The McDonaldization of Social Work: a critical analysis of Mental health Care Services using the Choice and Partnership Approach (CAPA) in Canada

Abstract

In this paper, we report on a provincial consultation in Canada, of the adoption of the CAPA model, which was designed to improve mental health service delivery to mental health stakeholders. While the delivery of mental health services in Canada is largely the purview of the medical profession, the implementation of an interdisciplinary team approach has included the social work profession as a significant part of that team, but the direction and mode of service continue to be largely determined by the assumptions embedded in the medical model. We interviewed 50 participants, conducted three focus groups, and circulated an online survey with 115 responses. We explored how the CAPA model commodifies mental health care and the impact this has on social workers employed in that system through exploring the McDonaldization categories of efficiency, calculability predictability and control. The participants were critical of the commodification of mental health service delivery and expressed how the expectations for practice were a lack-of-fit for the practice of social work. We explored the perceived strengths and barriers and our findings suggested that the rise of neoliberalism and managerialism has superimposed a business model approach to mental health services so that fiscal efficiency, parsimonious use of professional time and a focus on individual responsibility are now driving principles.