Since the beginning of the 20th century, social work in various spheres of public life has played a crucial role in improving the provision of mental health services to Canadian citizens. The professional skills of social workers and their focus on personal assistance for a speedy recovery can support people on the path to positive change. The purpose of such practices is to help restore the well-being of an individual and to help strengthen each person’s control over his or her life, and to promote the principles of social justice. Social work, as a profession, has always played a significant role in managing risks and difficulties in working with people with the most profound social needs, who often cannot become full members of society. Mental health workers not only provide direct assistance but also explore the social context and social consequences of mental illness. Accordingly, it is necessary to identify the historical and current features of the development of mental health services in Canada.
Historical Background of Social Work in Mental Health
At the beginning of its existence, mental health care in Canada had similar features to other countries, such as France, the United States and the United Kingdom, which had the greatest impact on the country’s development. However, over two hundred years of development, Canada’s mental health system has undergone many changes (Sussman, 2017). Since 1900, mental health services have been established throughout the country, as well as the volunteer movement, which is considered the forerunner of social work in mental health.
During a long period, the limited number of mentally ill patients could receive adequate assistance because of the lack of resources. In the 1940s, only 872 patients could be treated in Canada, as there were only 32 psychiatric units per country. In 1959, these departments could accommodate approximately 65,000 patients, and by 1976, there were total of 21,000 patients in psychiatric and general hospitals (Sussman, 2017). Accordingly, due to such conditions, social workers had to constantly lobby the interests of severely ill patients in order to provide them with appropriate medical services.
In the late twentieth century, ideological attacks on Canada’s mental health system and significant funding cuts undermined the work of social workers. The community-based system has also collapsed due to disputes between bureaucrats and influential politicians. All health care providers, including social workers, were accused of abuse of power, unethical behavior and resistance to change, although they actually initiated positive changes in the system. These processes have resulted in a serious deterioration in the provision of medical care to the mentally ill and the departure of leading mental health professionals abroad (Sussman, 2017). Moreover, these chaotic changes have mainly affected not only patients, doctors and social workers but also society as a whole.
The potential danger to the social work profession was in late 2006 when Ontario proposed a new law to make the practice of psychotherapy fully controlled and to introduce a new profession of “psychotherapist.” However, social workers contribute through direct practice, administration and education, and are therefore needed in the health care system (Ashcroft et al., 2018). People with mental disorders were perceived by society as a burden, and the fact that mental disorders can affect a person of any social status was not recognized. Therefore, the educational work of social workers, including lectures for students, once fought against these unjustified stereotypes that still remain in the public mindset.
Current Context of Social Work in Mental Health
In Canada, social workers in the context of mental health, who work on an altruistic basis and free of charge, are starting to receive attention from the government. The Canadian Federal Government is constantly developing new initiatives and increasing funding for projects to support social workers in mental health care (Amir, 2016). However, despite official statements about improved medical and social services and claims of better care, living and treatment conditions for severely mentally ill persons have worsened. The system allegedly returned to the conditions of the twentieth century, as the number of homeless people and prisoners among the mentally ill is increasing (Sussman, 2017). Inadequate and improper treatment and care for mental health problems have a significant impact on the Canadian economy. Therefore, social work in the field of mental health is more aimed at minimizing political risks and limiting financial risks than at maximizing the well-being of families and the community.
The Canadian health care system requires that only suitably qualified and trained workers with sufficient medical experience can diagnose patients. Social workers are permitted to apply for Approved Practice “Authorized Practice Endorsement” (APE), which will allow them to diagnose, assess and treat mental and behavioral disorders (Mignon, 2020). Accordingly, professional regulations create a competitive environment for the employment of social workers in Canada and provide a high level of training for those who work with severe mental disorders.
Nowadays, social workers have the resources to conduct social assessments, counseling, provide the patient with psychotherapy and advocacy; they also value working with people who experience vague symptoms of mental disorders to maintain their health. Moreover, at present, even primary health care systems for the mentally ill involve social workers on the basis of an integrated interprofessional approach (Ashcroft et al., 2018). For example, there is the Mental Health First Aid program that helps people who are experiencing a mental health crisis. Besides, since the problems of poverty, adolescence, and indeterminate sexual orientation can negatively affect a person’s mental state, social work should become comprehensive assistance.
The biggest problem in Canada is the uncontrolled increase in mental disorders in different ethnic and social minorities in a changing cultural environment. For example, mental and psychological problems of adolescents in 50% of cases are the result of unintentional injuries and suicides. In addition, although dementia is generally considered to be a major mental health problem among the elderly, there are nearly as many people over the age of 60 who suffer from either anxiety or depression (Mignon, 2020). That is why social work with mental health issues is currently in the process of transition as social workers learn how to use an interdisciplinary and comprehensive approach to work with different patients.
During the various processes of reforming health care in Canada, mental health facilities were either downsized or converted for other purposes. However, with the development of social work as a profession, it has become possible to provide sustainable funding for public access to mental health services within the country. Although the social work profession appears to be quite fragmented, a number of Canadian organizations and educators are constantly implementing various projects to promote social work research and improve the treatment of mental illness.
Amir, E. (2016). New developments for family caregivers in the context of mental health in Canada. Canadian Journal of Community Mental Health, 34(4), 143-149.
Ashcroft, R., McMillan, C., Ambrose-Miller, W., McKee, R., & Brown, J. B. (2018). The emerging role of social work in primary health care: A survey of social workers in Ontario family health teams. Health & Social Work, 43(2), 109-117.
Mignon, S. (2020). Social work and mental health: Evidence-based policy and practice. Springer Publishing Company.
Sussman, S. (2017). The history of mental health services in Canada. Journal of Internal and Emergency Medicine, 1(1), 7-13.