New social work graduate certificate offers holistic approach to supporting mental health

The long-awaited publication of the Diagnostic and Statistical Manual of Mental Disorders-III-R in 1987 was a big deal for nearly everyone involved in the psychiatric program for adolescents at St. Boniface Hospital in Winnipeg. The psychiatrists, psychologists, nursing staff, along with a young member of the team named Rick Enns, couldn’t wait to get their hands on the manual when it arrived.

“It was sort of like Christmas morning, you know?” recalls Enns with a chuckle. “We had just one copy, and that was the psychiatrist’s copy, but we all ran and looked up our ‘favorite diagnoses’.”

With seven years to work on it, Enns and his colleagues were certain the new version would be much better, thereby allowing them to diagnose the kids they were treating with more precision, which they hoped would allow them to provide better care. 

“The next question,” says Enns, “was of course, ‘Well, so should we re-diagnose the kids in our program?’ When you think of it, over the long term, their diagnosis was inconsequential in some ways, but it was also very consequential. Because certain medications tended to go along with certain diagnoses. So, we wondered, maybe this adolescent isn’t depressed, but they’re anxious. Well then, instead of an antidepressant, we’ll give them an anti-anxiety medication!’ Even though they're often the same meds anyway!” 

Holistic, community-informed perspective to mental health

Fast forward to 2024 and Rick is now Dr. Rick Enns, PhD, RSW, an associate professor with the University of Calgary Faculty of Social Work’s Edmonton campus. But his 30 years as a practitioner led him down a different pathway in approaching mental health, that aligns with a growing movement that champions a more holistic, critical, and community-informed perspective to mental health that, in many ways, challenges the status quo he was a part of back at St. Boniface. 

A few years ago, Enns, along with others in the faculty, began advocating for a graduate clinical social work specialization in Community-informed Practice for Health & Well-being — to challenge dominant, medically driven models of mental health care in social work practice.

The unique specialization, designed for social workers practising in mental health, is being offered as a graduate certificate in fall 2024. The certificate equips social workers with alternative approaches in mental health and a holistic, community-informed approach to their practice. Students will also get the tools needed to critically question the current and dominant  bio-medical views of mental health.

Enns points out that the certificate reflects a growing interdisciplinary critique of diagnostically driven mental-health practice, and an understanding that practitioners need to understand the broader context and experiences of clients.

Certificate features both theoretical and practice-focused learning

The certificate consists of four courses that delve into various aspects of community-informed practice. 

The first course introduces students to the critique of mental health practice, focusing on challenging the Diagnostic and Statistical Manual of Mental Disorders (DSM) and its claims of diagnostic reliability and validity, and considering long-standing critiques like anti-psychiatry and critical psychiatry, and more recent movements like Mad Studies. 

The second course focuses on assessment — or developing an authentic understanding of those we work with — and encouraging social workers to foreground community and experience in their assessments, rather than relying solely on diagnosis.

The final two courses focus on specific practice contexts within specific communities, such as Indigenous populations, and racialized communities and LGBTQ2S+ populations. These courses aim to help social workers understand and navigate the complexities of community-informed practice and challenge dominant models of care.

Enns acknowledges that this approach may not be for everyone and respects the personal and professional journeys of each student, and he emphasizes the importance of critically analyzing and questioning the foundations of practice while also recognizing the reality of psychological and emotional distress.

While the certificate will likely be of interest to any clinical social worker, Enns believes it might be particularly valuable for those working in a variety of community settings, including those who work with newcomers, community development, those working to address houselessness, those involved with anti-racism initiatives as well as those who work with LGBTQ2S+ and Indigenous clients.

“As social workers we need to think critically about what we're doing, and whether we're engaging in a different kind of colonization in our mental health practice,” says Enns. “You know? To make sure that what we are doing is not just another variation of the impulse behind residential schools, for example, where we recast the experience and possibilities of Indigenous peoples in western and colonial terms. This is what we do when we try to impose what I would argue is a very questionable, and certainly contested, psychological or diagnostic frame on individuals.

 “Social work has been complicit in colonization, and I hope this certificate helps students to critique and re-think social work practice with individuals and families experiencing psychological distress and anguish.”