Is there a place for ‘madness’ in social work practice?



This submission to The Social Lens: A Social Work Action Blog by Jeanie Suparman, BSW 4th Year Student

In this blog, I want to share my experience as a student with a psychiatric disability (known as madness by the mad community), my struggle in completing my practicum, and finding my place in the social work field.

For the past few weeks, I have had a lot of trouble keeping up with the four-day work week required for practicum. I have gotten accommodation to reduce that commitment down to three days a week, but it makes me question my abilities and competencies as a social worker. I am a person with psychiatric disabilities and I am quite aware of how my symptoms can potentially jeopardize my ability to practice. For example, I have a hard time receiving feedback without having it impact my self-esteem and worsen my mental health, but feedback is necessary for a reflexive, competent social worker. Having self-doubts and low self-esteem are symptoms of my mental illness that may impact my practice, leading me to wonder if I am not meeting the standard where “Social workers do not engage in the practice of social work…while suffering from illness or dysfunction which the social worker knows or ought reasonably to know impairs the social worker’s ability to practice” (BC College of Social Workers, 2016, p.12).

At the same time, the pursuit of social justice is also an important value of social work (CASW, 2005). The social model of disability views people with disabilities as the oppressed group, with able-bodied people being the cause or the contributor to that oppression (Shakespeare, 2006). A similar model may apply to people with psychiatric disability, where we face oppression due to not behaving or thinking the way that ‘healthy’ people do. Thus, the pursuit of social justice based on this social model would involve advocating for workplaces to change their environment such that a person with any disabilities would not be disadvantaged. Does this mean that we should change our Standards of Practice (BCCSW, 2016) so that people with certain disabilities are not excluded from the profession? Or should the profession only include those who can function as a typical able-bodied person?

To answer this question, I referred to academic journals and found that there is not much research that has been done to learn about the experiences of social workers with psychiatric disabilities, and how they can maintain their competency. However, I found some discussions on whether Social Work schools can be the gatekeepers of the profession while not being discriminatory towards people with disabilities, especially when their disabilities lead to unethical practice or lack of competency (Neely-Barnes et al., 2014; Watkinson & Charmers, 2008). I am aware of The Duty to Accommodate where workers are entitled to accommodation as long as it does not result in an undue hardship (Ontario Human Rights Commission, 1989); however, many workers either do not know that they can ask for accommodations, discouraged by the process of asking, or feel reluctant to disclose their disability due to fear of judgment (Kiesel et al., 2019). I also wonder if a recruiter would choose a worker who asks for accommodation over a similarly skilled person who doesn’t need accommodation.

I believe in the value that I can bring as a practitioner with experience living with mental illness and accessing the psychiatric system. I strongly value the self-determination and empowerment of my clients after experiencing first-hand what it is like to be powerless patient in a psychiatric system. However, I value the safety of my clients more than feeling included in the profession, so I would likely take a step back if I know that my mental health will endanger my clients. I know that I need to work harder to prevent my illness from impairing my practice, which people who are mentally healthy do not have to do, but that is all I can think of to ensure that I am practicing ethically. My wish is that having a mental illness becomes more normalized in the profession and that asking for accommodation doesn’t make me less than others.

References

BC College of Social Workers. (2016). Code of Ethics and Standards of Practice. British Columbia College of Social Workers. https://bccsw.ca/registrants/code-of-ethics-and-standards-of-practice

Canadian Association of Social Workers. (2005). CASW Code of Ethics. https://www.casw-acts.ca/en/Code-of-Ethics%20and%20Scope%20of%20Practice

Kiesel, L. R., Dezelar, S., & Lightfoot, E. (2019). Equity in social work employment: opportunity and challenge for social workers with disabilities in the United States. Disability & Society, 34(9-10), 1399-1418.

Neely-Barnes, S. L., McCabe, H. A., & Barnes, C. P. (2014). Seven rules to live by: Accommodations in social work education and the field. Journal of social work in disability & rehabilitation, 13(4), 279-296.

Ontario Human Rights Commission. (1989). Ontario Human Rights Commission policy on ableism and discrimination based on disability. Toronto: Ministry of Citizenship, Government of Ontario.

Shakespeare, T. (2006). The social model of disability. The disability studies reader, 2, 197-204.

Watkinson, A. M., & Chalmers, D. (2008). Disability, professional unsuitability and the profession of social work: A case study. Social Work Education, 27(5), 504-518.

THE SOCIAL LENS: A SOCIAL WORK ACTION BLOG - The views and opinions expressed in this blog are solely those of the original author(s) and do not express the views of the UBC School of Social Work and/or the other contributors to the blog. The blog aims to uphold the School's values and mission.