Is the nursing profession… healthy?

sYou might say Kristen Choi MS ’18 supported nursing. “I kind of picked it up at the last minute during my last year of high school,” she admits, “because I wanted a job that would combine math and science with meaningful human relationships.”

It worked for her — and for UCLA. Now an assistant professor of nursing and public health, Choi earned her Ph.D. so she can use science to address some of the systemic problems she’s observed in mental health care. Today, in addition to teaching, pursuing her research, and practicing inpatient child psychiatry, she has become a sought-after expert in tackling some of the most vexing problems facing modern health care.

In 2020, she became one of the first nurses ever to appear in Forbes List of “30 under 30 in health care”.

Certainly a great honor. It was especially meaningful because 2020 was a tough year for you nurse. The nurses faced very difficult working conditions during the pandemic and risked their lives to take care of the sick. Many people first realized what nurses did and how important it is to our health care system.

Nurses have certainly been the backbone of getting through this pandemic. Not just for the disease itself, but for the mental health issues that followed.

In the first year, we were so focused on COVID-19 itself that we didn’t think about the secondary effects: pandemic stressors, economic hardship, grief and loss, and social isolation.

led to a better appreciation of nursing. But do you think this is something that will continue after the pandemic, or are people’s memories short-lived?

Good question. One of the most uplifting things about the pandemic for me was seeing that applications to nursing schools and public health programs were off the charts across the country. Many young people now want to work in the field of epidemiology, infectious disease, medicine, public health, or nursing. This is very encouraging – we need their ideas and energy.

How can we make sure that we take care of our nurses?

You and your loved ones are less likely to die or suffer complications in the hospital if the nurses who take care of you are well-rested, don’t work long hours, have few staff and aren’t overburdened with patients. You’re more likely to survive in the hospital when the nurses are provided with the tools they need to care for you. We need to do a better job of getting this message across to healthcare and policy leaders. It is in the public’s best interest that you have a healthy nursing workforce.

In your opinion, what are the biggest problems facing our healthcare system today?

We still have a lot of problems about access and cost. There are many people who cannot get the kinds of health care they need when they need it, and this is especially true in the mental health field. About 1 in 3 Americans live in a designated area with a shortage of mental health providers. Therefore, we end up having a mental health system that only has the ability to manage crises. Even for people who have health insurance, access to mental health care may be limited based on the type of insurance they have. It is often difficult for people with public insurance to access mental health providers and therapists.

What drew you to mental health and psychiatry specifically?

One of them was personal. My family was involved in foster care when I was in high school and college. I was really able to see how damaging trauma can be to children, and how much it affects their mental and emotional health even at a very young age. The other was based solely on clinical trials. I’ve seen that people with mental illness are treated differently. They have been treated with a lot of stigma, judgment and blame. It was one of the first clinics I received as a nursing student in the psychiatry unit. It was clear to me that there are huge gaps in mental health care. So, I was interested in studying childhood trauma and its impact on mental health and how we can better design health care systems to be more responsive.

2020 has been a difficult year for you as a nurse. Nurses risked their lives to take care of patients. Many people first realized how important they are to our healthcare system.

What mental health problems have emerged in the epidemic?

Telehealth has been an important innovation during the pandemic. But while I’m excited to see technology being leveraged in mental health care, the majority of telehealth models I’ve seen are used to increase choices for people who It was Access to care – but not to reach unserved or underserved populations. This is a concern, because we may actually be making disparities in mental health care worse. We need to think about how technology can be leveraged in mental health care from an equity perspective.

What drew you to studying vulnerable groups?

I have seen for myself the way in which marginalized groups of people – including people of color, undocumented people, gay and homeless people and more – are denied access to safe, high-quality, affordable and timely mental health care, over and over again. These inequities have been a source of research direction on how we can improve mental health care so that we close disparities in mental health outcomes.

What other problems might no one talk about?

One problem that we still haven’t adequately addressed is gun injury and violence. About two-thirds of gun-related deaths in our country are suicides. Gun-related suicides increased during COVID-19, as did other forms of gun violence. Another major problem is substance use disorders. Treatment often takes place in a silo. I would also like to see our mental health workforce grow.

Every day we are bombarded with terrible news. What do all these worrying events do to our mental health?

It’s really hard. We live in a challenging time. Stress can make you feel numb about more reports of bad news. We can feel indifferent or powerless to make a difference in the face of big problems that have no easy solution. For people experiencing current events, it is important to seek help.

Do you think there is any reason for optimism?

yes. I think we can get to a better place. I wouldn’t work in this field if I thought it was really hopeless. I’m excited about innovations happening at a local level, and to see less stigma around mental illness in younger generations. I expect nurses to play a big role.

Read more from UCLA Magazine Fall 2022.

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