POLICY

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Widespread change starts with the individual. Someone who believes in a cause and is willing to advocate on behalf of it. Doing so isn't always easy. It takes time, energy and perseverance. But when enough of us decide to fight for change, we make that change a reality.

Our community advocacy pillars represent five areas of modern society that are in need of mental health reform — our schools, homes, work environments, places of worship and government institutions. Each pillar offers high-level advocacy recommendations for those willing to get involved on a community level.

When it comes to policy change, mental health advocacy is all about urging lawmakers to fight for more accessible services, increased patient protections and less policing of those in need.

Looking to be a mental health champion within your community? Let's dive deeper:

Principles

1) Prioritize Prevention & Early Intervention Services

The best way to tackle our mental health crisis and save individuals from years of hardship, is to catch disorders and respond to them early on. It can be challenging to overcome a mental health condition in adulthood after symptoms have been ignored and left to worsen. By teaching our youth how to discuss, recognize and respond to emotional crises, we are creating future generations that are equipped with the skills they need to manage symptoms and lead happy lives.

There are three steps to this process — prevention, early detection and intervention. Lawmakers should fight for the implementation of preventative services that begin immediately after birth. Once born, parents should have easy access to services that strengthen their home and the emotional wellbeing of themselves and their child, such as parenting programs, social emotional learning, in early education, and community building initiatives. Mental health screening should be made mandatory for parents and children, and if a diagnosis arises, there should be professionals on site to inform the family of their treatment options. Other preventative programs such as workplace training for employers, public education training for teachers, and local partnerships between families, schools, courts and healthcare providers, should be funded so that leaders across disciplines have the knowledge to recognize and respond to mental health problems.

Beyond prevention, advocates and community leaders should call for ongoing screening services and school-wide intervention programs, such as those that dictate when law enforcement should be called during a mental health crisis of any policies that dissuade students from seeking needed accommodations. Federal legislation should work to improve the quality and oversight of treatment facilities, specifically those in lower income communities, so that care is evidence based, ongoing, and specific to the needs of each child. Treatment plans should take into account the dynamics of each family, and should include the full continuum of care, such as therapy, medication, peer support services and mindfulness based activities. And policymakers should look to implement laws that call for the ongoing training and licensure of educators and youth leaders, as well as the removal of any laws that support seclusion or restraints for youth battling a mental condition.

2) Enhance Cultural Competence & Diversity Within the System

Mental illness impacts people of every country, ethnicity, age, gender, sexuality, class and occupation. It does not discriminate, which means that our healthcare systems shouldn’t either. Unfortunately, cultural bias remains strong and impacts who receives care, how they receive it, the diagnoses they’re given and the treatment plans that are put in place.

Cultural competence refers to the ability of a provider to meet the social, cultural and linguistic needs of patients. It’s no surprise that people coming from different backgrounds have different ways of expressing mental health challenges. Without doctors that understand their cultural viewpoint, it is extremely hard to accurately reach and treat everyone who needs help. Lawmakers should prioritize the recruitment and training of staff from minority communities in countries around the world. Schools and clinics should work to enhance representation amongst their staff. It’s been shown that people are more likely to trust and confide in those who are similar to them. We should expand cultural competence training to all existing professionals and community leaders so that they are equipped to recognize warning signs in people from outside communities. Additionally, we must work to create materials that are based off the experiences of people from specific cultures — a one size fits all approach will never work. Programs must increasingly be designed with multicultural perspectives in mind, as well as plans for implementing them in a wide range of communities.

3) Protect Patient Autonomy & Privacy

People battling mental health conditions have hobbies, careers, families, interests and future goals just like everyone else. They aren’t second class citizens and they should never be treated as such. Unfortunately, discrimination within the system runs rampant in countries around the world. Those battling mental illness are frequently forced into care they don’t want, restrained, denied jobs, ostracized and secluded from their communities. It must be a priority to create legislation that protects these individuals and empowers their success and happiness moving forward.

