Mental Health Advocacy for Nurses

U.S. federal agencies are responsible for the day-to-day enforcement and administration of federal laws. Below are agencies whose news, research, and policy decisions affect psychiatric-mental health nurses.

• Agency for Healthcare Research and Quality (AHRQ)
  Aims to generate evidence that enhances healthcare safety, quality, accessibility, equity, and affordability.
• Centers for Medicare and Medicaid Services (CMS)
  Administers the Medicare, Medicaid, and CHIP Programs
• Food and Drug Administration (FDA)
  Strives to assure the safety, efficacy, and security of human and veterinary drugs, biological products, medical devices, the food supply, cosmetics, and products that emit radiation.
• Federal Trade Commission (FTC)
  Works to prevent business practices that are anticompetitive, deceptive, or unfair to consumers without burdening legitimate business activity.
• National Institutes of Health (NIH)
  Health research agency under the U.S. Department of Health and Human Services.
• National Institute of Mental Health (NIMH)
  Institute within the NIH that is the lead federal agency for research on mental disorders.
• National Institute of Nursing Research (NINR)
  Supports and conducts research that builds the science for clinical practice, prevents disease and disability, manages and eliminates symptoms caused by illness, and improves palliative and end-of-life care.
• Substance Abuse and Mental Health Services Administration (SAMHSA)
  Agency within the U.S. Department of Health and Human Services that leads public health and service delivery efforts to advance the behavioral health of the nation.
• U.S. Legislature
  Find out what’s happening in the House of Representatives or the Senate, and write to your representative or senator.
• The White House
  Learn about the top news and issues of the day through the executive branch, and send your questions or comments to the president and White House staff.

Adapted from American Association of Neuroscience Nurses Advocacy Toolkit (2014)

Like most large organizations, Congress does much of its work by committee. Most Members of Congress are assigned to one or more committees. Typically, committee assignments, leadership positions, and party ratios remain the same throughout the two-year session of Congress. If your congressperson sits on one of these key committees, your participation is especially crucial because these members play a key role in crafting, advancing, or defeating legislative proposals.

Adapted from American Association of Neuroscience Nurses Advocacy Toolkit (2014)

• A bill is a proposal for a new law or a change to an existing law. The idea for a bill can come from a sitting member of the U.S. Senate or House of Representatives or be proposed during their election campaign. Bills can also be petitioned by people or citizen groups who recommend a new or amended law to a member of Congress that represents them.
• Once a bill is introduced, it is assigned to a committee whose members will research, discuss, and make changes to the bill.
• The bill is then put before that chamber to be voted on.
• If the bill passes one body of Congress, it goes to the other body to go through a similar process of research, discussion, changes, and voting.
• Once both bodies vote to accept a bill, they must work out any differences between the two versions. Then both chambers vote on the same version of the bill. If it passes, they present it to the president.
• The president then considers the bill. The president can approve the bill and sign it into law. Or the president can refuse to approve a bill. This is called a veto.
• If the president chooses to veto a bill, in most cases Congress can vote to override that veto and the bill becomes a law. But if the president does not sign off on a bill and it remains unsigned when Congress is no longer in session, the bill will be vetoed by default. This action is called a pocket veto, and it cannot be overridden by Congress.

Source: https://www.usa.gov/how-laws-are-made

Find Legislation

Who to contact & where:

All offices handle constituent communication differently. Therefore, you might want to call each of your Members’ offices and inquire on their preferred method of constituent input: 202/224-3121

• USAGov
  This government-sponsored website will assist novices in contacting their government representatives.
• United States House of Representatives
  Not sure of your congressional district or who your member is? This service will assist you by matching your ZIP code to your congressional district, with links to your member’s website and contact page.
• United States Senate
  A listing of the current members of the Senate, which included contact information and can be sorted by state, name, or class.

