NCCs at Work: Advocating for Equitable Access to Mental Health Care

Advocacy represents the very nature of the work that counselors do in helping others to be their best selves. In addition to providing care for their clients, counselors also have opportunities every day to effect change and become agents for social justice. Taking even the smallest steps to educate others about mental health care can make a positive impact.

This month, we reached out to some National Certified Counselors (NCCs) to hear about the work they are doing in their communities and how they are advocating for equitable access to mental health care services.

Zori Paul, MA, NCC, PLPC, PCIT, is a 2021 fellowship recipient through the NBCC Minority Fellowship Program (MFP). She is currently pursuing her PhD in counselor education and supervision at the University of Missouri–St. Louis. Her research focuses on mental health in the LGBTQIA+ community, particularly bisexual women of color, and cross-cultural mentorship relations.

“For counselors to truly advocate for equitable access to mental health care in underserved and never-served communities, we also have to realize mental health care for these communities goes beyond affordable and accessible therapy sessions,” Paul says. “We need to advocate for issues that may not seem very mental health–focused at first glance like affordable housing and increasing the minimum wage, legislation that protects the LGBTQIA+ community, immigration laws, legislation that protects reproductive rights, anti-racism, anti-sexism, disabilities rights, the Land Back movement, and so much more. Creating equitable access to mental health care includes addressing these as they show up in our country and the world.” 

In 2020, Paul co-founded Black in Mental Health, which celebrates Black excellence in mental health and provides helpful resources and a place for counselors to support each other.

“Black in Mental Health is an online initiative I co-founded that focuses on highlighting and amplifying the voices of Black mental health professionals, researchers, students, and advocates,” she says. “It originated, along with other Black in X initiatives, in 2020 as a response to the murders of George Floyd and Breonna Taylor and the many different experiences of anti-Black discrimination that occur every day that either go unheard or are covered up. Through events like our annual Black in Mental Health Week, we have provided space for Black mental health contributors to connect, share stories, and advocate for each other and the rich diversity in the Black community and mental health field. As Black in Mental Health continues to grow, I hope it can become an invaluable resource for Black mental health advocacy and continue to highlight the fantastic work that Black people in different areas of mental health are doing.”  

Pamela Fullerton, MA, MEd, NCC, LCPC, CCTP, C-DBT, is a 2021 doctoral counseling MFP Fellow. A doctoral student at Governors State University in Illinois, she is the owner of Advocacy & Education Consulting and an adjunct instructor at Northeastern Illinois University.

Fullerton, a Latinx counselor and clinical supervisor, along with two other MFP Fellows, recently created A Dream Decided, an NBCC Foundation Giving Circle, to raise scholarship funds for undocumented counseling graduate students. She often holds workshops for local agencies, schools, and organizations to support mental health awareness training and improve community involvement.

“I recently presented to National Louis University’s school counseling students on how to increase multiculturalism, social justice, and advocacy in the schools as a school counselor,” she says. “The students enjoyed the workshop, learned new information, and created tangible action plans to implement into their work at their school internship sites.”

Fullerton says she lives by the social justice and advocacy values she brings to her work, and that to her, advocacy means action.

“I remember working for a school during a time when the sociopolitical climate spewed falsities and hatred toward undocumented immigrants on almost a daily basis,” she says. “I decided to wear a shirt that stated ‘I support undocumented students.’ This was not a political statement (though I believe we cannot take politics out of counseling as social justice advocates); it was an advocacy and social justice statement. I was asked by the administration to take my shirt off or be reprimanded. I did not take my shirt off and instead washed it and wore it again. It does not matter if your action is joining a protest or calling a legislature to help change laws to benefit underserved communities, as long as you routinely engage in actions that will lead to social change in the spirit of diversity, equity, and inclusion, you are advocating.” 

Though we can all advocate for equity and access, Fullerton believes there is strength in numbers and encourages others in the counseling profession to act now.

