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Mental Health Access

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Introduction

Promoting mental health has transformed into advocacy of human rights for individuals

suffering from mental disorders and reducing the societal biases and prejudices linked to

them. This effort involves various strategies to overcome the main structural and attitudinal

barriers that hinder the achievement of positive mental health outcomes in populations (Saha,

2021). The origins of mental health advocacy can be traced back more than thirty years,

starting with the expression of concerns by families of those affected by mental disorders.

Subsequently, individuals dealing with mental illnesses have also contributed to this

discussion (Stuart, 2016). Over time, this collective endeavor has gained the support of

various organizations, numerous mental health practitioners, their respective associations, and

certain governmental bodies. Notably, the scope of advocacy has recently expanded to

encompass the needs and rights of citizens with mild psychological disorders and to address

the broader population's psychological health needs and rights (Javed et al., 2021). Advocacy

is universally acknowledged as one of the eleven crucial domains of action in any

comprehensive mental health policy, owing to the positive outcomes it produces for

individuals facing mental disorders and their families. Advocacy has significantly impacted

certain nations' mental health policies and legal frameworks. It is a pivotal driving force

behind improving mental health services in others (Saha, 2021). This essay explores various

advocacy approaches and the inherent advantages of mental health advocacy in combating

the widespread stigmatization and discrimination associated with mental health issues.

Concept of Mental Health Advocacy and Its Importance

Significance of Mental Health Advocacy

Advocacy in mental health policy is vital, including a wide range of constructive steps

for patients and their loved ones. Awareness-raising, information dissemination, education,

training, mutual assistance, counseling, mediation, defense, and condemnation are all
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examples of advocacy activities. These efforts address the inadequacy of resources in

families and in workplaces, the stigma related to cerebral health issues, and the violation of

patients' rights. By eradicating these hurdles, the healthcare sector can safeguard the rights of

mentally challenged individuals, increase awareness regarding the significance of mental

wellness, and prevent future mental health problems (Stuart, 2016). Mental health advocacy

initiatives have been essential in changing how people see those who struggle with mental

illness.

Role of Advocacy in Raising Awareness

There has been a rise in the number of cases where recipients of services explicitly state

what they need from such providers. This growing independence enables people to make

educated decisions about their care and everyday lives (Javed et al., 2021). There are several

benefits to having patients and their families participate in advocacy groups (Saha, 2021).

Improvements in mental health services, treatments, and care include, but are not limited to,

the following: improved and effective regulations and practices from regimes and

institutions; new statutes; better activism for mental health and prevention of psychological

disorders; sustenance and advocacy for the rights and interests of those with mental illness

and their families; and enhancements in psychological health services and treatments (Stuart,

2016). Awareness of mental health issues and including mental health on national agendas

are greatly aided by advocacy's role as a dissemination channel. Policy, legislation, and the

development of new services can all benefit from lobbying efforts.

Stigma Reduction Strategies in Mental Healthcare

Raising Awareness

Efforts to enhance awareness typically involve activities conducted at specific times

when primary stakeholders join hands to participate in initiatives to enhance public awareness

of mental health problems. These efforts often involve the participation of advocacy
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organizations or groups of organizations (Saha, 2021). For example, the WHO has labelled

October 10 as World Mental Health Day, heartening all patrons in psychological health to

discuss their efforts, uphold awareness about global mental health concerns, and consider

further steps needed to improve mental healthcare accessibility for individuals with cerebral

illnesses on a worldwide scale. Support groups in more than 100 countries participate in these

activities (Stuart, 2016). Some countries dedicate an entire week to awareness-raising

campaigns, during which psychological health promoters and backers participate in various

events to endorse public learning and understanding (Javed et al., 2021). However, evaluating

the effectiveness of these awareness-raising programs in achieving their intended goals

remains challenging, as comprehensive evaluations have not been conducted.

