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Whole-person care

By: Ernest J. Grant, PhD, RN, FAAN President, American Nurses Association

Meeting the mental health needs of all is critical.

THE WORLD IS HURTING in ways that are visible and, so often, invisible. According to 2017 federal data, an estimated 46.6 million U.S. adults (nearly 19%) were living with some type of mental illness. Yet roughly 57% didn’t receive mental health services.

These statistics are staggering, and nurses acutely understand that there are faces behind all these numbers. They are our patients. They are members of our communities and perhaps our own families. And, given recent national discussions, they very well may be our colleagues.

To create greater visibility on mental health issues and help make mental healthcare a reality, the World Health Organization designated October 10 as World Mental Health Day. This year’s theme is suicide prevention, which is aimed at stopping the nearly 800,000 people who take their own lives every year and the many more who try. This global observance also coincides with National Depression Screening Day, part of a monthlong effort to gain treatment for the millions who experience major depressive episodes every year.

These annual observances bring much-needed attention to mental health, but tending to the whole person—mind, body, and spirit—is the bedrock of nursing practice 24/7, 365 days a year. At the same time, we frequently face challenges in meeting that practice goal, including our own discomfort about asking the questions that could tell us what’s going on with our patients beyond the visible.

Given that nurses represent the largest segment of healthcare professionals and practice across all care settings, I believe we truly are the key to identifying those in need and helping them receive appropriate care and services. But it will take both an individual and a collective effort.

One program that’s been successful in strengthening mental healthcare is the Substance Abuse and Mental Health Services Administration Minority Fellowship Program at the American Nurses Association (MFP at ANA). With the support of the MFP at ANA, more than 400 psychiatric–mental health nurses from underrepresented ethnic minority groups have received their master’s or doctoral degrees. They’ve gone on to address behavioral health and related issues within diverse communities through their work as clinicians, researchers, educators, and policy experts. For example, MFP alumna Audrey Strock, DNP, AGPCNP-BC, PMHNP-BC, has developed and worked with programs to seamlessly integrate physical and mental healthcare. Another alumna, Frederica Hughes, DNP, PMHNP-BC, CPNP, uses her clinical expertise to support the recovery process for veterans living with mental illnesses.

On the broader advocacy side, ANA closely monitors and supports legislative and policy measures aimed at improving mental healthcare services and access. Currently we’re supporting H.R. 2848, the Parity Enforcement Act, which expands the U.S. Department of Labor’s authority to hold health insurers and plan sponsors accountable when they violate the Mental Health Parity and Addiction Equity Act of 2008.

Additionally, our governing body, the Membership Assembly, called on ANA to establish an ad hoc committee to study the issue of nurse suicide—another hidden problem—in the United States. We’ll continue to update you on the progress of this important work.

As individuals, nurses must do all we can to ensure we have the basic knowledge and skills to competently assess, screen, and refer patients who are  relying on us to provide the multidimensional care they need. Our premier organizational affiliate, the American Psychiatric Nurses Association, has a wide range of resources that can help. That site and ANA’s Healthy Nurse, Healthy NationTM  offer vital information on self-care, as well.

Also look to colleagues who can share how they broach sensitive conversations. Maybe it’s something as simple as saying, “You look a little down today, is there something you want to share?” That can be the opening that someone—a patient or a coworker— needs.

And let’s not forget the importance of our nurse-patient bond. Through it, we can make the invisible visible and potentially improve and save countless lives.


Ernest J. Grant, PhD, RN, FAAN President, American Nurses Association

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