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Mental  health disorders, even though suffered by many, remains stigmatized and  receives less attention than other health care issues (Swanton, 2016).   Many patients are not willing to disclose their mental health diagnosis  because of the fear of being looked down on or judged. There are also  limited mental health resources as well as some communities are not able  to gain some of these benefits due to insurance issues or the inability  to pay (Choi et al, n.d.).

             Two of the issues, that this writer believes need change are that of   the granting of FMLA leave to patients with diagnosed psychiatric  disorders and making treating options available to everyone. This writer  has worked with several clients who were having difficulties being  granted  FMLA or being denied. The FMLA is the Family and Medical Leave  Act. It works on behalf of those with medical and mental health  disorders who are unable to perform their job duties due to the  disability from the diagnoses (Wray et al., 2015).  Clients with  physical ailments may find it less difficult to be granted this paid  leave as their disorder is visible by the employer and those granting  the leave. When it comes on to mental health disorders, client tend to  run into several road blocks as their disorder is not readily visible. 

Many  clients explain that their request was denied or met several obstacles  as their diagnoses was not considered chronic or disabling. Many of the  clients argue that anxiety and depression make it difficult for them to  carry out their jobs that require them to come in contact with people.  The increased stress from interacting with others and trying to fit in  to the workplace can be debilitating but is rarely considered so by  employers. This is an area that needs attention and change. This writer  believes that Nurse Practitioners and other health care providers can be  an advocate for the client by providing thorough information on the  client’s illness that support the need for a leave.  The Nurse  Practitioner should be readily available to answer questions and educate  the employers on mental health disorders. In addition, the Nurse  Practitioner could advocate for change on a federal or state level by  writing congress or their elected leaders.

             Another issue that this writer believes need special attention is that  of making special procedures available to everyone. When treating mental  health disorders there are many treatments that would be beneficial for  a client, but the client will end up not receiving the treatment due  their inability to pay or insurance coverage (Wang & Xie, 2019).  This writer has worked with several client suffering with depression who  have exhausted the use of antidepressants but were not qualified for  ECT due to monetary reasons. The client is simply placed back on the  antidepressants with limited hope to treat their disorder. This issue is  also another social change issue that we as Nurse Practitioners could  propose to our elected leaders. The mental health community on a whole  is stigmatized and separated and this only separates them more by  causing a separation amongst themselves.


Choi, N. G., DiNitto, D. M., & Marti, C. N. (n.d.). Relationship Between the Types of Insurance 

Coverage and Outpatient Mental Health Treatment Use Among Older Adults. JOURNAL 

OF APPLIED GERONTOLOGY, 35(12), 1343–1362.

Swanton, M. (2016). Mental Distress. InsideCounsel, 16(181), 26–28. Retrieved from 



Wang, N., & Xie, X. (2019). Associations of health insurance coverage, mental health problems, 

and drug use with mental health service use in US adults: An analysis of 2013 National 

Survey on Drug Use and Health. Aging & Mental Health, 23(4), 439–446.

Wray, T. B., Dvorak, R. D., & Martin, S. L. (2015). Demographic and economic predictors of 

mental health problems and contact with treatment resources among adults in a low-

income primary care setting. Psychology, Health & Medicine, 18(2), 213–222.

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