Public Literacy Programs

Literacy agendas aim to enhance understanding concerning mental illnesses, including

their signs, indications, management, and avenues for seeking help, assuming that reducing

stigma will naturally follow (Stuart, 2016). The inception of the PAIMI Scheme in 1986 was

to safeguard and advocate for the privileges of people with psychological disorders, as well

as to scrutinize allegations of mistreatment and negligence within mental health care centers

(Saha, 2021). The PAIMI grants are legally sanctioned by the PAIMI Act of 1986,

specifically outlined in Section 10801(b)(1) and subsequent sections, with amendments made

in 2000. The support services of the PAIMI Initiative are intended to cater to those who are

legitimate and pass the criteria for psychological disorders as outlined in the governing

statute [42 USC 10802(4)(A)&(B) and 10804(d)] (PAIMI, 2023). The primary objective of

the PAIMI program is to deliver advocacy services grounded in legal principles, with a

particular focus on safeguarding and advocating for the freedoms of people diagnosed with

Serious Mental Illness (SMI) in the case of adults and Serious Emotional Disturbance (SED)

in the case of children (PAIMI, 2023). Additionally, the program is responsible for
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conducting investigations into instances of cruelty, abandonment, and infringements of

freedoms (Saha, 2021). The notion of mental wellness activism has been formulated with the

aim of advancing the human rights of those experiencing mental disorders and mitigating the

prevalence of stigma and prejudice (PAIMI, 2023). The intervention encompasses a range of

strategies designed to address the primary impediments, both in terms of structural factors

and prevailing attitudes, that hinder the attainment of favorable mental health results within

certain groups.

Advocacy Efforts

Role of Advocacy Groups

The primary objective of advocacy actions is to tackle disparities that arise from

societal institutions that deliberately or inadvertently restrict the rights of persons with mental

illnesses (Knaak et al., 2017). Advocacy encompasses a range of techniques, including

increasing public consciousness, distributing information, delivering educational programs,

giving mutual assistance and counseling, acting in mediation, campaigning for rights, and

condemning unjust actions (Saha, 2021). The primary aim is to ensure that persons diagnosed

with mental disorders can fully exercise the rights and freedoms protected by legal

frameworks while establishing effective means to address any unfair policies and processes

that may hinder their enjoyment of these rights (Nyblade et al., 2019). The inclusion of

mental health on the agenda of the 54th World Health Assembly in 2001 marked a substantial

lobbying effort by the World Health Organization. This initiative involved 132 health

ministers in four roundtable discussions (Stuart, 2016). According to Saha (2021), following

the conclusion of these meetings, a consensus was reached among all participants that

constraints imposed by restricted health budgets should no longer impede the allocation of

financial resources for mental health services. In addition, it is worth noting that on World

Health Day in that particular year, several local community organizations collaborated in a
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concerted endeavor to raise awareness about mental health issues and promote the need for

transformative measures (Javed et al., 2021). Psychiatric institutions across many continents

were made accessible to the general public to draw attention to inadequate circumstances and

infringements of human rights inside some establishments.

Precedent of John Paul II

Pope John Paul II, in a public address, appealed to the general public, imploring them

to actively protect the dignity and fundamental rights of persons afflicted with mental

diseases. The distribution of advocacy materials created by the World Health Organization

and national governments was extensive (Stuart, 2016). Thirty thousand posters and flyers,

10,000 booklets, and 40,000 promotional leaflets were distributed in China. According to

Saha (2021), the Pan American Health Organization developed public service ads

disseminated across several networks, including CNN. Concurrently, the World Health

Organization (WHO) Headquarters in Geneva initiated the production of many movies that

depict the various roles played by families in diverse nations (Knaak et al., 2017).

Additionally, specific activities were coordinated to engage kids, healthcare practitioners, and

decision-makers. The efficacy of these approaches in mitigating stigma remains inconclusive

(Stuart, 2016). However, in middle- and low-income countries, the absence of non-

governmental organizations may pose obstacles. Nonetheless, the initiatives undertaken by

the World Health Organization (WHO) provide evidence that local community groups may

successfully cooperate to enhance knowledge regarding the significance of mental health

(Javed et al., 2021).

Responsibilities of Various Advocacy Groups

Family-Oriented Advocacy Groups

Patients and their families play various roles in advocacy, including influencing

policies and legislative processes and providing practical assistance to individuals with
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mental disorders. Particularly in underdeveloped nations, families bear significant caregiving

responsibilities for those with mental illnesses (Saha, 2021). Families serve as the primary

caregivers in many regions and serve as vital support networks. Other than offering mutual

support and services, numerous family-oriented groups have evolved into advocates,

engaging in community education, increasing their influence on policymakers, combating

stigma and discrimination, and lobbying for improved services (Stuart, 2016). NGOs, which

consist of mental health professionals and individuals from diverse backgrounds, also play a

substantial role in advocating for patients and families. Their unique contribution to the

advocacy movement involves reinforcing and empowering patients and families.

