The Role of Social Work within Mental Health Care: Trends in Mental Health Service Use and Sociodemographic Correlates with Service Provider Selection

Background and Purpose: Mental health is a significant public health concern, with approximately 1 in 5 Canadians experiencing a mental illness every year. Mental health care is provided by a diverse range of professionals, including psychiatrists, psychologists, social workers, nurses, and physicians. Understanding access to and preference for specific professions is crucial for developing mental health interventions and policy. There is little understanding of the role of social work within the mental health system, and multi-year Canadian data is available. This research will provide knowledge on who accesses social work for mental health, which will provide social workers with a deepened understanding of their client base.

Methods: Six sets of the Canadian Community Health Survey were used (2007-2018). The sample size varied across the years and were weighted to be representative of the larger Canadian population. The outcome variables are those who have seen or talked to a health professional about their emotional or mental health. Specifically, we were interested in the top three mental health care providers: Physician (Family Doctor or General Practitioner), Clinical Psychologist, and Social Workers. The main exposure variables are sociodemographic characteristics including, age, sex, sexual orientation, culture/race, education, and household income. An exploratory analysis of mental health service provider use trends over time was conducted. Logistic regression analyses examined the association between sociodemographic characteristics and mental health service provider use.

Results: From our results, between 2007-2018 social workers were the third most commonly visited professional for reasons related to mental health, after physicians and psychologists. Between 2015-2016 and 2017-2018 there was a large jump in visits for psychologists whereas social workers and physicians slightly decreased. When examining data from 2015-2018, sociodemographic characteristics related to access to mental health care from a social worker included having lower income and less education. Whereas, individuals who were older were less likely to seek services from social workers. Similarly, those who sought mental health care from a physician (instead of a psychologist or social worker) were older, had lower income, less education, and less likely to be non-white. To contrast these results individuals who had higher incomes and education, were more likely to seek services from psychologists.

Conclusions and Implications: The findings indicate that social workers are an important resource for addressing mental health concerns, with many individuals seeking their services. However, the decrease in visits to social workers between 2015-2017 is noteworthy and requires further investigation. Furthermore, the sociodemographic characteristics related to access to mental health care highlight the need for targeted outreach, particularly for groups who may face additional barriers in accessing mental health services. By identifying the characteristics of respondents who were more likely to access care from social workers, it will provide a clearer picture of who social workers serve and the role social work within the mental health care system, both in Canada and the United States.