NRS 415 Benchmark – Creating Change Through Advocacy

Sample Answer

Nurses are advocates for different healthcare stakeholders, from patients to colleagues and professionals in the medical and health sectors. Nurses create change through advocacy by engaging elected representatives at state and federal levels to develop policies and interventions aimed at addressing public health concerns like access to mental health care services for a majority of Americans.

Mental health care, especially access to care services for the affected, is a public health concern that requires change through nurse advocacy efforts. By engaging in advocacy, nurses can influence legislation to improve access to mental healthcare services based on existing federal, and in some regions, state legislative policies.

These policies are critical to enhancing access to mental and behavioral health services for close to 21% of Americans suffering from some form of mental health disorder (MHA, 2023). The purpose of this paper is to explore nurses’ advocacy activities and efforts to increase access to mental health care for millions of Americans through legislation.

Problem

In no more than 250 words, describe the problem, who is affected, and the current ramifications. Explain the consequences if the issue continues.
Mental health is a growing public health concern based on evidence from the Centers for Disease Control and Prevention (CDC) and other entities that work collaboratively with federal and state health agencies across the United States.

The CDC (2023) asserts that over 1 in 5 adults in the U.S. live with a mental illness. Further, more than 1 in five youth (13-18 years) either currently or at some point in their life, suffer from a seriously debilitating mental problem. The CDC advances that close to 1 in 23 adults in the U.S. has a long-term serious mental health disorder like bipolar disorder, major depression, dementia, and schizophrenia.

The Mental Health America (MHA) notes that about 21% or close to 51 million adults in the country have mental illness. The organization also observes that the vast majority of these individuals suffer from comorbidities; including substance use disorder and opioid use disorder. However, close to three-quarters of those suffering from mental health illnesses do not access treatment.

For instance, MHA opines that in 2021, over 15% of adults had a substance use disorder, yet 93.5% never received any form of treatment. The current ramifications include increased susceptibility of the affected to comorbidities, reduced productivity, and a rise in the cost of healthcare, especially in treating those with chronic mental health disorders.

The ramifications also include increased resource allocation, the need for more access to health services, and expansion of facilities to cater to the growing number. The rising number of people with mental health illnesses has serious consequences on public health, if not addressed (Taylor et al. (2023). The implication is that more people will experience worse mental health outcomes leading to devastating effects like suicide, violence, and a general breakdown in public order.

Idea for Addressing Solution

In no more than 250 words, outline your idea for addressing the issue and explain why legislation is the best course for advocacy.
Addressing the issue requires improving access to mental health care services across states and through federal and state funding. The Council of State Governments (2023) mental health should be among the top policy priorities for states.

The council notes that mental health, including substance use disorder, are critical priority legislative areas for states to reduce the current prevalence of the problem. According to the council, 9 out of 10 adults in the country believe the country is in a mental health crisis with suicide being ranked as the 12th leading cause of death.

In 2020, close to 46,000 deaths were attributed to suicide; an indication of the magnitude of the issue (MHA, 2023). Evidence suggests that expanding access to mental health through resources and expansion of medical health insurance coverage will allow more people to get care services, particularly treatment and recovery.

More people are not accessing care due to stigmatization, limited resources like lack of insurance coverage, insufficient mental health personnel, and lack of information. Recent legislative policies and acts demonstrate efforts to increase access to care services. These policies emanate from legislative efforts in Congress; illustrating the core role that legislation plays in advocacy.

The COVID-19 pandemic increased and worsened the mental health crisis in the country (MHA, 2023). The current federal administration has enacted three policies to support and educate individuals, groups, families, and communities experiencing mental health problems. These policies raise awareness and lower the stigma related to seeking mental health services.

They include the American Rescue Plan Act of 2021, the STANDUP Act of 2021, and the Dr. Lorna Breen Health Care Provider Protection Act. The enactment of these policies demonstrates that legislation is the best course for advocacy to enhance access to mental health care.

Research the Issue

Perform research and compile information for your idea. Present substantive evidence-based findings that support your idea for addressing the problem (studies, research, and reports). Include any similar legislation introduced or passed in other states.

