Critical Clinical Social Work and the Neoliberal Constraints on Social Justice in Mental Health

Despite a strong history of social justice–based social work professional education in Canada, there has not been an intentional integration of direct critical clinical mental health practice with social justice–based theory. Progressive social work has tended to view clinical work as focusing on the individual and failing to contribute to social change. In this article, I elaborate upon a critical clinical social work approach influenced by postmodern critique, and feminist-, narrative-, and collaborative-based practice rooted in critical theory. Critical clinical practice disrupts the individual/social binary through counterviewing unhelpful dominant social discourses and producing counterstories that participate in social resistance. I explore the constraints of neoliberalism on social work mental health practice and its influence on the ability of social workers to practice social justice–based social work. Neoliberalism constrains social workers’ ability to address the social and structural determinants of mental health through its focus on economic rationalization, biomedicalization, and individual responsibilization, alongside rationalized practices that emphasize evidence-based and short-term efficiency-based models. I argue that social work is facing a crisis as a disempowered profession, as it attempts to reconcile its commitment to social justice and the importance of addressing inequity, marginalization, and oppression while often working in settings that demand the subordination of social work knowledge to neoliberal biomedicalism. Under these conditions, a critical clinical approach to mental health practice is needed now more than ever.