Writing:

• Include your full name, return mailing address, e-mail address, and phone number
• In the opening sentence, make your request clear and identify yourself as a registered voter, constituent, and a nurse.
• focus on only one or two issues that are of top priority to you.
• If applicable, include name of the legislation and the associated bill number, and why it should be supported or opposed
• Tell your own story, and explain the relevance to the issue at hand. Include relevant state or local information to explain how the issue affects your community and/or practice
• Offer to be a resource – Policymakers and their staffers are overworked and overwhelmed, so offer them your assistance; they will appreciate your input and help. If you have an article of interest or relevance, be sure to include it with your correspondence
• Ask for a response. Because policymakers and their staffers work for you, you have every right to (politely) ask for a response, and hold them accountable if your communication goes unanswered.

• To reach the offices of your two senators and your representative in the House, call the U.S. Capitol Switchboard at 202/224-3121 and ask to be transferred to their offices.
• Clearly state your first and last name, your hometown, and why you are calling.
• If you know the health legislative assistant (Health LA), be sure to ask for that staffer by name. If not, ask for the staffer’s name, and request to be transferred.
• Reintroduce yourself and immediately identify the topic you are calling to discuss
• Make a clear ask and include brief points as to why the issue is of concern to you, your community, and the nation, and why the Member should take action.
• Specifically, request a written response from the office on the Member’s position or action on the issue you addressed.

Meeting In-Person:

• Prior to arriving, schedule a meeting with the staffer or through the appointment secretary/scheduler for a visit with the Member of Congress. Be clear who will be attending and what issue(s) will be discussed.
• The day before, confirm the appointment as the Congressional schedule changes very often — and such changes often are beyond their control.
• Bring materials that you will provide to the Member/staffer at the end of your discussion, such as articles, APNA Issue Statements or Position Papers, etc.
• Open the meeting by thanking the Member/staffer for his or her time.
• Introduce yourself and fact that you are a psychiatric-mental health nurse, and mention where you live/work in the district/state, so they are clear you are a constituent.
• Be brief and clear, as you typically will have only 10–25 minutes for the entire meeting. (Tip: Prepare talking points!) Cover only a few (one to three) topics.
• Provide a personal story or real-life illustration and briefly cite evidence or statistics to support your position, particularly any local, regional, or state data, as necessary.
• Discuss how the policy change (e.g., increased funding for the Nursing Workforce and Development Programs) will have an impact on your community.
• Be sure to get a response – respectfully. Ask directly, and politely, for the policymaker’s views and position on the issue and what he/she plans to do about it.
• Leave your contact information.
• Follow up with a thank you note addressed to the member of congress whose offices you visited.

Town Hall Meetings

One of the most effective – and underutilized – ways to communicate directly with Members of Congress is to attend their town hall meetings. Almost every Member holds these events during “District Work Periods to gather input and learn the priorities and concerns of their constituents. Members of the media also often attend these meetings providing another opportunity to spread the message.

• Sign up for the alert list for your Members’ meetings.
• Be prepared in advance with your specific question and bring supporting materials.
• Clearly identify yourself and that you are a psychiatric-mental health nurse.
• Ask for a response to your question.
• Make an effort to say hello and introduce yourself to the Member and the staffer before or after the meeting.
• Follow-up with an email or letter to the Member and staff person. Remind them that you were at the meeting on X date at X location, and reiterate the issue you discussed.

Tip: Caseworkers, the staff members in a district office assigned to help with constituent requests, are terrific resources for psychiatric-mental health nurses. Their responsibilities may include helping resolve constituents’ problems in relation to federal agencies, so they are well versed in the challenges of Medicare reimbursement, private insurance, veteran’s benefits, and related issues. If you are experiencing a problem of your own or on behalf of a patient with which you are having difficulty attaining resolution, do not hesitate to enlist the help of a caseworker in your Representative’s or Senator’s office. Oftentimes, they can get a complex matter resolved quickly and painlessly.

