Improving the Access to Psych Care Options

–Laura El

Welcome

A psychiatric-mental health NP (PMHNP) is a nurse practitioner’s certification that specializes in mental health and promotes advanced psychiatric care and management. I personally created PMHealth NP hub to advocate for accessible mental health care and provide free resources. Content is intended for clinicians, professional students/facilities specializing in psych, and others providing psych care or similar interests, please read the disclaimer or find standard resources.

Jan.-February 2026: Happy New Year! Forgive me for all the inconsistencies here. We’re just living in crazy times. My December was rough mainly with work and the state of the country. I was going to do a post about THC going into a schedule 3 category but our president is truly a loose cannon. It’s still illegal, but the DEA can’t make a decision as well as the CDC, FDA, FBI, anything with letters in government is a lost cause … No one knows when the president is mentally coming or going and that issue is reflected everywhere! Including in healthcare, there’s no rhyme or reason. I’m angry, sad, confused, disappointed about our entire system in this country.

My latest post somewhat summarizes how I feel about everything and some people may not agree with my attitude, but I’m at a point in my life that mental health care and care in general is limbo and won’t get better. People can barely afford a place to live let alone mental health services… many of my patients are apologizing to me because they can’t afford the fees and at the same time they have to contemplate groceries. Even when people are stealing at stores, abusing food stamps, or taking advantage of welfare, I DON’T CARE -people have nowhere to turn for help. I just believe most people who are abusing the system simply reflects how much this country has failed us.

The banks, government, insurance companies, corporations, etc. has stolen more from us more than anybody else. If you’re mad at civilians breaking the law, please get more upset at your government and focus on how they are possibly sending us to more wars and giving billions to everyone else while you suffer or your family suffer more… I almost feel like they want the population to fight each other to continue to have control over us and to avoid arresting anyone on the Eps. Island.

Now the president is taking over Venezuela, he’s making threats again towards Greenland, Cuba, Iran, probably China and Canada and maybe he’ll eventually fly to the moon and start threatening Mars or build a resort there. And I actually agree with all of this, just let him keep running around! It’s how he did his most of his businesses…he just ran them into the ground, filed bankruptcy, and went back to doing whatever… (ok I’m trying to restrain my bad words here), but anyway maybe if this country is in bankruptcy, something will be affordable again. Thank you for attending my Ted Talk. We got 3 more years of this. Take care of yourselves out there, we have no leadership at the moment. Pay no attention to the emperor. Let him build his ballroom. Therefore, you can invest in yourself, keep doing what you can, and hang in there!

Oct-Nov. 2025: I believe America is in a DEPRESSION or headed towards a major economical crash. People cannot afford housing, food, education, transportation, healthcare, families, etc. I’ve mentioned before this website is trying to be future-oriented but mainly on SOLUTIONS, even if our government/healthcare is falling apart. But it’s another thing to have a platform and complain and I want that to stop (yes telling myself this out loud). Effective immediately, start looking at your influence in a more positive way to help others. People call it toxic positivity, but complaining will cause more suffering and it usually gets drowned out as nagging. Don’t invalidate or dismiss the concerns but rather use the energy to prioritize and be a part of the solution, not the problems.. and ultimately start trying to support local businesses and nonprofits or create one (a solution). It’s going to be a rough next couple of years! So I just plan on ranting more often on here. Continue to tolerate me and trying to keep up with the times, it’s not easy for me as well, but you’re not alone! We will get through this together. 🍂Happy Fall!🍂

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Sept-Oct. 2025: Hi, I really don’t have free time but here I am! I wanted to quickly say that you’re not alone feeling completely overwhelmed and horrified about what’s happening in America, let alone with healthcare. One way I manage is just rambling here and it’s about to happen again… When President Trump was in office the first time, I wrote my rants here/prior to Chat GPT and yes Grammarly tried to help but it was still rough! Because the pandemic was stressful so the posts appear manic anyway moving forward, I wanted to write more posts with AI but it really doesn’t capture the essence of my feelings or anything for that matter, it’s just generic slop -but I digress because it helps it some circumstances like going over these upcoming changes in policies and laws… Therefore, I think (I’m just testing the waters here) that a combination of both can be a powerful impact and clarifying what’s Chat CPT vs. my words/reality is more powerful than using 100% Chat GPT. It’s also refreshing to read or listen to something human, I can’t take it even on YouTube or other outlets using AI and maybe in some way, this can give some pushback. In human services, we need humans, AI cannot do everything.