Role of Healthcare Practitioners in Advocacy

Both general healthcare practitioners and mental health professionals should take a

more proactive approach to protect patients' rights and raise awareness about improving

services, especially as care transitions from psychiatric institutions to community-based

services (Saha, 2021). Mental health professionals can contribute to advocacy efforts by

incorporating patient and family-centered clinical practice and actively participating in the

planning of patient and family-oriented activities (Javed et al., 2021). Policymakers and

planners within health ministries have a crucial role in advocacy. They can directly influence

mental health by supporting advocacy groups such as patients, families, non-governmental

organizations, and mental health professionals (Stuart, 2016; Nyblade et al., 2019). They

must also persuade other policymaking bodies, including the executive branch of

government, the department of finance, various other ministries, the judiciary, the legislature,

and political parties, to prioritize and invest in mental health (Knaak et al., 2017).

Suggested Advocacy Approaches

Expected Challenges
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Anticipated challenges encompass a potential lack of endorsement from the general

populace and occasional discord among different factions (Saha, 2021). Sometimes,

caregivers, including psychiatrists and patient advocacy groups, are at odds rather than

working together (Stuart, 2016). To address these issues, stakeholders should contemplate

producing concise documents outlining and articulating vital mental health focal points.

Establishing Family Advocacy Groups

Pertinent agencies, organizations, or authorities must pinpoint one or two exemplar

psychiatric services characterized by best practices nationally and negotiate for a

collaborative pilot initiative (Stuart, 2016). Such an endeavor should involve the health

agencies and psychiatric services to establish consumer and family groups endowed with

advocacy roles (Javed et al., 2021; Nyblade et al., 2019). To ensure the success of this

initiative, technical assistance and financial support are indispensable (Knaak et al., 2017).

Establishing Advocacy Partnerships

Mental health facilities should identify and establish partnerships with one or two

pertinent agencies and authorities dedicated to safeguarding the rights of individuals with

mental disorders (Stuart, 2016). Enhancing the capacity of advocacy groups by providing

information, training, and financial resources, with an emphasis on consumer organizations,

is also highly recommended (Saha, 2021). Furthermore, mental health institutions should

collaborate with governmental entities to devise comprehensive strategies and conduct public

awareness campaigns, using radio broadcasts and distribution of informational newspapers to

inform the general public about the activities of these advocacy groups.

Conclusion

Establishing an advocacy movement can enhance the execution of mental health policy

and legal frameworks, yielding numerous advantages for various groups. People with mental

health conditions may experience improved comprehension of their requirements and

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fortified protection of their rights. They may access higher-quality services and actively

formulate, grow, oversee, and assess these services. Families caring for individuals with

mental health issues could receive enhanced support, while the general populace could

achieve a more comprehensive grasp of mental health and related conditions.

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References

Javed, A., Lee, C., Zakaria, H., Buenaventura, R. D., Cetkovich-Bakmas, M., Duailibi, K., ...

& Azeem, M. W. (2021). Reducing the stigma of mental health disorders with a focus

on low-and middle-income countries. Asian journal of psychiatry, 58, 102601.

Knaak, S., Mantler, E., & Szeto, A. (2017, March). Mental illness-related stigma in

healthcare: Barriers to access and care and evidence-based solutions. In Healthcare

management forum (Vol. 30, No. 2, pp. 111-116). Sage CA: Los Angeles, CA: SAGE

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Nyblade, L., Stockton, M. A., Giger, K., Bond, V., Ekstrand, M. L., Lean, R. M., ... &

Wouters, E. (2019). Stigma in health facilities: why it matters and how we can change

it. BMC medicine, 17, 1-15.

PAIMI (2023). Protection & Advocacy for Individuals with Mental Illness - Disability Rights

Arkansas, Disability Rights Arkansas. https://disabilityrightsar.org/about-dra/paimi-

protection-advocacy-for-individuals-with-mental-illness/#:~:text=The%20PAIMI

%20Program%20was%20established,treat%20individuals%20with%20mental

%20illness

Saha, G. (2021). Advocacy in mental health. Indian Journal of Psychiatry, 63(6), 523.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8793719/

Stuart, H. (2016). Reducing the stigma of mental illness. Global Mental Health, 3, e17.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5314742/