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Social work professionals face creeping fascism in 'unfit to practice' policies

People sitting around a table. Photo: Kennisland/flickr

On April 12, 2017 the regulatory body for social workers and social service workers in Ontario -- the Ontario College for Social Workers and Social Service Workers -- posted a news update on their website, announcing an imminent change to their regulations. The change in part provides "the College with the authority to request information and documents related to the Continuing Competence Program at any time." (bolding in original) It further notes: "Members are already required to make a declaration in the CCP [Continuing Competence Program] at their annual renewal of registration…This addition to the Registration Regulation allows the College to request information and documents related to a member's CCP at any time." (italics in original -- see here)

It goes on to state, that it is "[i]mproving language in the current regulation so that all applicants are required to indicate whether or not they suffer from any physical or mental condition or disorder that would affect their ability to practice social work or social services work in a safe manner." (bolding in original)

 Drawing on what is at this point a frighteningly easy-to-recognize code word -- unfit to practice -- finally, the College states, "The new wording furthers the College's public protection mandate by ensuring that members are fit to practice in a safe manner."

On the surface, the direction being taken here may seem like a good idea. After all, who would want "incompetent" social workers out there practicing?  People, say, lacking in communication skills, practitioners who commonly exhibit poor judgment, people hopelessly Eurocentric, or worse yet, sexually predatory social workers. However, a closer look, with more critical eyes, is needed to discern what is really happening. For the most part the College is not looking for predatory social workers. They are not on the lookout for racist social workers. Despite the addition of the words "physical illness," they are not weeding out people too physically ill to manage their job (though obviously, the physically ill and physically disabled are likewise in jeopardy).

 They are on the hunt for social workers who in the eyes of the establishment have a "mental illness." In the process, they are in essence requiring any professional who has ever been given a psychiatric diagnosis (as most everyone who has ever seen a psychiatrist has been) to declare that diagnosis. Correspondingly, they are reserving the right to require data and information about this, in their words, at any time.

Is this general direction new? Alas, it is not -- just an intensification of a direction already in place. What is being called "unfit to practice" is becoming an ever-increasing feature in regulatory governing not only for social workers but for most of what is known as the "regulated professions." Perfectly capable professionals routinely lose their professional standing and livelihood by just such regulations. By way of example, in their ground-breaking research into current regulation in nursing, Chapman, Poole, Azevedo, and Ballen  (2016) document how such information, regulations and processes are being used against perfectly capable nurses, with the professionals in possession of such information using it to harass these colleagues, to place their colleagues under hyper scrutiny, with the inevitable result being that all actions of the jeopardized nurses end up interpreted as signs of mental illness and many highly capable nurses eventually lose their right to practice.

Let there be no mistake about it. This is a loss to society. At the same time, this does unnecessary and irrevocable damage to the professionals so treated. 

The critical point to keep in mind here is that, whatever credence you do or do not afford the concept, "mental illness" has nothing to do with safety, despite the regulatory bodies so naming it. There is no proof whatsoever that professionals with psychiatric diagnoses are any less safe than any other professional. By the same token, despite the facile conflation of "mentally ill" with "incompetence," it has nothing to do competence. Someone with a psychiatric diagnosis may or may not be incompetent, just as any other professional may or may not be. What we are witnessing in short is prejudice and oppression pure and simple. We are witnessing ableism. We are witnessing "sanism." We are likewise seeing incredible short-sightedness -- for the truth of the matter is that people in touch with their own personal difficulties have a tendency to be better helping professionals -- not worse ones.

I would add that it is not only the helping professions that are taking systematic measures to weed out people whom they see as mentally ill. Just as the helping professions are calling such practitioners "unfit to practice" and creating regulations which make it easy to get rid of them, institutions of higher learning (universities and colleges) are calling students deemed mentally ill "unfit to study" and progressively placing them on "mandatory leave." Hundreds of universities around the world have just such polices and most of those that do not are aggressively  considering them (see, for example, University of Toronto's recent "mandatory leave" proposal; for an in-depth critique  of University of Toronto's  proposal, also see here) And it is all of this together which I am dubbing "creeping fascism."

