In the coming days, I will bow out as president of the Order of Social Workers and Marriage and Family Therapists of Quebec, at the end of a mandate of just over three years. At the same time, I will draw a line under a career of almost 40 years in Quebec social services. I leave with the feeling of duty accomplished, of course, but also with a concern for the future of our social services.
Over the past few decades, I have had a front-row seat to witness the slow but steady erosion of the place occupied by general social services in the scale of priorities of our governments. I began my career when the Department of Health and Social Services was still called the Department of Social Affairs, illustrating the priority then given to the social determinants of the health of our population.
Then, from reform to reform, there was a growing imbalance between the health and social missions of the State, the latter being too often the instrument of the former. Social services have thus become and remain the poor relation of our public network, both in terms of funding and the importance or visibility allocated to them.
I would like to tell you that the reform of the Minister of Health, Christian Dubé, will mark a reversal of the trend, but a priori, everything indicates the opposite. The lack of consideration for social services in the debates surrounding the bill no15 — until their pure and simple erasure in the name of Santé Québec — only increased my concerns for the future. The first appointments and the governance structure of the organization do not bode well either.
When I began my mandate as head of the Order, we were still in the midst of the COVID-19 pandemic. Several observers then warned us: it is in the medium and long term, well after the first ravages of this coronavirus, that we would feel the effects of health measures on the mental health of the population.
Three and a half years later, here we are. All well-being indicators are red. Mental health issues and anxiety are on the rise, particularly among young people. Homelessness and poverty are increasingly visible in all regions. The number of reports to the DPJ is reaching peaks, as are cases of mistreatment of our elders. Too large a portion of our population is suffering and, unfortunately, our state is failing to provide them with the social services that would allow them to get better.
No matter, I withdraw with hope for the future. Throughout Quebec’s history, groups and social movements have always mobilized to preserve the model of progressive society that we have built here. The Summit of the Estates General of Social Work held last April was a further demonstration of this. I dare to hope that our decision-makers will be able to carry out these citizen aspirations and move away from short-term logic.
“Madness is doing the same thing over and over and expecting a different result,” the adage goes. After decades of mixing structures that converge in the same direction, perhaps the time has come to try something else. Perhaps the time has come to take the prevention turn, for real, and to put in place policies that will reduce the problems at the source.
It’s true in health, it’s true for social services. Getting young people active and helping them eat a healthy diet ultimately reduces the risk of chronic diseases. In the same vein, by increasing the supply of affordable housing, we reduce the risk of homelessness; supporting vulnerable parents prevents developmental delays or neglect. In short, with quality social services, we can act on the social determinants of health and improve, in the long term, the living conditions of our population.
The time has come to make our social services a national priority again.