Adapted from American Association of Neuroscience Nurses Advocacy Toolkit (2014)

Find Your Nurse Practice Act

Media advocacy is the strategic use of the press to promote psychiatric-mental health nurses, their positive impact, and needed policy changes by influencing public opinion and drawing policymaker attention to the achievements of the field. This is accomplished by PMH nurses proactively showcasing their achievements, innovative work, and expertise through press and social media promotion.

PMH nurses continuously innovate and address community needs. Here are some examples of the type of achievements that can be developed into stories that can be promoted in your local press:

• Effective new programs that address a community need
• New outreach efforts to reach vulnerable populations or solve a local problem
• New treatment options that can help reach more people in need of care
• Local events you’re hosting
• Awards received
• New research or a book to be published

How To Promote Your Story

• Draft a short summary of your story with key facts in one place. A good format to keep it succinct is three paragraphs. You should describe the problem, the developed solution, and your positive results. For stories like events and awards, focus on who, what, where, when, and how. For research, focus on the aim of the work and the context or implications around your key findings.
• Determine your goal. In some cases, you may want to use your story to educate the community or make them aware of available resources. In other cases you may want to use your story to advocate for positive changes needed to address a community problem. Or, your story may be told to help convey a need for volunteer or additional help to expand services for the community. Think through what could be the ultimate goal of your press outreach effort.
• Alert the communications department of your institution to let them know your press outreach plans and/or enlist their help to contact local press with your story. Ensure you have their approval to conduct press outreach. There may also be opportunities for your communications department to share your story on their social channels or in a newsletter.
• Reach out to APNA to share your story summary. APNA often further amplifies member initiatives and press coverage through social media and newsletter articles. Contact inform@apna.org.
• Prepare to serve as your own spokesperson. Review your story summary and ensure you can comfortably communicate the context, implications, and results of your work to the average lay person. Reporters may want to speak with you about the story and quote what you say about it. Prepare to be articulate, succinct and only use language you’d be comfortable seeing quoted in news stories.
• Prepare others that may need to be interviewed. In some cases you may want to be prepared to offer others to speak about your story. For example, a reporter may like to speak with someone impacted by your initiative or a public official that can further demonstrate the impact you made. If necessary, reach out to 1 to 2 people who can speak in support of your story and secure their permission to offer for them to be interviewed, if a reporter is interested in your story.
• Collect relevant visuals. If your story is about something that can be shown, collect a few quality photos to share upon reporter request. For example, if your story is about a mobile treatment unit, have quality photos of the unit available. If you’ve received an award in person, secure a photo of yourself receiving the award. Note: do not send photos to reporters unless they are requested – press outlets do not like to receive email attachments due to potential viruses.
• Research local press outlets. Create a list of print and broadcast outlets that service your community or state. Review their websites to identify the best way to submit a story pitch or call and ask who would be best to talk with about a story like yours.
• Draft a story pitch email. Your pitch should contain just enough information for a reporter to determine if your story is worth covering – no more than 2-3 paragraphs. Structure your pitch with the most newsworthy information in the first paragraph and details in following paragraphs. Don’t forget your subject line – keep it short but eye catching. (See sample pitch emails below.)
• Reach out to reporters or news desks by email or phone. With shrinking staff and budgets reporters are more overwhelmed with story ideas than ever. Ensure your story stands out by being clear, succinct, providing key facts, and highlighting results achieved. Avoid reaching out on days when breaking or national news stories have landed.
• Follow-up on your story. News outlets are swamped with story submissions and have few staff resources. If you don’t receive a response, try again. Be tenacious and reach out a few days later with a friendly follow-up. You can always put the story aside and try again at a time in the future, or if it can wait, tie your story to Mental Health Month in May or other relevant observances.
• Be gracious if a press contact turns your story down. Your goal is to develop a positive relationship with the press that can serve you well for future stories. Offer to serve as a resource if a reporter plans to do future stories on mental health topics. Ask if there are particular types of stories that the news outlet likes to cover – this may help you tailor your outreach in the future.
• Secure a Story? Let APNA know. If your efforts result in local press coverage, email inform@apna.org so that APNA might amplify your success through its communications channels.

