1. January 25th, 2016
A unit discussion board topic (there are 1 to 2 discussion assignments to be completed weekly).
This one is for week 3.
Course: COUN5223--Introduction to Clinical Psychology
Discussion topic & directions: Advocacy for Clinical Mental Health Counselors
Explore the Current Issues pages of the American Counseling Association's (ACA) Web site,
provided in this unit's studies. Read about the various federal policy issues that the ACA is
currently working toward changing. Then, to complete your post:
 Select and describe one issue of interest. Identify public policies on the local, state, and
national levels that affect the quality and accessibility of mental health services.
 Describe advocacy processes needed to address institutional and social barriers that
impede access, equity, and success for clients.
 Search the internet to determine who else might be advocating toward or against this
specific policy and list these organizations.
 Discuss why they may or may not be advocating in the same manner as clinical mental
health counselors.
 Explain why it is important to support counselor advocacy and influence public policy
and government relations on local, state, and national levels to enhance equity, increase
funding, and promote programs that affect the practice of clinical mental health
counseling.
My Response:
Hello, Dr. Attridge and fellow learnes!
Following, is my response to this unit's discussion board:
1. Current issue of interest, and policies affecting mental health service: A fairly current
issue posted by the ACA in March of 2013, pertains to the employment of mental health
counselors by the Veteran's Administration (VA). According to this article, the need for veteran
mental health care is growing, and there is a high number of qualified mental health workers
available to fill this service need. Nationwide, the number of qualified professionals exceeded
120,000 licensed professionals meeting all of the stringent associated requirements that come
with it--such as master's level CACREP education, post-master's supervised hours, and strict
adherence to codes of ethics (ACA, 2013).
In 2006, the President and congress passed legislation under P.L. 109-461, recognizing licensed
mental health professionals as viable clinicians within VA facilities. Two years following the
legislation, the VA adopted their own standard Licensed Professional Mental Health Counselors
(LPMHC), as qualified for service within the administration. Despite these two milestones,
qualified mental health counselors are still set aside for professional opportunities within the VA.

2. In 2012, only 58 positions were posted for mental health counselors, with 1,527 mental health
counseling positions posted as only assessable to social workers (ACA, 2013).
There are three levels of public policy that could contribute to change within this issue:
A. Federal Level: the ACA suggests professional individuals to encourage congress to place
pressure on the VA to cease discrimination in hiring mental health counselors. Additionally,
eligibility requirements for LPMHC should be tightened to include the passing of the NCMHCE
exam, something that the VA does not require at this time. Counselor education should be
CACREP accredited at a master's level, and mental health counselors should also be included in
their paid trainee program (ACA, 2013). In 2013, the VA additionally underwent congressional
budget cuts that resulted in loss of mental health specialist positions. Lt. Gen. Patricia Horoho
requested furlough exemptions for these specialists, in hopes of extending treatment of PTSD.
Unfortunately, this request was denied (Mukherjee, 2013).
B. State Level: through regional and state branch divisions, the ACA holds a national net-
working opportunity to facilitate available positions through their office of professional affairs.
By collaborating with one's state branch, these position of interest can be more readily filled, and
the efficacy of mental health counseling services exemplified (ACA, 2013).
C. Local Level: liaisons should be appointed within one's counseling community, that
advocates for the hiring of LPCs in a local VA . Also, issuing public notices to local VA health
care systems (markedly to VISN directors, VMAC directors, and human resources), can remind
them of their empowered ability to hire LPCs, and the act of discrimination when they don't
(ACA, 2013).
2. Other organizations advocating for or against above issue, and why:
The first organization I explored is NAMI (National Alliance On Mental Illness). I took
the time to listen to a lengthy webinar (1hr. & 45 min, and can be accessed in provided
reference.) sponsored and endorsed by SAMHSA. NAMI is an alliance started by two military
wives/mothers known as the "NAMI Mommies", who started the alliance as a way to take much
needed military mental health care into their own hands. The main guest speaker was Ingrid
Herrera-Yee, PHD, founder/president of MSBHC (Military Spouse Behavioral Health
Clinicians), and current president of NAMI. She presented their recently implemented program,
NAMI Homefront--a six-session training designed to educate both families and caregivers of
military personnel, experiencing mental health conditions (NAMI, 2016). Qualified teachers of
this community program is based more on personal experience than educated credentials. NAMI
believes in mental health care being less implemented in "clinical" fashion by those "outside" of
the military culture, and more-so by individuals with a variety of educational backgrounds and
training, who have direct experience with the military. To NAMI, personal relating is more
important than "a bunch of letters after a name" and desire a less "manualized" implementation
of mental health care (NAMI, 2016). Though they would not be advocating for the same cause as
mental health counselors, they would still be a strong stakeholder to partner with, if advocating
mental health counselors were steeped in personal military understanding coupled with efficacy

