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Review
. 2025 Jul;23(3):291-297.
doi: 10.1176/appi.focus.20250008. Epub 2025 Jul 1.

A Legacy of Advocacy: The Past, Present, and Future of Mental Health Professionals in Systemic Reform

Vincent Migliaccio  1 , Tadeus Lopez Ulloa  1 , Jessica Isom  1
Affiliations
Review

A Legacy of Advocacy: The Past, Present, and Future of Mental Health Professionals in Systemic Reform

Vincent Migliaccio et al. Focus (Am Psychiatr Publ). 2025 Jul.

Abstract

Mental health professionals must promote population mental health through a structural approach that extends beyond the clinical encounter. This includes incorporating policies that target social and structural drivers of health, such as income, education, housing, and health care access. In this article, the authors review historical and contemporary advocacy contributions by mental health professionals, policy areas that influence mental health services, potential targets for advocacy interventions, barriers to and facilitators of advocacy engagement, and advocacy-related incentives for mental health professionals. Drawing on a novel model of advocacy and a framework for advocacy action planning, the authors demonstrate how mental health professionals can advocate for systemic change as a professional responsibility. By leveraging advocacy strategies across the domains of practice, communities, and government, mental health professionals can drive policy changes that promote equitable health outcomes.

Keywords: Advocacy; Mental Health Care/Service Delivery Systems; Mental health professionals; Policy change; Population health; Social drivers.

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Conflict of interest statement

Dr. Migliaccio reports being a salaried employee at the contract research organization IQVIA. The other authors report no financial relationships with commercial interests.

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