The number of people worldwide suffering from a mental disease keeps growing, while the tendency towards an increasingly specialized mental health care seems also to be accentuating. As a consequence, the demand for specialized mental health nurses has also increased. Psychiatric nurses play a very important role in promoting health and helping patients regain control of their lives. This article analyses the role of these professionals in relation to patient empowerment by means of emancipation, self-efficacy and self-management. This article aims to push these concepts further than the traditional ideas of health promotion in mental health nursing.


Patient empowerment has been defined by the WHO as the cornerstone of health promotion and, therefore, there is a need to develop and implement methods that take into account the patient’s voice. The article describes empowerment as the overall process of increased self-esteem, which is essential for individuals to gain the energy needed to fully develop their personal health capacity. People with a mental disorder that have participated in patient-centered educational activities have shared positive health experiences in relation to empowerment. According to mental health professionals, empowerment processes in mental health care and services are dependent on financial priorities and on the sharing of responsibilities at an organizational level.


For a person to be considered emancipated he or she has to be independent, free and autonomous in their decision-making. Emancipation is linked to the process of self-reflection, to acquiring new knowledge, motivations, values and goals, which will free the individual from preconceived and impairing ideas he or she might have had.

Patient emancipation involves setting the patient free from the control exercised by nurses, doctors, and other authorities. For a person with mental illness, greater knowledge and understanding of the situation can support individual emancipation and increased self-management.


Self-efficacy concerns a person’s beliefs about his or her capability to create designated levels of performance and to exercise influence over different life events. Self-efficacy involves beliefs that determine how the individual feels, thinks, motivates him or herself, and behaves. Those who have high confidence in their abilities approach demanding tasks as challenges to be mastered, rather than as threats to be avoided, and they quickly recover their sense of efficacy after failures.

Studies show that the promotion of self-efficacy in people with a mental illness reduces stress and lowers vulnerability to depression. It is common for individuals susceptible to mental illness to experience hopelessness and feel an inability to control their life. From a health promotion perspective, the role of nurse professionals is essential to improve their patients’ self-efficacy.


Self-management plays a key role in allowing people with long-term mental illness to manage on their own, and to become autonomous in the context of their care and treatment—which traditionally has been entirely controlled by their clinicians

The concept of self-management refers to the person’s ability to manage the symptoms, treatment, physical and psychosocial consequences, and lifestyle changes inherent to living with a long-term condition. Efficient self-management encompasses the ability to monitor one’s condition and to affect the cognitive, behavioral, and emotional responses necessary to maintain a satisfactory quality of life.

Through learning from daily life experiences, a person is able to make changes to his/her daily life and reconstruct his/her self-identity by exploring personal limitations or boundaries. Self- management in mental health care is about transferring the focus from treating a condition or illness to enabling a person to live with that condition or illness over the long term.

The article concludes by asserting that the approach presented can serve as a foundation for further discussions and studies on health promotion and empowerment and the importance of emancipation, self-efficacy, and self-management within mental health nursing. A greater understanding of these concepts among mental health nurses will contribute to improve health-promoting care provided to persons with long-term mental illness.


Source: Jönsson PD,Nunstedt H,Berglund IJ, Ahlström BH, Hedelin B,  Skärsäter I, Jormfeldt H. Problematization of perspectives on health promotion and empowerment in mental health nursing—Within the research network “MeHNuRse” and the Horatio conference, 2012. 2014. Int J Qual Stud Health Well-being.

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