I don’t use it in patient care or charting but I’m reading how more providers are using it. At my job Chat GPT and other AI websites are banned and now more states are banning it…  I guess it’s to avoid putting private information in there, etc. but at my job I also don’t have access to Google Drive or any Cloud services…. They want me to use WORD/One Cloud so I write notes there but I hate it (most features are behind a pay wall) so this is difficult when you have a full caseload but I still manage, however, MANY providers don’t…I try to complete everything that day, which I do even with >15 patients…but I have a PA friend who works outpatient and usually has >30 notes with intakes and it’s just sad, it takes HOURS for her to finish charting. When I worked the emergency department at >100 patients a day, I’ve never took work home but as a provider it’s almost mandatory and clear that providers need more help, I just don’t see it coming!

The point I’m trying to make is people are relying on cloud/AI services, which may get more banned… It’s already banned in colleges/schools and more places… Therefore, more work is occurring on the computer versus with patients, so NOT to take care of yourself or loved ones…  and there are laws/policies that are in motion that the most average person 🙋‍♀️ don’t know about that is also going to make services more difficult. Mainly because you have to rely on yourself and not these new technologies despite them being $$$$… I’m also worried if insurances are going to stop coverages because people are using AI tools since the payouts are getting lower.. I’m not sure but this is the hell hole providers/people are living in! The healthcare system wants us to use AI or take away supportive HUMAN help, but at the same time AI is getting banned and it goes back to putting MORE responsibilities on the provider, hence the burnout is real and serious. Lastly, I’m starting another section about these laws and policies and how to manage this in private practice or in general. Therefore, you’ll see more crazy posts but thank you for understanding and attending to this important matter.

July-August 2025: Howdy! Time is flying and healthcare is not changing for the better. I always felt like long as you care for the health and education of the society, it should be better. Nope! Our politicians and government officials just gave up and instead of a country rewarding good behavior or anything good, it’s like we’re being punish with more taxes and restrictions. It can be discouraging, however, do not go extreme. People are angry and want to start a revolution and I get it, but don’t! I tell my patients and peers be careful what you’re posting, avoid rubber bullets, don’t make threats, stay out of trouble … keep working to have your freedoms and move strategically not emotionally. You don’t want to damage your name, career, business, or get targeted/harass and catch cases. You’re not useful behind bars.

This is the time to show how being rational and reasonable is the only way to be sustainable. If you can’t control your emotions, yes seek help. I have patients that are in the health/psych field because if you can’t help yourself, you can’t help others ⚠️Yes it’s been busy for me and instead of having breaks, many of my patients/people/life is in crisis mode. Medications can only do so much, look at the Commander in Chief. If the President is basically out of control, then so is our country. I’m giving my patients food, sometimes for themselves and for the foodbanks, some are homeless, losing jobs/insurance, undocumented, I’m doing free sessions or wellness checks. I’ve done this before while working in emergency and in community mental health…but this is private practice! yes it’s heartbreaking, but familiar grounds. In general, try to do the best you can, but don’t try to solve every problem. Focus on the priorities.

