More recently the concept of advocacy has been broadened to include the needs and rights of persons with mild mental disorders and the mental health needs of the general population. Advocacy is an important concept in nursing practice; it is frequently used to describe the nurse-client relationship. The term advocacy, however, is subject to ambiguity of interpretation. Advocacy for nursing stems from a philosophy of nursing in which nursing practice is the support of an individual to promote his or her own well-being, as understood by that individual. It is an ethic of practice.
The term 'advocacy' has taken on a meaning beyond its legal origins and is now of importance as a concept in health and social care. Within nursing, the role of advocate has been accepted as an important one, although there are arguments against nurses taking on such a role. No matter the role or the setting, nurses can pursue strategies to help their individual patients and advocate for a comprehensive mental health system.
The state of mental health services has never been equal to that of services available for other conditions, such as cardiovascular disease and diabetes. Like diabetes, mental illness can be treated successfully with ongoing care. The world community needs to focus on mental health, because without it, there is no health.”
The concept of mental health advocacy, in which mental health nurses are involved, was initially developed to reduce stigma and discrimination and to promote the human rights of persons with mental disorders. It includes a variety of different actions aimed at changing the major structural and attitudinal barriers to achieve positive mental health outcomes in populations.
Patient advocacy is not merely the defence of infringements of patient rights. It may also encompass, but is not limited to, patients’ rights advocacy. Advocacy is an important role of psychiatric nurses because their patients are ethically, socially and legally vulnerable. Nurses are to intervene when surrounding people’s opinions impeded patients’ safety, healthcare professionals’ policies impeded patients’ decision-making, own violent behaviors impeded treatment and welfare services for patients, own or families’ low acceptance of illness impeded patients’ self-actualization, inappropriate treatment or care impeded patients’ liberty, and their families abused patients’ property.
Advocacy in mental health nursing can improve the individuals' understanding of their situation, enables their views to be heard, ensures that they have the opportunity to be partners in their care and increases their autonomy. It promotes the rights of those who suffer discrimination because of their age, disability, sexuality, gender or culture. It has been argued that advocacy also ensures the quality of the care system. People with intellectual disabilities, physical impairments, mental disorders and also children and older people often find it difficult to make their voices heard when decisions concerning their lives are made. Their reliance on others and concomitant social isolation can leave them vulnerable to exploitation and abuse.
Mental health nurses should be able to support a patient’s healthcare experience through advocacy for the patient without worrying about how our institutions, organizations, administrators, physicians, managers and peers will see our efforts. They should not have to worry about reprimands or retribution when doing the job they are, in fact, trained and taught to do. Keeping open lines of communication, forming relationships with other members of the healthcare team, and being very aware of the rules of practice should make the advocacy role easier.
References
Gaylord, N. & Grace, P. (1995). Nursing advocacy: An ethic of practice. Nursing Ethics 2(1):11-18. Accessible: https://www.ncbi.nlm.nih.gov/pubmed/7728551/
Jugessur, T. & Iles , I. K. (2009). Advocacy in mental health nursing: An integrative review of the literature. Journal of Psychiatric Mental Health Nursing 16(2):187-195. Accessible: https://www.ncbi.nlm.nih.gov/m/pubmed/19281550/
Olin, J. (2012). What exactly is patient advocacy? RN Central. Accessible: http://www.rncntral.com/blog/2012/what-exactly-is-patient-advocacy/
The American Nurse (2011). Overcoming stigma. Accessible: www.theamericannurse.org/2011/04/12/overcoming-stigma/
Toda, Y., Sakamoto M., Tagaya, A., Takahashi, M. & Davis, A. J. (2014). Patient advocacy: Japanese psychiatric nurses recognizing necessity for intervention. Sage Journals.
Varghese, P. J. (2015). Advocacy in mental health: Offering a voice to the voiceless. Indian Journal of Social Psychiatry 31(1):4-8
Daniel D. Faleti
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