Mental health nursing clinical specialization: extinction or adaptation?

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Abstract
Mental health nursing as a distinct clinical specialty appears to be headed for oblivion, unless adaptive responses are made to the current crisis. A systems model is used to depict nursing's response to the crisis; components of the model include within-system changes and environmental changes affecting the system. The entropic input of mental health practitioners' exodus to the private sector, integrated curricula, decreased graduate enrollment, paucity of research and accountability, unclear identity, lack of cohesion, and economic pressures precipitate the output of fear of extinction. However, fear of extinction may stimulate a response that would produce facilitative feedback to provide a strengthening transformation of the system. Recommendations regarding clinical practice options and educational preparation are offered.

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