I saw some posts on Facebook about changing the charges/costs for services in general vs. free but I try to keep charges as simple and as low as possible for the patients… that’s one of the reasons I went into private practice… to have more profits I was going to sell products, but currently I’m okay to NOT add more stress… Therefore, I’m hoping to have some free time to make posts! I was going to start more of a lifestyle approach, but since crazier times are happening in this country, I can focus more on the politics/business/financial side of psych care…

I’m happy that more states are considering full-practice for NPs and hopefully the trend keeps going (POSSIBLY IN THIS CENTURY) … Some people believe it’s oversaturated and how insurance companies are not accepting new providers, which is problematic but again there’s still many other ways to work, function, advocate, create a niche, etc. Nothing is easy for anyone at this time so I’m grateful to just have a job, but if you love what you do or a certain population/area, focus on that… whether it’s in psych or another career path. Okay hopefully I can posts more sooner, thanks and be easy on yourself!

May-June 2025: Happy Mothers Day and Mental Health Month, which should probably be every month! Thank you also for your advocacy for telehealth, per DEA things are postponed till Dec. 2025 to reevaluate the plans to be more restrictive. Even if this website wasn’t a factor, I try to  promote the importance of making your voice heard, doing surveys, sending emails, showing up to local meetings, etc. to make some kind of difference.. Besides I can’t work, yell at insurance companies, do notes, and then march to Washington DC so I try to get people to keep caring about the country… and more bills are being pass for to allow more full practice of NPs so someone is paying attention but these things still take years and decades to make a difference. It’s been so busy for me, I usually just avoid talking about politics because I have so little understanding about what’s going on and what’s real so how have I’ve been handling everything? I water my garden. Anytime I’m stress, irritated, or worried about nuclear wars, I just go to my yard and water plants. It seems like I’m slowly identifying with animals and trees. I’m working almost everyday but know how necessary and important psych care is, especially now… it’s not over-saturated, we’re still battling to simply be acknowledge… many facilities, government agencies, law officials, and people in general still don’t recognize our profession.. and things take forever to see real changes due to the lack of help and access… and I’ve been so busy, it’s amazing how time flies..  thanks for bearing with me… in addition to all this, I don’t complain and still very much love helping people so it’s not all doom and gloom. I still make sure to take care of myself and my plants… I wrote a lot of complementary health, and still plan to make some posts about lifestyle changes/other alternative medicine. Don’t limit yourself to just the conventional and the regular jobs use this time to think outside the box and continue to take care of yourselves! Hope to have some more posts up soon 🙂

Feb.-March 2025: Are you still hanging in there? Great! Please 🛑Comment Here🛑to oppose the DEA trying to put more restrictions on prescribers and tell them about the lack of access for health services before March 18, 2025.

I get the DEA concerns, but this will affect millions -many patients can’t drive, special needs, elderly, live in rural areas, etc. and people who went years without help, are finally able to receive some form of treatment. I also don’t see many people heading into the psych profession and I don’t blame them. Most people are barely taking care of themselves let alone others and getting pushed to the limits everyday.

I try to avoid politics because it’s a trigger, but unfortunately the government wants more control. Why isn’t this okay? Because look at all the useless spending, our economy, the cost of living, taxes, lack of resources, everything is bloated and already restrictive to just live a basic rough life.

Our government usually makes everything worse and our agencies aren’t making anything better and overall everything is really just profit-driven. I wish they cared, but how is that possible when they primarily listen to the 1% or the shareholders.

They’re not even listening to the doctors and yet, the government is supposed to have our best interest?? Well I mention this because the DEA (Drug Enforcement Administration) is not different. I’ve had to go through so much just to get a license in another state, despite not even prescribing scheduled medications. I gave up trying in another state, the whole west coast is restrictive, I have more hope in Mt. Rainer erupting than for things to get better.  

There’s no one to contact, numbers disconnected, hung up on… thankfully I’ve saved an email, I think they finally responded out of pity. I had to find a collaborative physician, spending HUNDREDS, despite not prescribing schedules… This had to occur to be panel with insurance and everyone knows insurance is another scam… anyway I didn’t plan to see people in another state, but it’s so dire that people are just desperate and found me in other ways.

