Although epidemiological literature reports a significant overlap between depression and alcoholism among women, the dynamics of this relationship requires further exploration. The present paper documents significant lifetime histories of depression among women in treatment for alcohol problems, and presents findings on these women's experiences of the relationship between depression and alcohol use problems. In this community-based treatment sample, 18 out of 18 women participating in qualitative interviews reported histories of depression and almost 80% were currently using anti-depressant medication. The use of alcohol as an attempt to escape difficult emotions or alternatively to produce positive emotional experiences is discussed within the gendered context of the stories women tell about their depression and alcohol use.

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Despite a strong history of social justice–based social work professional education in Canada, there has not been an intentional integration of direct critical clinical mental health practice with social justice–based theory. Progressive social work has tended to view clinical work as focusing on the individual and failing to contribute to social change. In this article, I elaborate upon a critical clinical social work approach influenced by postmodern critique, and feminist-, narrative-, and collaborative-based practice rooted in critical theory. Critical clinical practice disrupts the individual/social binary through counterviewing unhelpful dominant social discourses and producing counterstories that participate in social resistance. I explore the constraints of neoliberalism on social work mental health practice and its influence on the ability of social workers to practice social justice–based social work. Neoliberalism constrains social workers’ ability to address the social and structural determinants of mental health through its focus on economic rationalization, biomedicalization, and individual responsibilization, alongside rationalized practices that emphasize evidence-based and short-term efficiency-based models. I argue that social work is facing a crisis as a disempowered profession, as it attempts to reconcile its commitment to social justice and the importance of addressing inequity, marginalization, and oppression while often working in settings that demand the subordination of social work knowledge to neoliberal biomedicalism. Under these conditions, a critical clinical approach to mental health practice is needed now more than ever.

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