Standard 6 of Practice in Mental Health Nursing: Eliminating Stigma and Encouraging Inclusion

Rationale behind this Standard 6
The 6th Standard of Practice in Mental Health Nursing (2010) proposes that mental health nurses
should look for and use all the possible opportunities to eliminate or minimize the stigma
attached with mental health problems. They must strive to encourage social inclusion and
community engagement for individuals with mental illness. The rationale behind formulating this
standard is that people with mental health issues face seclusion as society has attached various
kinds of stigma with mental illnesses. In addition, stigma and lack of inclusion in society restrain
those individuals and their families from getting access to support services which promote their
recovery. It is not only moral duty but also professional obligation of nurses to remove stigma
and discrimination against the mental illnesses as these are source of self-stigma and withdrawal
which further affects their mental health negatively and leads to social exclusion. In recent times
also, society has poor attitude towards mental illness. People have developed myths about metal
illness and people having them such as dangerousness, incompetence, etc. which causes reduced
sympathy and low acceptance of individuals with mental health problems in the community, and
enhanced exclusion and discrimination. Such attitudes restricts the scope to which individuals
with mental illness can contribute to the economy. Like, it is observed that people with mental
illness get detached from their peers and they often find it difficult to become an active and
productive citizens as adults. It results in a section of unproductive population impacting the
overall economy of the nation apart from the healthcare cost burden. Several elements singly or
in conjugation work together in conceiving and sustaining the stigma against mental health
problems. A common element is that majority of the settings in society label people with mental
health problems leading to development of a certain stereotype. As a person is labeled and
prejudiced in a wrong way, it eventually leads to his/her exclusion from those social settings. A

differentiation is common in communities in which the people with mental health problems are
viewed as “them”, while the general population is viewed as “we”. This differentiation causes
discrimination and the people who face this stigma experience status loss, disapproval, and
seclusion. It is seen that fellow community members feel uneasy when they are around
individuals with mental disorders. They want to maintain a safe distance between themselves and
people with mental health issues. Research suggests that the lesser community understood the
individual with mental health problems, the lesser they wanted to be involved with them, be
surrounded by or be associated to them (Ouellette-Kunz, 2010). In fact people with mental
illness are regarded as extra burden over community and contribute to the stress on the family
and society in general. The labelling and inaccurate understanding regarding people’s mental
problems due to the stigmatization affects the points of views of people around them which leads
to social detachment. Apart from the community, support services also support the
discrimination against people’s mental illness as it is engrained in service worker’s attitude
which results in fear, unfamiliarity, and stereotype for mental health problems. Research
indicates that individuals with mental health issues commonly receive inferior health care
services than the general people (Walker, McGee, & Druss, 2015). The notion that mental
disorders are associated with impairment or incapacities reinforces the negative attitudes and
stigma which promotes discrimination against people with mental health problems. They
completely or partially fall behind from participation within community (Morin, 2013). Social
distancing is an impediment in the course of treatment as for a person with mental illness to
recover a sound and supportive social network is extremely useful. This standard is relevant in
this scenario and can prevent it from occurring.

What are the attributes (knowledge, skills and attitudes)
necessary to meet Standard 6?
Health professionals should have a range of attributes in order to implement Standard 6.
Knowledge
Evidence-based practice- Nurses must be familiar with the best practices linked with different
types of mental disorders and should implement them in service provision. Nursing actions must
be informed by evidence. Nurses should be aware of current guidelines by updating themselves
with current literature in order to provide best possible care based on empirical evidence. Nurses
should work towards continuous professional development so that they can improve their
competence in theory as well as practice continuously.
Educate- Apart from therapeutic duties, nurses also have duties of imparting knowledge through
education to the patients and their families. Nurses must have adequate knowledge about the
anti-stigmatic awareness programme. They should spread awareness regarding evidence-
informed public anti-stigma programmes that are associated with and reinforced by significant
anti-discrimination steps in context of mental health problems. Patients should be taught about
their recovery process so that their confidence can be build and they can get back to their
previous life. Their carers should be made aware on how to avoid intentional or unintentional
stigmatic practices around the person with mental illness. In addition, community programmes
can be planned to address the existing misconceptions regarding mental health issues so that
discriminatory practices can be prevented and inclusion of those people can be enforced in
society.