“Look at the research. We are still falling short in serving minoritized populations,” she says. “The battle for equitable access to services and advancing social justice causes is a LARGE battle that none of us can take on independently. Where do you want to put your energies? Where do you believe you can make the most difference in fighting for our underserved populations? Find that area(s) and make a plan of action to do your part.”

Kapil Nayar, MA, NCC, ACS, LPC, ChT, a doctoral student in counselor education and supervision, says that where advocacy is concerned, counselors should ask themselves “If not me, then who?”

“It is an inquiry that my mentors have said to me time and time again,” Nayar says. “Generally speaking, as counselors, we individually are a direct reflection of the field. Much of our work is emulated by our clients, and that ripples into our clients’ nuclear homes, and transitively, more macroscopically, society. If we do not petition and advocate justly for our clients, we are part of the problem.” 

Nayar stresses that it’s every counselor’s responsibility to be an advocate.

“It’s through this front-line work that we have an obligation to advocate for our clients, not only because this is the ethical thing to do, but also because this is what we want our clients to eventually do for society,” he says. “This is the only way to spark change.”

He would like to see more movement in the political and legislative spheres, adding that counselors and their clients need stronger voices.  

“I think there has been a lack of oversight specifically as it relates to nonprofit and for-profit accrediting bodies for facilities, and that falls into loopholes established by our congressional bodies and lawmakers. Often the people that this impacts most—folks suffering with mental health and/or substance use disorders—are not being heard, let alone listened to. I think this is the most important thing, we, as a field need to drive momentum toward changing.”  

It is critical for counselors to speak up, even in difficult circumstances, he adds.

“Practice raising issues that you see to the highest echelon. I know our field is inundated at the moment, and there is more than enough on our plates, but how many of us shy away from doing the moral or just thing for fear of retaliation? To normalize this, I’ve started publicizing concerns I hear on social media just to prove that folks are not the only ones endorsing such concerns. Counselors need to unite and petition for the field, just as we do for our clients. Each time a counselor advocates for a client, another counselor, or the profession in general, there is a ripple effect.”

Turesa Gilchrist, MSEd, NCC, a 2019 master’s counseling MFP Fellow and a school counselor in Virginia, says that being an advocate for her students is essential to their success.

“I think it’s important for school counselors to advocate for equitable access to mental health care in underserved and never-served communities because it is an integral part of our role as agents of change. To best support students’ academic motivation and achievement, we must first foster their social and emotional needs,” Gilchrist says. “This includes using our knowledge and skills to positively contribute to students’ mental health and psychological well-being. Building the success of our students means advocating for our most vulnerable populations to have access to the services that they need to be adequately supported, represented, and empowered, both inside the classroom and at home. As school counselors, we can make sound, impactful practices by consistently working to bridge the gaps in access to care for our communities in need.”

Gilchrist encourages other school counselors to take part in programs in their schools and to create their own initiatives as well.

“I serve as the Multicultural Education Advocate (MEA) at my school, as well as a member of the Multi-tiered Systems of Support (MTSS) team. My role as the MEA is to lead programs and initiatives that promote diversity and inclusivity. This includes leading a book study using Culturally Responsive Teaching and the Brain to facilitate school-level discussions, as well as provide monthly awareness such as honoring Black History Month and National Women’s History Month. Through MTSS, I work to create a welcoming, positive, and supportive school environment through schoolwide initiatives for student and staff wellness through themes such as Virginia Kindness Week and SEL activities.”  

Education is the heart of all advocacy efforts. By raising awareness about mental health, counselors can work together to help remove barriers to care, increase access, and reduce the associated stigmas. Understanding the social, economic, and cultural factors that impact mental health highlights the need for additional resources to address the discrepancies.

“We have to keep in mind that not all students have the same protective factors in place,” Gilchrist says. “We have to be intentional in collaborating with stakeholders and building necessary partnerships to best cultivate equitable counseling resources and learning opportunities, especially for marginalized students. Through these efforts, we are able to build genuine relationships and create a sense of belonging amongst our schools and communities.”