Shaping Care, Shaping Us: A Systemic Analysis of Mental Health Service Models and Professional Identity in Canada
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Authors
VanLe, Aralia
Issue Date
2026-02-21
Type
Capstone
Language
en
Keywords
mental health care systems , neoliberalism , stepped care , comprehensive primary health care , access , equity , counsellor practice
Alternative Title
Abstract
This capstone critically examines the ideological, structural, and ethical forces shaping access to contemporary mental health care, with particular attention to the expansion of stepped and stratified care, digital platforms, and metrics‑driven governance shaped by neoliberal policy environments. Drawing on global health history, international research, and critical policy analysis, the project traces how mental health systems have shifted from the principles of Comprehensive Primary Health Care toward Selective Primary Health Care, replacing universal, needs‑based, and publicly accountable models with efficiency-driven frameworks that often constrain equitable access. Central to this analysis is the counsellor's role: the paper considers how professional choices about practice settings, modalities, collaboration, and whose work is recognized may contribute to hierarchies, fragmentation, elitism, and privatization drift towards a two-tier system, and how counsellors might choose differently to foster more inclusive and equitable care. The capstone highlights tensions between evidence-based standardization and foundational public health values of equity, universality, participation, and client-centered care, illustrating how counsellors can actively navigate these pressures to create meaningful change. It also acknowledges that public–private partnerships (P3s) increasingly form the backdrop for contemporary mental health modalities, inviting reflection on how counsellors ethically navigate the tensions these structures produce. By reframing stepped care within a values-driven, access-oriented framework, the project argues for aligning system design with ethical commitments and for strengthening the profession’s role in advancing equitable, community-centered practice.
Description
Citation
Publisher
License
Attribution-NonCommercial-NoDerivs 3.0 United States
openAccess
openAccess