Dear Colleagues, 

We are pleased to share this special issue with you focused on mental health. Together, the authors of these articles provide up-to-date, evidence-based information on mental health issues and conditions that affect quality of life for our patients across the adult lifespan

In these pages, readers can learn about providing trauma-informed care as a regular part of primary care practice. The author describes strategies to promote recovery, well-being, and resilience as the overarching goal in care for trauma survivors. As well, readers have the opportunity to learn about eating disorders in middle-aged and older women, a mental health condition often considered to occur only in adolescents and young adults. The author addresses associated factors, identification, potential complications, and resources for the management of disordered eating in midlife and older women. Another author describes the prevalence, risk factors, and symptoms of perinatal anxiety disorders. The article’s focus is on early diagnosis and management to optimize healthy outcomes for pregnant and postpartum women and their infants. Readers also are provided with an update on current screening recommendations for postpartum depression. The author includes information on both nonpharmacologic and pharmacologic interventions as well as strategies for prevention. Rounding out all of this current information on women’s mental health is a review of mental health screening recommendations for women age 50 and older from the Women’s Preventive Services Initiative. Recommendations described include screening for unhealthy alcohol use, anxiety, depression, substance use, and intimate partner violence.

Planning for this special issue began just prior to the start of the Covid-19 pandemic. As it continued, we decided it was important to include some perspectives on how the pandemic is affecting nurse practitioners and nurse practitioner students in the form of two commentaries. In one commentary, the author reflects on the emotional and mental health of providers during this challenging time and the importance of workplace mental health strategies and social and emotional support systems. In the other commentary, the authors take readers along on the journey of a women’s health nurse practitioner student in the final semester of her program and into graduation. Covid-19 changed how course work and clinical hours were completed, jeopardized potential job opportunities, and added stress to everyday work and family life. This new graduate and her professor share lessons learned.

Concurrent with planning and developing this journal issue focused on mental health, we have witnessed the terrible unfolding of repeated, ongoing violence and the unjust treatment of individuals of color in a country where we proclaim that everyone is equal under the law. Recent events have given a louder voice to this untruth and the need for systemic change to end racism in all aspects of our society. The grave acts we have been witnessing are not new nor are the calls for action asserting that Black Lives Matter. But as these violent incidents have become more alarmingly visible, the drive toward meaningful change has become increasingly urgent. 

As nurse practitioners, we must make a concerted effort to expand our understanding of how racism negatively affects mental health and the provision of mental health services. Mental health matters to individuals who are affected daily by bias, discrimination, violence, and fear because of their race or ethnicity. It will take a collaborative, long-term effort to end bias, discrimination, and health inequities and disparities, including those involving mental health, that are exacerbated by racism. We must make a firm commitment to being part of the change at provider, health systems, community, and national levels.

Finally, the events occurring in our nation today in all likelihood will cause a rise in the prevalence of mental health conditions. We will see more patients with high levels of stress, depression, anxiety, and substance use. Nurse practitioners providing care for women are in an ideal position to listen well and recognize when help is needed. I hope you find the articles in this special mental health issue useful in your practice as you provide care for women across the lifespan.

Beth Kelsey, EdD, APRN, WHNP-BC, FAANP