Evidence 1 In their article, Coombs et al. (2021) identify barriers to mental health care. The authors assert that having effective policies that expand healthcare coverage will ensure that more Americans can access mental health services.

The article suggests that reducing the cost of mental health services will incentivize many Americans to seek care services and reduce the stigma associated with the problem.

Evidence 2 The brief by the Institute for Health Policy and Leadership (IHPL) (2022) demonstrates that having legislation like the American Rescue Plan Act among others can enhance access to mental health as they mandate state and federal governments to allocate sufficient resources to mental healthcare services.

The brief advances that supporting and educating individuals, groups, and families with mental health issues, and raising awareness require effective policy approaches to reduce the problem.

Evidence 3 The U.S. Census Bureau (2023) advances that federal health systems and facilities should expand access to mental health care due to the increasing number of cases. The Bureau observes that different factors are contributing to these cases, requiring evidence-based interventions.

As such, the Census Bureau recommends changes in existing legislation to expand enrollees and beneficiaries through public health emergency initiatives. A core part of this is the expansion of Medicaid Services to help individuals have coverage to access mental health services.

Stakeholder Support

Discuss the stakeholders who would support the proposed idea and explain why they would be in support.
Stakeholder(s) Supporting 1 Nurses, especially psychiatric mental health nurse practitioners (PMHNPs), will support the expansion of access to mental health services.

As a core part of health care provision, nurses will work collaboratively with all stakeholders to enhance access and advocate legislation to increase those getting treatment.

Stakeholder(s) Supporting 2 Physicians and other healthcare providers will also support the idea since their core role is to offer beneficial patient care. Physicians will also support the idea because it reduces harm to individuals by expanding resources at different levels of government.

Stakeholder (s) Support 3 The individual patients, the community, affected families, and the general public will support the idea because of the expected benefits. For instance, the idea will enhance access to care, raise awareness about mental health, increase support for patients and their families, and reduce associated stigma.

Stakeholder Opposition

Discuss the stakeholders who would oppose the proposed idea. Explain why they would be in opposition and how you would prepare to debate or converse about these considerations.

Stakeholder(s) Opposed 1 Health insurance providers may oppose the idea as it will mean reduced profits since more people will be using their cover to access services. These organizations will oppose the idea and probably raise the cost of premiums in the marketplace. However, they should collaborate with all stakeholders to tackle mental health problems affecting the nation as a public health concern.

Stakeholder(s) Opposed 2 Health organizations, especially those mandated to provide mental health emergencies, may oppose the idea because of an expected rise in expenses. Therefore, they should consider the cost of mental care for patients and their families as well as being a public health concern that requires redress.

Financial Incentives/Costs

In no more than 250 words, summarize the financial impact of the issue and the idea (added costs, cost savings, increased revenue, etc.). Provide support. Mental health problem exerts an increased financial burden on state and federal resources. Today, close to 21% of adults in the U.S. suffer from some form of mental health illness.

Further, 90% of Americans believe that the mental health problem is a national crisis that requires urgent measures to reduce and prevent its occurrence, especially increased resource allocation. In their study on untreated mental illness in Indiana, Taylor et al. (2023) found that untreated mental illness can have substantial effects on society through direct healthcare costs, reduced productivity and performance, and overall adverse health outcomes like disabilities.

For example, the global economy loses close to $1 trillion each year due to lost productivity associated with mental health problems like anxiety and depression. The implication is that the financial impact of the issue is substantial. For example, the White House (2023) asserts that the federal government spent about $280 billion on mental health services in 2020, with 25% of these resources coming from the Medicaid program.

Therefore, expanding access to mental health services, especially at early stages through raising awareness and reducing stigmatization, will reduce these costs. The proposed idea will lead to reduced costs of care, and save state and federal governments billions from expending on mental health care services.

For example, Taylor et al. (2023) assert that the Indiana State government spent $4.2 billion annually on untreated mental illness, with $3.3 billion in indirect costs. These figures mean that having better access to mental health care services will reduce expenditure by both state and federal governments and increase better outcomes for patients and their families.

