Equitable Mental Health Care Is Mental Health Care for All
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Abstract
In my view, this quote captures the drive to achieve equity in mental health care. All people have worth, and every person’s worth adds to the worth of every other person. Our psychiatric-mental health nursing care is driven by this absolute belief that all people are of equal worth, of equal value. This belief is true for the newborn babe taking her first breath in her mother’s arms to the aged matriarch taking her final breath at death’s embrace. It is true for the most upstanding citizen to the most heinous criminal in our society. It is verified as one of our nation’s core principles in the declaration of independence: “We hold these truths to be self-evident, that all [people] are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” Thus, striving for equal and equitable mental health care is endeavoring to uphold a basic human right centered on the conviction of the inherent worth of all people. Not only should all attain their optimal level of mental health and well-being, but each one’s success directly affects everyone else’s. Your mental health directly affects me, and mine affects you. Therefore, achieving equitable mental health care for the individual is attaining mental health care for all. A few months ago, I participated in a local National Alliance for Mental Illness’s 5K run. One of the most rewarding moments in my career was running into some prior patients from a state psychiatric facility where I began my professional nursing career. I had cared for them in their “crisis” state, possibly the lowest point in their mental health. At this occasion, it was inspiring to see them not only actively involved in a social event, but also promoting mental health care in their community. I was so happy to see them advocating for their own worth as people living with mental health challenges and advocating for the worthiness of others with the same challenges to receive care! I imagine that you also have been inspired by the outcomes of your meaningful care for many. For each individual patient, their families, and community, our continued, concerted work to improve equity in mental health care will certainly result in mental health care for all! Equality in mental health care implies that existing resources are distributed in ways by which care is available to whomever needs it, whereas equity indicates that the available resources “fit” individual needs (McCartney et al., 2019; Shim et al., 2018). These separate but related notions can be likened to the availability of shoes. Equality means that everyone who needs it has, or has access to, shoes. Equity means that people are also provided with the right shoe size. Inequalities and inequities in mental health care occur because of disparities in the availability of or access to care, often due to systematic biases, discrimination, and stigmatization of individuals or groups within society (Rees et al., 2021; Shim, 2021; Williams & Cooper, 2019). Indeed, racial/ethnic minority groups, rural communities, and sex and gender minority groups have disproportionately poor access to mental health care (Agency for Health care Research and Quality, 2022; Gerolamo et al., 2022; Mongelli et al., 2020; Reynish et al., 2021; Willging et al., 2006). A recent report by the Satcher Health Leadership Institute highlighted that between 2016 and 2020, among indigenous and racial/ethnic minoritized groups, there were 116,722 excess premature mental and behavioral health-related deaths, resulting in an excess of US$278 billion cost burden due to mental illness, substance use, and suicide (Dawes et al., 2022). The consequences of mental health care inequities are deadly and come with a hefty price tag. As the largest members of the mental health care workforce, psychiatric-mental health nurses are crucial in addressing inequities in mental health care. Indeed, the recent scope and standards for psychiatric-mental health nursing (American Nurses Association et al., 2022) validate our roles in preventing and treating mental disorders through integrated care approaches that promote mental health literacy, screening for disorders, providing rehabilitation after crises, and delivering ongoing recovery 1168091 JAPXXX10.1177/10783903231168091Journal of the American Psychiatric Nurses AssociationOkoli research-article2023