Brian Williams: The solution to Florida’s mental health crisis may already exist

Mental Health Matters AP
Our current mental health crisis requires all hands on deck.

It is no secret that America’s mental health care system is stressed. Increasingly high rates of depression, anxiety and suicidal thoughts make clear that the United States is battling a serious mental health crisis, which is wreaking havoc on families, communities and our already overburdened healthcare system.

Floridians face a challenging mental health landscape. According to Mental Health America, Florida ranks 7th in prevalence of mental illness yet a meager 46th in mental health care access. And 58% of those with a mental illness are not receiving treatment.

Among Florida adults who reported symptoms of anxiety and/or depressive disorder, the most common mental illness, nearly a quarter reported needing counseling or therapy but not receiving it in the past four weeks.

Mental health access across the state has become such a concern that the Florida Legislature approved the largest mental health funding yet earlier this year: $2.5 billion for expanding mental health and substance abuse programs.

Florida mental health patients’ difficult situation is exacerbated by the fact that the state faces a serious shortage of mental healthcare providers. According to the Kaiser Family Foundation’s analysis of U.S. Department of Health & Human Services data, the state needs more than 500 new providers just to meet existing needs. In other words, the health system severely lacks the clinical personnel to serve its sole purpose — caring for people.

As a doctor licensed to practice in Florida, I’ve witnessed firsthand the devastating impact of the lack of mental health access within the state and felt the strain of the system while providing care. Too often, I see patients who are struggling to find the care they need, either waiting months for an appointment with a mental health provider or being sent to the ER at the risk of endangering themselves or others.

But what if additional providers were available and ready to treat more patients without costing the state a single cent?

What if the only thing keeping patients from the care they need is the removal of a simple bureaucratic barrier?

The provider population who stands ready to help are highly trained and educated Psychiatric Mental Health Nurse Practitioners (PMHNPs or psychiatric nurses). They are Advanced Practice Registered Nurses (APRNS) with extra training in mental health and behavioral issues.  Unfortunately, Florida’s current laws and regulations prevent psychiatric nurses from autonomously providing much-needed specialty care to Floridians struggling with mental health challenges.

Oddly, while APRNs practicing autonomously in primary care can provide some mental health care, their mental health specialist colleagues — who have more education and training on the topic — are not permitted to provide the same treatments in the same way.

Allowing psychiatric nurses to practice autonomously will not only relieve our health system but will save taxpayer dollars. If APRNs were utilized to their full scope of education and training, the state would save hundreds of millions of dollars each year.

It’s rare to find opportunities to expand access to mental healthcare without spending a penny. Florida legislators should take advantage of this one and join the 27 other states that permit psychiatric nurses to practice autonomously.

Our current mental health crisis requires all hands on deck. Psychiatric nurses are ready to bring the full scope of their training to bear in support of patients. Florida legislators should let them.


Brian Williams, M.D., is a Florida Board of Medicine-licensed physician.

Guest Author


  • Pam Wessling

    January 30, 2024 at 10:19 am

    I hope this does not fall on deaf ears – I will push it along, too. I am a retired FNP – but after 40+ years in nursing it is clear that every patient and family has a mental and/or emotional component to their health care.
    FNPs and Nurse Midwives were created by doctors who were short handed but needed nurses with additional training to help them. However, our biggest block in practice comes from insecure doctors who fear their practice being challenged or loss of reinbursement.

  • Adrianna Newburry

    January 30, 2024 at 6:39 pm

    I was suicidal, was baker acted into Spring Brook hospital in Brooksville FL, no therapy, understaffed , I was physically injured by a worker, who was fired but left me physically and mentally injured in this place. I was put in there to help me and came out worse.

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