To quote in regard to these phenomena from a previous publication of mine:

There is a historical echo here that is unmistakable. While I am well aware that the people applying these policies are not intending this echo and indeed would be shocked at the suggestion of it, I cannot but notice that "unfit to study" and "unfit to practice" are on a continuum with "unfit to live" -- or to use the more common designation, "life unworthy of life" -- a concept that ushered in the systematic murder of Jews, "mental patients" and others during the Nazi era, with the eradication of "mental patients", significantly, coming first, paving the way for the others. (For one of the earliest and most influential articulations of this fascist concept, see Binding and Hoche,1920; for an analysis, see Lifton, 1986.)

Now to be clear, I am in no way equating these measures or in any way comparing them -- for the differences are enormous. Nor am I imputing what might be called "intent."  However, I am suggesting that they exist on a continuum. I am likewise suggesting that with this extension of psychiatric rule into areas like academia and into professions like social work and nursing (both, not coincidentally, "regulated professions"), what we are witnessing is creeping fascism -- hence the title of this piece. 

Alas, it is all too easy for the fascistic nature of such measures to go undetected for it is not the blatant fascism that we hear about on the streets in Charlottesville. It is not hatred. It is rather, to coin a phrase, "respectable fascism." Indeed, it bears all the marks of being kindly as well as responsibly intended. All the more reason we need to be on the alert.

That noted, to return to the proposed changes with which with this blog article began:

Since the news of the regulatory change in question was posted on the website of the College of Social Workers and Social Service Workers, an ad hoc group has coalesced to oppose what is happening. When one of the members of this ad hoc group contacted the College to talk, his objection was purportedly trivialized and put down to mere miscommunication (as if the very knowledgeable social work professor in question was not fully capable of deciphering what he was reading). By the same token when another professor associated with this group talked to a representative of the College and asked about the mandatory reporting, she was advised purportedly (in a tone that suggested that the information being given should be reassuring) that there was no problem here, that the College was just keeping this information on file in case it became of use later. Interesting! And just how long are they intending to keep it? It would seem indefinitely. 

Question: Does anyone feel reassured by the clarification provided by the College? Does anyone believe that the information which the College is allowing itself to keep indefinitely will not substantially bias and bias indefinitely how the practitioners' actions and words are interpreted? And with whom might this highly sensitive information be shared? Given that people of colour are disproportionately diagnosed as mentally ill, is not the reporting that the College is requiring going to lead to even less social workers of colour practicing, ergo, more social workers dealing in colonizing ways with groups and cultures that they do not understand? Is not the very act of compelling the self-reporting of personally sensitive and prejudicial information a flagrant invasion of privacy? If this is how officials at the College treat their colleagues, how do they treat their clients? How is it that folks with criminal records can have their record expunged in the fullness of time, while practitioners who have committed no crime whatsoever have to live with a record that sits in a computer and can be trotted out and used against them at any time? How can a society which places a value on freedom tolerate such ongoing and intrusive scrutiny?

If at this point, you too are becoming alarmed, I would invite you to protest what is happening here. Consider giving the College and pivotal members of the legislature a shout and letting them know that when the College resorts to measures like this, they are not safeguarding the welfare of the public -- rather, they are eliminating some of our best workers, placing all workers under surveillance, and in the process making the lot of us complicit in oppression. Correspondingly, if you are someone who advocates for human rights, do think of getting involved, for human rights are blatantly at stake.

Finally, if you are a social worker, or indeed, a member of any of the other "regulated health professions," whether or not your profession or provincial professional association has yet formally adopted policies of this ilk, a word to the wise: beware, be prepared, organize.

Photo: Kennisland/flickr

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