Patient rights span everything from policies regarding autonomy, community inclusion, access to care and privacy. For starters, policy should protect the autonomy of every individual, and ensure that they have the right to make decisions about their own care and recovery. People should not be coerced or forced into treatments they don’t want. Voluntary services should be the standard. In cases where a person poses a risk to others or themselves, outside intervention may be considered. Similarly, people should never be physically abused or restrained via chemicals, seclusion, shackles or other abusive measures. Governments should enhance efforts into uncovering, monitoring and shutting down the use of these methods.

From a community perspective, individuals should never be kicked out of or kept from schooling, housing and jobs because of their diagnosis. Legislation should work to weed out discrimination in these areas and punish institutions that continue to uphold stigmatized processes. Inclusion should be promoted through community programs that help to enhance an individual’s connection with their immediate surroundings. Lastly, privacy laws must have the right to control their personal records, and have a say over who can see and access their healthcare information. Healthcare providers should provide in-depth information about their privacy and confidentiality standards to all patients, and institute policies that ensure individuals are notified of any potential scenario in which records may need to be shared, such as court orders, requests by an employer, or cases in which abuse is disclosed during therapy.

4) Stop the Criminalization of Mental Illness

All around the world, people battling serious mental illness are locked up rather than placed in treatment. In some countries, incarceration rates and conditions are worse than others. What remains constant, is that when underprivileged individuals go without the care and necessities they need, their likelihood of arrest and imprisonment is far higher than it should be. Once incarcerated, people often face poor conditions, spiraling mental health, and an increased likelihood of suicide or recidivism. They are kept from the services and treatment they need to recover, and create a massive burden on law enforcement and federal budgets, despite the majority of crimes being low level and non violent.

Across societies, we should be working to keep mentally ill individuals out of jail, off the streets and away from violent crime. There are many factors at play here — poverty, addiction, homelessness. To confront them simultaneously, community leaders and criminal justice reform organizations should partner with mental health professionals, law enforcement, policymakers and prison staff to fight for two key goals — implementing better mental health services in prisons, and funding preventative services to keep people from arrest.

Individuals have a right to treatment, even when they’re behind bars. Statues should be enacted to expand treatment options, including medications, within prisons around the world. Once released, treatment should be made accessible for those battling severe mental illness in order to lessen the likelihood of recidivism. Crisis Intervention Programs, as they’re called in the US, should be implemented so that law enforcement is trained to handle psychiatric crises and keep individuals from arrest. They also serve as a way to get the broader community invested in creating change. Other initiatives may include community support groups and programs that offer emotional guidance and keep kids off the streets, or re-entry programs that help people assimilate after release. And finally, lawmakers should fight for legislation that keeps nonviolent, low level offenders out of prison, and instead, places them in rehabilitation programs or therapy.

5) Break Down Barriers to Care

High quality and ongoing mental health care remains a luxury. No matter the country or region you live in, it’s unlikely that the majority of individuals have the time, money and resources to engage in productive treatment within their existing healthcare system. Breaking down financial, geographic, and stigma-related barriers to care is key in sparking widespread change. Until mental health services are accessible for all, we will continue to face a myriad of cross-cultural dilemmas, such as poverty, homelessness and addiction, as well as a worsening mental health crisis in countries around the world.

People battling mental illness should have access to all clinically approved medications and evidence based treatments in the country they reside in. They should not be kept from certain treatment options because of a limited healthcare plan, and those who are uninsured, should be provided outlets for reaching the same quality of support as those on insurance. Mental health screening should be made mandatory in communities and schools around the world. Lawmakers should work with school systems to update curriculums and school programs, so that students are both learning about mental health at a young age, and encouraged to discuss it with adults and peers. Comprehensive support services should be funded so that low income communities in particular have access to a wide range of treatment options, as well as complementary services such as transportation to and from therapy, peer-to-peer support groups and housing and education initiatives. Healthcare providers and workplaces should create parity between physical health benefits, and those for mental illness, so that services are affordable and consistent. Once in treatment, individuals should not be forced to change medications by a new provider, if symptoms are being managed and controlled effectively. However, they do have a right to treatment or provider changes if they see fit.

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