Legislature Information Needed and Process for Proposal
Discuss how to advocate for your proposal using legislation. Include the following Provide the name and complete contact information for the legislator. Describe the steps for how you would present this to your legislator. Presenting the idea to the legislator requires seeking an audience with her through an appointment.

The second step is collecting sufficient evidence using facts from authoritative sources on the health problem. Upon getting the engagement, I will make the case by presenting the report and imploring the representative to analyze it. After the analysis, I will ask the legislator to consider the critical aspects of the presented idea for consideration during the state legislative session.

Inter-professional Collaboration in the Legislative Arena

In no more than 250 words, discuss the role inter-professional collaboration plays in advocacy through legislation Inter-professional collaboration implores healthcare providers, from nurses to physicians, to work together based on a shared goal to drive change in their organizations or the public when dealing with healthcare issues like mental health problems.

Inter-professional collaboration ensures that nurses and other healthcare providers can present common approaches and interventions based on research evidence to legislators and other stakeholders to advocate policies and legislations aimed at expanding access to mental health care for different health populations and individuals affected by the problem.

Advocacy needs sufficient evidence from different sources that allow providers and other stakeholders to dissect and select the most appropriate when dealing with health issues; including mental health problems (Alderwick et al., 2021). Accessibility to mental and behavioral care services is important based on existing and even proposed bills in Congress.

Using inter-professional collaboration will help nurses work with all stakeholders and engage elected representatives using a common position. The collaboration will lead to one voice about the issue of limited access to mental health care services. The collaboration with other providers will ensure that all advocate increased resources and legislation to improve the quality of care for mental health patients.

The inter-professional collaboration will also ensure that nurses present a unified position backed by or supported by evidence from current research and data from authoritative sources like federal agencies (Gantayet-Mathur et al., 2022). Therefore, inter-professional collaboration will help stakeholders to design better strategies for legislation to address increased access to mental health care provision.

Leadership Competencies and Styles

The American Organization of Nurse Executives (AONE) has identified leadership competencies relevant for nurse leaders to guide practice within the health care system. Describe two leadership competencies identified by the AONE that would also be necessary for a nurse to advocate for the legislative solution you have proposed. Discuss how the theory of servant leadership supports these competencies. This section should be addressed in no more than 250 words.

Nurse leaders require and should possess certain competencies to guide their practice and leadership roles in healthcare delivery and systems. The American Organization of Nurse Executives (AONE) advances that these competencies are critical for nurses to make informed decisions and choices when delivering care to diverse patient populations.

The two leadership competencies relevant to advocating legislative solutions include communication and relationship building (Hughes et al., 2022). Further, nurse leaders should have explicit knowledge of the health care system and its operations to advocate better access to mental health care.

These requirements imply that nurse leaders work with all stakeholders to identify effective policies and interventions to increase access and quality of mental healthcare services for patients. Communication is important as it enables nurse leaders to share information, their vision for change, and the expected benefits from implementing the suggested policies.

Communication is also essential for nurse leaders to develop teams and relationships with other professionals in the healthcare sector when making presentations to elected leaders in Congress and even at the state legislature. The servant leadership model supports these competencies since a servant leader develops relationships and works through teams based on knowledge.

Servant leaders also possess better communication attributes to convince their followers about suggested or proposed approaches to healthcare delivery or interventions (Luca et al., 2021). As such, the model requires a leader who communicates well, understands their situation and organizations, and works through teams.

Christian Principles and Nursing Advocacy

In no more than 250 words, discuss how principles of a Christian worldview lend support to legislative advocacy in health care without bias. Be specific as to how these principles help advocate for inclusiveness and positive health outcomes for all populations, including those more vulnerable, without regard to gender, sexual orientation, culture, race, religion/belief, etc.

The Christian worldview is based on Christian teachings as contained in the bible and advanced by Jesus and His disciples. Christian healthcare workers should advocate for the suffering and less privileged.

Christians should advocate increased access to mental health care services for millions of people suffering from the problem as a demonstration of their love for fellow humans as commanded by God (James 1 26-27; 2 14-26 KJV).