3. of their vital array of expert services. Compassionate understanding for NAHMI's views would
be vital.
A second organization is SAMHSA (Substance Abuse and Mental Health Services
Administration). SAHMSA holds great concerns as to military mental health care, including the
fact that many military personnel do not seek available treatment due to discrimination fears and
affects on their military careers--a concern of NAMI's as well. They also echo NAMI's concerns
that their unique culture may not be wholly understood by the greater health care community at
large (SAHMSA, 2014). As mentioned above, SAHMSA endorsed NAMI'S Homefront
presentation, and works with them in verifying efficacy of such programs. While employment of
mental health counselors is not necessarily a priority to SAHMSA, they would be a strong ally if
again, mental health counselors could be promoted through expertise credentials, coupled with
personal understanding of military culture. Required knowledge in a culturally-related
competencies task force may be beneficial for mental health counselors in the future. I was able
to spend time talking with a younger Army veteran in my community, who gave me even more
perspectives to reflect on, such as high military personnel/low counselor ratio, and lengthy
processes prohibiting a sense of personalization in client/counselor relationships.
3. Advocacy processes for overcoming barriers: One of the first barriers to overcome, is
instilling educated empowerment within clients. This first level equips a client for self-advocacy,
by empathetically informing them of contributing environmental and systemic factors. A client
can also be helped to assess their own lives, to identify if there are personal life factors
contributing to the problem at hand. Through this process, world views of both the client and
their environments can be examined and cross-compared. A client can come to clearly identify
and understand existing barriers (Erford, 2014). In the above case, this would apply to military
personnel/veterans and their families.
At this point, a counselor can further assess if barriers warrant forming an advocacy plan of
action. Assessing time, resources, and support systems can begin to take advocacy into the
community at large. This process may require a setting of realistic goals, flexibility and
compromise, and the formation of trusted contacts/allies in various external systems. Further
following the processes of advocacy, including continual reassessment of progress,
communicating successes to news media and the community, as well as extending thanks to
supporters, will continually contribute to a potentially successful outcome (Erford, 2014). As
can be seen from the issue above and the stakeholders involved, all of these processes align.
4. Importance of supporting counselor advocacy: Advocacy is a critical component of the
Mental Health Counseling future. Without it, counselors may lose their uniquely esteemed status
in the helping professions, and no longer engage in the valuable services they have to offer
(Erford, 2014). As seen above, Mental Health Counselors are being lost in the shuffle of other
less qualified professionals--not only within the military and VA culture, but within
congressional recognition as well. Mental Health Counselors will have to exercise their voice
and make known the need for their invaluable service through the advocacy of their own
profession.

4. 5. Counselor Advocacy and Multi-Dimensional Public Policy: for client systemic barriers to
further be addressed, counselors must take advocacy to expanded levels. When counselors move
to the local--or community--level, they begin to communicate the issue to other groups with like
concern. Alliances are formed through collaboration, and strengths and weaknesses can be
assessed. Together, alliances can form an action plan, and prepare to advocate at political levels
to address systemic changes. Information comes to be disseminated within the public, generating
Mental Health counseling awareness, along with systemic and environmental barriers preventing
service access. Counselors can also begin reaching across multiple professional domains,
proving their efficacy in understanding of human development and communication skills
(Erford, 2014).
By the time counselors reach state and national levels of advocacy, they should be well-prepared
to identify their defined cause and the avenues through which to channel change. With acquired
allies, they will collectively be ready to lobby legislators and policy makers for program changes
and funding requests. Throughout this tier process, counselors never lose communication with
their clients in re-assessing their advocacy plan as still aligned with their initial goals (Erford,
2014).
Thank you for allowing me to share!
~Tamela
ACA (2013). Counselors continue to be all but shut out of the VA. ACA: Government Affairs.
Retrieved from: http://www.counseling.org/government-affairs/current-issues/position-
papers/2013/03/26/counselors-continue-to-be-all-but-shut-out-of-the-va.-here's-what-you-can-
do-to-help
Erford, B. (2014). Orientation to the Counseling Profession: Advocacy, Ethics, and Essential
Professional Foundations (2nd ed.). Upper Saddle River, NJ: Pearson, Inc.
Mukherjee, S. (2013, March 14). Military Leaders: Sequester Cuts Will Prevent Veterans From
Assessing Mental Health Services. Think Progress. Retrieved from:
http://thinkprogress.org/health/2013/03/14/1720021/sequester-cuts-veterans-mental-health/
NAMI (2016). SAMHSA-Sponsored webinar: On the Homefront: Connecting military, vets, and
their families with mental health care. NAMI: National Alliance on Mental Illness. Retrieved
from: http://www.nami.org/About-NAMI/NAMI-News/SAMHSA-Sponsored-Webinar-On-the-
Homefront-Conn-%281%29
SAMHSA (2014). Veterans and Military Families. SAMHSA: Substance Abuse and Mental
Health Services Administration. Retrieved from: http://www.samhsa.gov/veterans-military-
families