Introduction

Figure 12.1 Understanding all of the legal and ethical issues surrounding client care is critical to ensure the nurse can support a client who is unable to make their own choices and carry out their own actions. (credit: “Legal Gavel & Open Law Book” by “howtostartablogonline.net”/Wikimedia Commons, CC BY 2.0)

Chapter Outline

12.1 Client Representation for Empowerment and Relationship Rebuilding

12.2 Autonomy and Independence

12.3 Self-Advocacy

12.4 Client Advocacy

When a person has autonomy, they are able to make appropriate choices in their life. They are empowered and can form meaningful relationships that provide them the self-determination required to make their own life decisions. To have autonomy and self-determination, the person may have to advocate for themselves and feel comfortable in doing so to achieve their required outcomes.

When nurses encounter clients in the mental health-care field, the clients have often experienced some type of trauma. Whatever the cause, the client may feel or live with symptoms that make them feel as though they have lost control of their emotions, actions, and/or ability to self-determine. Often the disturbance in their equilibrium results in embarrassment, anxiety, and stigma. The effort to achieve a more balanced state includes a variety of interventions that can return them to a place where they can advocate for themselves and have the ability to make autonomous decisions.

Nurses will encounter clients at various levels of functional ability. Therefore, nurses must recognize each client as an individual and meet them where they are. According to the American Nurses Association (ANA) Scope and Standards of Practice, advocacy, respect, and communication begin the process of caregiving; they also require consideration of cultural differences and absence of stigma (ANA, 2015). For each client, the mental health nurse works to complete an assessment, establish a trusting relationship, and meet the immediate needs through collaboration with other members of the health-care team. Supporting the client’s ability to self-determine, increase the level of functioning, and enhance client empowerment are roles of the mental health team.