Like Christ who suffered on the cross for their sins, Christian healthcare workers should advocate better and expand access to mental health resources through legislation, not just at the state but also federal level, by engaging their elected representatives.

They must have and shoulder a sense of responsibility so that they serve and speak up for the poor concerning underlying injustices that cause, maintain, and entrench poverty and suffering.

Through these efforts, Christians will show their faith and wisdom through humble giving to the needy, and offering practical help and comfort to those in need. Advocacy will imply that Christians are impartial and have refused to ignore the public health crisis due to the mental health problem engulfing over 50 million adults before even factoring in the minors.

Therefore, advocacy for the issue is not about aligning with certain groups, racial backgrounds, or cultural practices but focusing on love as the foundation of the Christian worldview.

Conclusion

Advocacy is an approach to create change in improving access to mental health care is critical. Nurse leaders and nurses should work in collaboration with other health providers to advocate access to better quality mental health care for patients and health populations suffering from this problem.

Existing evidence supports the legislation approach as the most appropriate for addressing this problem. Therefore, nurses should consider the financial savings from cost expenditure on mental health, and integrate core competencies in their advocacy and Christian worldview to advance the proposed approach to help individuals suffering from mental health illness.

References

• Alderwick, H., Hutchings, A., Briggs, A., & Mays, N. (2021). The impacts of collaboration between local healthcare and non-health
  care organizations and factors shaping how they work a systematic review of reviews. BMC Public Health, 21, 1-16. DOI https //doi.org/10.1186/s12889-021-10630-1
  
• Centers for Disease Control and Prevention (CDC) (2023 April 25). About Mental Health.
  https //www.cdc.gov/mentalhealth/learn/index.htm
  Census Bureau (2023 June 26). Public Health Emergencies and Mental Health.
  https //www.census.gov/library/stories/2023/07/public-health-emergencies-and-mental-health.html
  Coombs, N. C., Meriwether, W. E., Caringi, J., & Newcomer, S. R. (2021). Barriers to healthcare access among US adults with mental
  health challenges A population-based study. SSM-population health, 15, 100847. DOI 10.1016/j.ssmph.2021.100847
  
• Gantayet-Mathur, A., Chan, K., & Kalluri, M. (2022). Patient-centered care and inter-professional collaboration in medical resident
  education Where we stand and where we need to go. Humanities and Social Sciences Communications, 9(1), 1-24. DOI https //doi.org/10.1057/s41599-022-01221-5
  
• Hughes, R., Meadows, M. T., & Begley, R. (2022). AONL nurse leader competencies core competencies for nurse leadership. Nurse
  Leader, 20(5), 437-443. DOI https //doi.org/10.1016/j.mnl.2022.08.005
  
• Institute of Health Policy and Leadership (IHPL) (2022 July). Policy at a Glance Recent Federal Mental Health Policies.
  https //ihpl.llu.edu/sites/ihpl.llu.edu/files/docs/Policy-At-A-Glance/July%202022.pdf
  Luca, C. E., Cavicchioli, A., & Bianchi, M. (2021). Nurses who assume the role of advocate for older hospitalized patients A
  qualitative study. SAGE Open Nursing, 7, 23779608211030651. https //doi.org/10.1177/23779608211030651
  
• Mental Health America (MHA) (2023). The State of Mental Health in America.
  https //mhanational.org/issues/state-mental-health-america
  Taylor, H. L., Menachemi, N., Gilbert, A., Chaudhary, J., & Blackburn, J. (2023, October). Economic Burden Associated With
  Untreated Mental Illness in Indiana. JAMA Health Forum, 4(10) e233535-e233535).
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• The Council of State Governments (2023 March 8). Mental Health among Top Policy Priorities for the States.
  https //www.csg.org/2023/03/08/mental-health-among-top-policy-priorities-for-the-states/
  The White House (2022). Reducing the Economic Burden of Unmet Mental Health Needs.
  https //www.whitehouse.gov/cea/written-materials/2022/05/31/reducing-the-economic-burden-of-unmet-mental-health-needs/