I honestly can’t count more than 3 psychiatrists in general in my state so I understand the pain. Let’s do some rough statistics… without researching, have you ever noticed that the worst crimes are from the states that are the MOST restrictive for nurse practitioners? Unfortunately as smart and as great doctors are, they can’t keep up with the demand…. and good luck finding one! Meanwhile, more people and families are becoming more hopeless by the day.

On a good note, I did 3 posts today! I have a lot more to say but overall I’m doing super great and happy. I had plans to post more but my younger siblings decided to visit me to play videogames this week. This was not my choice, but I try to be nice. Yup, if you ever want to learn how to not care, study the youth! It can be a war on the horizon, market crashes, UFOs and they just have no thoughts about any of it but give them HOPE. I told one of my younger patients that despite what’s going on in our country, there are still adults out here that care and she got emotional. Then it dawn on me that if you think you’re struggling imagine the youth trying to figure everything out so they’re coping the best they can. Sometimes all you have to do is listen, so don’t be hard on yourselves or rush anything. Try to take it easy and stay focused🌻

🛑Post Your Comment to the DEA Before March 18th!🛑

January-Feb. 2025: Welcome and Happy Winter. Sorry for the delays, I got bombarded over the holidays, cooking, running around, praying no one ends up in jail. I honestly thank everyone for being patient with me. It wasn’t my plans to keep the website off for that long and still making changes, but to make a long story short -I have international populations and had to rewrite a lot to make things easier to understand because yes I want psych care to be global so I can live on a beach… and apparently I wrote a lot on this website so it’ll take me awhile to rewrite stuff…and looking back at what and how I was writing I’m overall ashamed. I probably should’ve been medicated during the pandemic but, here I am! Moving forward, I will try to make the website more professional because the American healthcare system is getting worse… however, with regards to the website -it’ll be more lifestyle or practical related to mental health… some areas will have AI to make it straightforward, but with the blog -I can continue to ramble because that’s what make this website special! And there are millions of other normal websites, this will not be one of them.  Another reason why I needed to start writing again is because having my own practice, I feel the need to warn providers to just not do it or be careful. I’m trying to nice, but having a business is not ideal for the majority of people…including myself. I was so close to just starting another business away from healthcare and to make desserts, but then my family reminded me that the general population is no different from the psych patients. So I’m stuck, but still happy and going strong. Thanks again for all the love✨

Sept/Oct. 2024: Yayyy! My baby is back up and running. I was going to put a post up and was shocked to see the site deleted. Thank goodness my urges and determination outweighs the rest of my craziness and was able to get it back.. Speaking of crazy, I’m currently doing my private practice and working at another one, mentoring, trying to start another business, and THIS website. So forgive me the absence and not being able to respond to emails, but the good news is that I’m back with a vengeance and I have MUCH to say about everything so if something happens to the website… I’ll just start another one llol.. I have major posts/update plans for October. Thank you for your patience! Hopefully, everyone is doing well…I’ve been great despite our mental health care system getting worse, which is why I won’t stop babbling or writing… not to mention how the access to care IS disappearing or being ignored. Continue to make sure you’re taking care of yourselves as well! I brace people for how times will get worse and to stay grounded/focused… Eventually, the website will discuss more lifestyle issues such as the dreaded taxes and finances… and not just healthcare. Alright, be back soon! 🍂🍂Happy Fall🍂🍂  

March 2024: I’m still in the universe. I know it’s been a roller coaster for everyone and WOW with everything that’s going on! In addition to starting my practice, I’m already ready to retire lol I’m still building a caseload, slowly but surely because being selective with everything is important… I do plan on doing a post about the whole process while having some form of inner peace. In the meantime, I’m trying to get through taxes lol… I also wanted to focus part of the website on lifestyle topics, especially with finances and I’m hoping to start content/updates again by the summer/fall when things level out a little more! Like I don’t need or want any more curve balls okay take care of yourselves as well :)) 

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