Resistant Insistent Persistent: A Global Call by Mental Health Nursing Leaders

In recent years, the global mental health landscape has shifted dramatically. Rising rates of mental illness and distress, compounded by geopolitical instability, climate-related trauma and systemic inequities, have placed unprecedented pressure on mental health systems worldwide (World Health Organization 2022, 2025). Amid this crisis, mental health nurses—who comprise nearly half of the global mental health workforce—remain under-recognised, under-resourced and under-represented in global and national leadership and policymaking (World Health Organization 2025; Jackson et al. 2025). The November 2025 Mental Health Nursing Leaders' Summit in Barcelona, Spain, marks a pivotal moment to reclaim visibility, assert disciplinary self-determination and chart a transformative path forward. Mental health nursing has long operated within the shadows of nursing and medically dominated paradigms (Croguennec et al. 2024; Davies et al. 2024; Marć et al. 2019; Stewart et al. 2024). Sercu et al. (2015) have noted that ‘stigma constitutes a threat for professionals who work in mental health care, through their association with mental illness as a discrediting attribute’, and Flaskerud (2017) adds that the perception of lack of skills in a medical model and self-stigmatisation may inform the crisis of invisibility and submission to other models. Despite its persistent intersectoral reach and holistic approach, the discipline is frequently subsumed under more general nursing frameworks, diluting its identity and limiting its scope of practice (Wand 2024). This systemic marginalisation has led to what scholars describe as epistemic injustice—silencing mental health nursing voices in practice, policy, education and research (Fisher 2023; Grim et al. 2022; Lakeman and Hurley 2021; Okoroji et al. 2023; Warrender et al. 2024). This invisibility is not merely symbolic; it translates into diminished influence over care models, funding decisions and regulatory frameworks (Delaney and Vanderhoef 2019). As comprehensive nursing agendas gain traction, mental health nursing risks being reframed as a sub-specialty rather than a distinct discipline, further eroding its autonomy and impact (Foster and Hurley 2024). The challenges facing mental health nursing are compounded by complex global geopolitical determinants (Wilson et al. 2022). The post-pandemic surge in mental illness intersects with rising numbers of displaced populations, systemic racism, gender-based disparities and economic exploitation (Mabil-Atem et al. 2024; Wilson and Waqanaviti 2021; Wilson et al. 2024; Wilson and Usher 2015). Climate change adds another layer of trauma, with phenomena like ecoanxiety and solastalgia affecting communities worldwide (Albrecht et al. 2007). These pressures have exposed a fragile workforce pipeline (World Health Organization 2021). Burnout, occupational violence and limited career progression have led to high attrition rates, particularly among early-career mental health nurses (Hannigan et al. 2000). Educational models often fail to equip graduates with the necessary skills for mental health settings, and academic institutions struggle to recruit qualified faculty (Hazelton et al. 2024). In many countries, mental health nursing lacks discrete regulatory recognition, undermining its legitimacy and safety standards. This initiative reflects a growing and persistent consensus that mental health nursing must define its own future, informed by its unique knowledge base, practice models and relational expertise (Hove et al. 2023; Lakeman 2023; Santangelo et al. 2018). The global volume of mental health nursing workforce assets can be mobilised to halt the decline in global mental health outcomes, improving productivity, quality of life and human rights. The world audience needs to hear and heed the insistent mental health nursing voices to address today's most challenging concerns. While we pay respect to the mental health nursing leaders of the past, we look to the future where dynamic change is required to ensure that mental health nurses are equipped en masse to deliver urgent, safe, progressive and tailored global mental health care. Our vision is bold; obstacles remain, including resistance from medical and nursing paradigms, educational constraints, workforce shortages and systemic discrimination. However, the Summit highlights strengths: inclusive dialogue, lived experience engagement, interdisciplinary respect and strategic positioning of mental health nurses as the global majority of the mental health workforce. The November 2025 Mental Health Nursing Leaders' Summit to be held in Barcelona, Spain, is more than a gathering; it is a declaration of intent. It calls for a unified global voice, reclamation of disciplinary identity and commitment to transformative change. As mental health needs escalate worldwide, it's time for mental health nurses to lead from the centre of global mental health reform, with the required measures of persistence, insistence and resistance to achieve improved universal mental health nursing care outcomes for the world. The authors have nothing to report. Kim Usher is the Editor in Chief of the International Journal of Mental Health Nursing. Rhonda L. Wilson is an editorial board member of the International Journal of Mental Health Nurses and President of Australian College of Mental Health Nurses. Catherine Daniel is the Vice President of Australian College of Mental Health Nurses. Nathan Dart is a Board Director of Australian College of Mental Health Nurses. Tanya Park is a Board Director of the Australian College of Mental Health Nurses and is an Associate Editor of the International Journal of Mental Health Nurses. Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.