Mental health has a social context

BY JIM MORTON, MSW, SOCIAL JUSTICE COMMITTEE CHAIR

I’m drafting this report in the midst of the COVID-19 pandemic and its uncertainty. The emergency is colouring everything. An invisible and as-yet untreatable virus endangers us. In our efforts to protect ourselves though social distance, our lives have been shorn of routine; nothing is as it was. We are threatened by illness, by being on the front lines of essential services, by unemployment, by loss of income, and by inability to meet rent and mortgage costs. We have little clarity about what is coming next or how the crisis will end.

All of these threats strain our experience of well-being as individuals and families, ironically making our Social Justice Committee’s focus on achieving optimum mental health for Nova Scotians more important than ever.

During the past year, this committee’s continued attention has centred on concerns initially raised by social workers about an undervaluing of social work within mental health and addictions teams. As the College explored these issues, its focus coalesced around the significance of the social determinants of health, on the necessity of genuine consultation with communities about service needs, on the importance of funding that meets World Health Organization standards, and on the imperative of looking at mental health as a life-long journey that can only be understood within the context of community and clientfamily experience.

I am deeply grateful for the participation of our committee members who inform and energize our work, and our staff advisor who provides professional leadership and valued support.

Last summer the College commissioned research to explore social work and mental health services in Nova Scotia. The research project was awarded to Dalhousie University School of Social Work professors, Dr. Catrina Brown, Dr. Nancy Ross, and Dr. Marjorie Johnstone. Their work has been unfolding throughout the year and a report on their investigation is expected later in 2020. The Social Justice Committee has been pleased to witness the progress of this initiative and looks forward to having additional evidence to inform the path forward.

In anticipation of the research report, the social justice committee began to identify potential community partners who may inform and participate in advocacy work on mental health. We know, as with COVID-19, achieving better mental health in Nova Scotia will require many allies pulling in the same direction.

Several opinion pieces, commenting on mental health from a social work perspective, were published in the provincial press and circulated to members and others via social media.

The committee was excited to plan and organize, Big Ideas: A Conversation About Mental Health, a public panel discussion to be delivered at the Halifax Central Library during National Social Work Month. That event, along with Mental Health Today and Tomorrow, the annual NSCSW conference for 2020, were cancelled due to the COVID-19 emergency. The Social Justice Committee is very appreciative of all of the efforts, by so many people, in the preparation of both these important gatherings and is hopeful that the mental health ideas they were intended to explore will find other venues for exploration in the future.

As noted above, the NSCSW Social Justice Committee’s recent work had its origins in concerns about social work’s perceived value within mental health services. As someone who has invested a career in the field, I have continually returned to that question during the past year. There is no doubt we have a place. Social work was on the front lines of the revolutionary developments in community and inpatient mental health during the twentieth century. We know, as the central tenet of our profession, that human beings are social beings and can only be understood with in the context of family and community life.This knowledge is critical to multidisciplinary team deliberations, to service planning, and essential in the consulting rooms where clinical encounters unfold.That said, neoliberal, austerity-driven governments have, for the last forty years, discouraged an interest in social context and encouraged the evolution of a reductionistic medical model that emphasizes brief service, ‘biological psychiatry’ and cognitive interventions which focus on individual patients. Social workers understand the limitations of this narrow perspective and I am encouraged that our committee, and the College, are ready to promote a more progressive, contextual vision for mental health as we move forward.

The COVID-19 pandemic may also be teaching us something about the value of social context. We’ve been recognizing that we are all in this together and using the powers of governments to make serious investments in the welfare of people.

We’ve been learning, even as we manage our distance, that our survival requires cooperation, and we’ve been demonstrating that understanding as we applaud and serenade the social workers and health care workers and grocery store employees… all those who are risking themselves on the front lines for our welfare. It seems clear that a better, more egalitarian, less stressed future surely involves doubling-down on these values, which involves, of course, ensuring that people have access to income, housing, food, meaningful work, and to what is essential for sustaining wellness.

The NSCSW Social Justice Committee is eager to play a leading role in advocating for such a future. As social workers, we know that meeting basic human needs is foundational for optimum mental health. And we are certain that asserting our social work values and knowledge within the world of mental health and addictions is critical to high quality service planning and delivery.

Any lessons learned from COVID-19 are, however, unlikely to be enough. Many of us will be needed to lead the push for a better, more socially responsible future. As J.S. Woodsworth, one of our social work ancestors, put it about a century ago, “To this end, may we take our share of the world’s work and the world’s struggles.”

COMMITTEE MEMBERS:

Harold Beals, Prasanna Kariyawansa , Janelle MacDonnell, Haley MacIntosh, Alexa MacLean, Megan McBride, Dermot Monaghan, Jim Morton (Chair), Juanita Paris, Cassie ShawBishop, Patricia Stephens-Brown, Maggie Stewart, Michelle Towill, Annemieke Vink (Staff), Valerie White.