It is recommended that you read this letter after the first three essays on this website, and hopefully also my thoughts on psychiatric medications or you will not have the context that will best make sense of what I have written here.

What Is Unique About The Social Work Profession?

When social workers get together there is an affinity or bond that many of us recognise, which arises out of our concern for social justice and empowerment. Coupled with that is the breadth of our knowledge base; in particular I am thinking of constructivism, and of systems theory. These are core to our ways of viewing clients and groups.

Many staff (not just social workers) privately indicate they oppose the customary management of clients that relies so heavily on medication. They dislike the labelling of clients but do it as required. The systems require a focus on problems and symptoms, yet our knowledge base tells us that people are more likely to find solutions when we assist them to get in touch with their strengths and past successes.

Is it already apparent that defining people’s problem behaviour as ‘illness’ shapes the beliefs and responses of clients, families and organisations? Is it already apparent that this definition has resulted from powerful groups with vested interests?

Oppression In Mental Health Services

,p>iscussions and literature of psychiatry, is that one often hears comments such as, “He should realise he has a mental illness, and just take his medication.” I find this oppressive. It is one group’s definition being imposed onto another.

The premise is the belief that the powerful group’s construction of ‘illness’ is right.

There are other constructions offered in the literature (e.g. family roles, trauma) but they are not currently in favour. Consequences flow from the construction that dominates.

What are we doing about it? Do the majority of social workers agree with the theories of biochemical imbalances? If so, is this based on the critical appraisal of the evidence, or passively accepting what is commonly expressed?

What Do Social Workers Believe?

Do we know what the majority of our social work colleagues believe? Shouldn’t we find out? There is little or no discussion about these concepts. There is no way for our profession to move forward to highlight the misuse of professional and organisational power unless there is a better understanding of what we believe.

A colleague told me about a nurse who attended a workshop on “Recovery.” The nurse said, “Why didn’t anyone tell me (before today) that people can recover from psychosis without medication? I’ve always been telling the patients they must take their medication.”

Staff unaware of constructivist ideas are likely to accept ‘mental illness’ as the truth, blinding them to the actual experience of people. The evidence that people can recover without medication comes from the success of placebos in every clinical trial.

With increasing information becoming available about the dubious science and ethics employed by multinational pharmaceutical companies, one needs to be sceptical of claims of medication effectiveness.

An Opportunity and Responsibility

I think social workers are very capable of raising discussion about the dominance of certain ideas, and the consequences for our clients. If enough agree, there is an opportunity to lead people to critically reflect on the practices that often harm people physically and emotionally.

Many know there are alternative approaches to assist people. Many know the harm associated with labelling. Many know the harm associated with the medications given to people. We have a responsibility to assemble our knowledge and find avenues to raise concerns, and promote alternatives.

Call to Action

We need to develop forums to share our knowledge, our concerns, alternative views. We need to plan how and where we can influence the structures and systems to take more heed of constructivist knowledge.

We need to collaborate for change, celebrate each step, and continue until we succeed.

(The End.)