Nurse Psychotherapists as Autonomous Mental Health Providers: Advocating for Change

In Canada, as in other jurisdictions, the complexity of the healthcare system, care delivery, emerging healthcare needs, and demographics impacted by aging populations and immigration policies are influencing the need for advanced education and expanded roles for nurses. The scope of practice and educational pre-licensure requirements for nurses has incrementally evolved and expanded. While driven by healthcare needs, scope of practice changes, like any change, are impacted by many factors—stakeholder acceptance, safety considerations, felt need, and political will. Expanded scope of practice has thus been authorized by regulators and governments, only after intense advocacy related policy initiatives that reinforce the need for such a service, the cost quality benefits of such a service, and the ability of nurses to provide the service have been demonstrated. In Ontario, this was the case for the authorization of nurses to be included in those able to perform the controlled act of psychotherapy. This chapter explores key elements that are part of a successful advocacy strategy to enable autonomous roles in nursing, in this case, nurse psychotherapy. These elements include visionary leadership, strategic advocacy, education, regulation and standards. Nurses themselves often lead such advocacy initiatives through specialty interest groups, and/or their professional associations.