The social reality of mental health

For decades, social workers have been active in the field of mental health through interventions involving people and their environment. They consider individuals’ subjective reality, context and living conditions, as well as their social roles and network, from a perspective of recovery, empowerment, full citizenship and social justice. Despite the expertise developed in social work regarding mental health, interventions targeting social determinants such as income, social status, education, physical environment, housing and work conditions as well as social support networks are not often taken into account during treatment, thereby promoting the use of care protocols that focus mainly on symptoms related to a disorder.

Many proponents of social research believe this situation exists due to the difficulty of producing evidence-based data on these determinants. That said, an increasing number of services provided in the health and social services network are directed by experts who support the positivist approach, and who prioritize evidence-based data (derived from randomized clinical trials) to identify the best practices to adopt. Other researchers attribute this phenomenon to the social construct surrounding performance, productivity, empowerment and self-realization ideologies that prevail in our societies. According to them, this dogma is conducive to individual and psychologizing interventions, which empower individuals in terms of providing an explanation and a solution for their troubles.

Notwithstanding the predominance of established medical and psychological mental health discourse, a strong current has emerged in recent years, which considers mental health a social reality and recognizes the impact of social determinants on mental health. This current proposes interventions that focus on complementarity of knowledge, interprofessional collaboration and interdisciplinarity, from a recovery and citizenship perspective for individuals. It speaks more than ever to the knowledge and practice of social workers. Since they witness on a daily basis how living conditions affect the quality of life of individuals, especially their physical and mental health, the contribution of social workers is key to help document and understand the complexity of situations experienced by people and communities, while acting on this complexity.