RPNs began the practice of Community Psychiatric Nursing practice in Western Canada and continue to be major human resources in the provision of this service. As Canadian health services move toward a Primary Health Care focus, RPNs are familiar with services that create community-based and community-driven services. Further, RPNs support the practice of Primary Health Care that can afford Canadians an array of essential services that promote health generally; if the practice can afford seamless entry and quality, accessible resources.

Discussion of the principles of Primary Health Care individually seems necessary to capture the relevance to mental health/illness issues in Canada.

The maintenance of universality is frequently more pressing for people who are affected by mental health/illness issues. Poverty, under-employment and unemployment are familiar concepts to many people who live with mental illness. Although the focus of resources on health care services is intended for the majority, and a minimum level of care is defined by the community within a Primary Health Care approach, people affected by mental health/illness issues often are reluctant or resistant to self identify their needs. This population then is at risk for becoming invisible and under-served. It is imperative that there be available human resources, from policy makers to front line service providers, who are knowledgeable advocates to ensure appropriate resources are allocated to mental health.

The principal of community participation has historically held little meaning for people affected by mental health/illness issues. History demonstrates that Canadians are not alone in marginalizing, stigmatizing and ostracizing people affected by mental health/illness challenges. Meaningful participation in care is central to building personal capacity in people affected by mental health/illness issues. The Registered Psychiatric Nurses of Canada would emphasize that 'helping people to help themselves' is crucial to recovery and critical to empowerment.

Although there is a focus on community/aggregate, the individual systems not traditionally viewed as health care often are unaware of the presence of people they serve who are affected by mental health/illness issues. Barriers to intersectoral collaboration in health services generally are evident through the literature and range from historical, political, cultural, linguistic and geographical restrictions. People affected by mental health/illness issues may be limited by their illness or stigma of their illness to assert the need for diverse services.

Mental health professionals and people affected by mental health/illness issues are too familiar with receiving 'lip service' rather than concrete resources to make a positive difference in the quality of mental health services available to Canadians.

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