Challenging the Constraints of Neoliberalism and Biomedicalism: Repositioning Social Work in Mental Health

Abstract

This article explores the impact of neoliberalism and biomedicalism on social work mental health care practice through presenting the results of a Canadian provincial study which illustrates the experiences of social work service users, providers, and supervisors. While Canada has a universal health care program, the intensification of the free-market approach is evident in the shifts from public sector support to growing rationalization and marked cutbacks to the provision of social welfare services. The specific impact of neoliberal economic restraint on social justice in mental health services has pressured practitioners to adopt medicalized, short-term strategies, under efficiency-based models. The participants in this study reported significant co-occurring concerns with the state of mental health service delivery, and results suggest social work is increasingly co-opted by the conservative individualizing, pathologizing, and contextualizing dominant biomedical framework in the provision of mental health social services and lack of professional practice autonomy.

Clinical Social Work Practice in Canada: A Critical Examination of Regulation

“…There have been criticisms about the lack of national standards and competencies for entry-level social workers in Canada (Bogo et al, 2011). Establishing social work competencies in Canada has been limited and divisive with concerns about this reinforcing managerialism, neoliberalism, power and control, and a reductionist approach (Brown et al, 2022). There are also concerns about professional suitability or competence among social workers and this is particularly salient when considering the minimal requirements for membership/licensure to many regulatory bodies which places social work programs in a gatekeeping role of determining that those minimum standards are met by graduates (Birnbaum & Lach, 2014).…”

“I needed the help. They weren’t giving it”: Experiences of young people in tertiary education on waitlists for mental health services in Aotearoa

“…However, there is concern that this is at the expense of wait times for the second appointment (Campbell et al, 2022). Service providers implementing the CAPA model in Canada have reported clients waiting months to receive a partnership appointment (Brown et al, 2022). Additionally, although the CAPA model has no restrictions on the number of sessions that should be provided (Pajer et al, 2022), service providers have described feeling pressured to limit sessions and move young people through the system quickly to prevent wait times from getting out of control (Brown et al, 2022).…”

“…Service providers implementing the CAPA model in Canada have reported clients waiting months to receive a partnership appointment (Brown et al, 2022). Additionally, although the CAPA model has no restrictions on the number of sessions that should be provided (Pajer et al, 2022), service providers have described feeling pressured to limit sessions and move young people through the system quickly to prevent wait times from getting out of control (Brown et al, 2022). This mirrors young people's experiences in Aotearoa, with participants in Dowell et al's (2021) report describing feeling pressured to be 'better' within a certain number of sessions, and feeling as if their counsellor was trying to rush through sessions and get rid of them.…”