Background: The COVID-19 pandemic necessitated a rapid transition to telemental health (TMH) for behavioral health services in the behavioral health department of a large integrated primary care organization. Although the COVID-19 pandemic was the initial trigger for rapid organizational change, systems were developed with a focus on longer term scalability and sustainability. Methods: This paper discusses the process of organizational change within our healthcare delivery system using the Strengths, Opportunities, Aspirations, and Results (SOAR) framework. Within this framework a structured mixed methods survey of 38 clinicians representing 5 different disciplines was conducted. Internal and survey data were analyzed to evaluate and guide the iterative change process. Results: The majority of BH clinicians reported that they were as or more effective with TMH. The transition to TMH in our organization resulted in increased access to care, with a 10.3% increase in BH visit completions. The transition to TMH may benefit clinician work-life balance, but requires resources to support clinical, technological, and communication/teamwork changes. Implications/conclusions: TMH is a feasible treatment modality for integrated care settings. It is cost-effective and well-accepted by clinicians. The SOAR framework can be used to guide rapid organizational change and ongoing QI processes.

Addictions nurses often encounter barriers to care for clients such as stigma, especially in settings outside addictions specialty care. This article utilizes a case-study format to show and discuss concepts related to client engagement in recovery and overcoming stigma. Laura, a 65-year-old woman, presents with a worsening of her alcohol use disorder in the setting of a recent retirement, worsening symptoms of major depressive disorder, and the stressors associated with the COVID-19 pandemic. She presents with her depression and is reluctant to discuss her alcohol use, after a past experience in a program that utilized a confrontational approach. Her primary care provider describes her as "in denial," but this case study will discuss elements including stigma, self-stigma, and the culture of addictions treatment and their impact on recovery. Finally, this presentation will describe how the addictions nurse can leverage a person-centered and recovery-oriented approach to promote engagement and positive problem solving with the client and the care team.

The coronavirus disease 2019 (COVID-19) pandemic has influenced daily life in many ways, with significant effects on mental health and coping. Psychiatric nurses can leverage their expertise in supporting adaptive coping among individuals affected by the stressors of the pandemic. Literature related to common mental health stressors of the COVID-19 pandemic can guide nurses seeking to support clients. The current article uses the Roy Adaptation Model and a review of the literature to provide a framework for nurses to intervene and promote improved mental health across all settings. The role of nursing in promoting adaptation to COVID-19 mental health stressors is essential during and after the pandemic.