Interview Tips

• Memorize 3-4 key messages from your story, with relevant facts and statistics. If doing an interview by phone, plan to have your key points in front of you for reference.
• Rehearse and plan the delivery of your key messages in comfortable, conversational form. Plan to answer questions like: Tell me about X? Why is this important? How did you come up with the idea? What do you most want readers/listeners to know or understand? Where can people go for more information?
• Avoid acronyms or industry jargon. Reporters are unlikely to be educated about your topic, therefore you need to be able to communicate key points clearly so a broad audience can easily understand.
• Dress professionally if your interview is on camera or video conference. Plan to wear solid colors instead of busy patterns.
• Strive for a friendly, but knowledgeable tone. Bring your bedside manner skills and warmth to the interview!
• Prepare lighting and camera angles for remote video interviews. For best results, face a window for natural light or place a lamp in front of you to shine on your face. Elevate your computer so you are looking straight at the camera and reduce distractions in the background.
• Be trustworthy and accurate. Share citable facts. If you don’t know the answer to a question, don’t guess. Let the reporter know you will look into it and follow-up with an answer via email following the interview.

Friendly Reminders

• Always ensure ethical guidelines. Maintain patient confidentiality, adhere to professional standards, and avoid conflicts of interest.
• Reporters are human beings. They can make mistakes, have prejudices, or have bad days. Your remarks can sometimes be misquoted or misinterpreted from time to time. You can calmly and professionally reach out to the reporter to request a correction, but be prepared they may not always accommodate this request.
• There’s no such thing as “off the record.” Assume that everything you say could turn up in a resulting news story. Don’t say anything you wouldn’t want to see shared to the public.

SAMPLE Pitch Emails

When developing a story pitch email, keep it as short and direct as possible. Include:

• A compelling subject line
• An introduction that grabs attention (look online for relevant statistics to cite)
• A concise summary of the newsworthy story with supporting facts
• A call to action with your contact information

Example 1

Subject Line: Innovative [EFFORT NAME] Delivers Quality Mental Health Care in [TOWN]
Good morning [REPORTER’S FIRST NAME],
In Illinois, more than 950,000 people are experiencing mental health challenges but are not receiving the treatment they need. This treatment gap can occur for a number of reasons, including cost, a lack of transportation, or a lack of knowledge of available mental health resources.
To reach more patients in need of quality mental health care in [TOWN], psychiatric-mental health (PMH) nurses from [INSTITUTION] have stepped forward to develop [INNOVATIVE TREATMENT MODALITY, OUTREACH EFFORT, COMMUNITY EVENT, ETC.] that is bringing care to more vulnerable populations in our community. [PROVIDE A FEW KEY DETAILS ABOUT THE STORY AND HIGH LEVEL RESULTS]
I would love an opportunity to share more details about the positive impact of this effort. Is there an upcoming time that might work for you to speak by phone?
Thanks in advance for your time.
Best regards,
[YOUR NAME]

Example 2

Subject line: Local Psychiatric-Mental Health Nurse Awarded [AWARD NAME]
Dear [NAME],
The [ORGANIZATION NAME] has announced that [NAME] has been awarded the coveted [AWARD NAME] for [SPECIFIC ACHIEVEMENT]. This prestigious award highlights the vital [WORK DONE BY PMH NURSE PROFESSIONAL] in [TOWN].
[BRIEFLY EXPLAIN THE SPECIFIC ACCOMPLISHMENT THAT LED TO THE AWARD]
Would you be interested in covering this story? Here is a link to the award announcement (INCLUDE WEBSITE LINK) I would be happy to speak by phone to provide any additional information needed or arrange to share relevant high-resolution visuals you may use.
Best regards,
[YOUR NAME]