Mental health social work practice: Navigating tensions

The United Nations Special Rapporteur has called for ‘a revolution in mental health care to end decades of neglect, abuse and violence…enabl[ing] a long overdue shift to a rights-based approach’ (/3). Principles underpinning social work practice with people living with mental distress who receive diagnoses such as schizophrenia, personality disorders and bipolar disorder, align with sought after changes. Using Cooperative Inquiry and referring to the Model of Holistic Competence in Social Work, this study investigated mental health social work seeking to foster this shift. Findings confirmed inherent discordance between social work values and mental health care dominated by biomedical and neoliberal views. Upholding social work values in this context involves complex practice, integrating procedural and meta-competencies. By incorporating skills in relational practice and advocacy; knowledge of multiple explanatory frameworks for mental health and mental health systems literacy; self-regulation; fostering tenacity whilst addressing ‘othering’; and judgement informing choices around conformity and confrontation, social work navigates tensions associated with this discordance. This paper highlights the nature of values-based social work practice as aligned with mental health reforms.