It may be the person who greets them at a front desk and helps to overcome stigma by greeting with a smile, by welcoming them in, remembering their name, making them feel accepted. It may be the doctor, the nurse, the PA, it may be the therapist who gets to know the whole family. We're all part of the treatment team working together. Let me just say at this point to everyone out there, it's an exciting time to be in mental health. It's an exciting time to be promoting brain health with some of these new treatments on the horizon.Thank you, Jeremy, for this rich and informative discussion. And thank you to our audience for watching this Psychiatric Times® presentation. If you enjoyed the program, please subscribe for our e-newsletters to receive upcoming programs and other great content right into your inbox. Thank you for all of you for joining us. And Jeremy, as always, it was wonderful to work with you. Take care.

Jeremy Schreiber, MSN, PMHNP-BC: Thank you so much, Dr. Mattingly.


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