More than a diagnosis

Statistics tell us that we are at a crisis point: addiction and mental health problems are at an all-time high. Social workers, along with countless other health care professionals are burning out. Too often, not unlike the clients we serve, we also may turn to unhealthy coping strategies to try to keep moving forward.

For all of us humans, it can feel like we are all running on a treadmill that is getting faster and faster with each new crisis.

Hurricanes, mass casualty events, pandemics, inflation, managerial policies of severity and funding cuts… the harder we work, the more it seems like things are getting worse. It is not surprising that so many people want to give up. Growing numbers of us are turning to self-medication, addiction and other strategies to try to numb themselves just enough to try to make it yet another day.

Our NSCSW social justice committee, in partnership with Dr. Catrina Brown and her research team, recently organized a mini-conference on mental health and social justice. The researchers confirmed the findings that had been presented in our 2021 Repositioning report about social work’s place within Nova Scotia’s mental health system, and have continued their inquiry across Canada. Nearly every social worker employed in the field of mental health and addictions is experiencing severe moral distress because their skills are not being utilized appropriately. Rather than working to help clients understand the historic and systemic roots of their feelings and challenges, these clients are diagnosed and medicated. If they do receive counseling, their “therapy” consists of being told of the cognitive fallacies in their thinking, and they are encouraged to engage in “behavioural activation” to makes them forget their problems.

We believe that the time has come for our profession to transform adversity into opportunity. Social workers are uniquely positioned to lead social change, and yet often, are amongst the most challenged to do so, for precisely the same reason: we live and work at the intersections of oppression and liberation. We are drawn to theories that rely upon strengths-based principles, but sometimes forget to see how that applies, not just to our clients, but to ourselves and the systems within which we function.

Every day, we behold the injustices of systemic racism, queerphobia, oppression and institutional colonization, bearing witness to the enduring impact of intergenerational trauma, and advocating for those at the margins of society.

Social work is a profession that listens, deeply.

We can hear the resounding call for justice in the individual cry for help, as well as in organizational and systemic strategies to either respond or silence this cry. Our collective task is to connect these dots: to link our advocacy efforts with our therapeutic interventions and group work. We must listen, connect and sift through the different voices and perspectives, to clearly identify those voices, theories and labels that serve to maintain the status quo, and amplify those voices and perspectives that are working to shift us toward justice and wellness.

We are therefore advocating for a profound shift in the way mental health services are currently being delivered, away from addressing mental health concerns as if they were purely biological and medical conditions, or ones that short-term individual counseling can resolve alone.

• We believe that no amount of individual, short-term behavioural therapy or pharmaceutical medication will be enough to fully help someone whose struggle against systemic barriers of poverty, oppression and discrimination has led them to a place of hopelessness.

• We believe that our well-being is inextricably linked with the well-being of every other living being, and the wellbeing of the eco-system within which we live.

• We also believe in the therapeutic benefit of clients recognizing the root systemic causes of their symptoms of distress.

• We affirm that any policy to address mental health services in Nova Scotia must be part of a plan that centres the social determinants of health.

• We request that all policy be developed, grounded in the voices and perspectives of first-voice community members, clients and other stakeholders.

Committed to social justice and community organizing, values at the core of our profession, and armed with compassion for our clients and a passion for change, our profession has the potential to represent a tremendous threat to those in power.

This is the power of social work: our ability to listen, our ability to connect with others, and our ability to see the connections between individuals, organizations and communities. What sets social work apart from all other disciplines is this ability to hear the thematic connections between the micro, mezzo and macro dynamics. We are the connectors and the brokers. We are the ones who make the connections between individuals and community resources. And in this, lies the resilient triumph of our profession.

While individually, our voices may sometimes be silenced, we have the ability to turn our individual setbacks into a powerful network of advocacy, specifically thanks to our unique social location and diverse skillsets. We are not alone. There are thousands of us. And each of us are embedded in communities, and working with clients who are embedded in communities.

We will therefore be launching a campaign in 2023 that invites our community to share their stories of why they believe change is both necessary and possible, and why each of us — whatever our challenges or strengths may be — deserves to be seen as more than a diagnosis. Stay tuned to learn more about how you can participate.

We have tremendous power- if we stop internalizing our distress and medicating it, but rather join together with so many others who have been silence, repressed or oppressed. Let us reclaim our voice, and in so doing, fight back from the pathology, alienation and fragmentation that maintains the status quo.