In 2022, in the middle of a breakdown during the COVID years, I got lucky. I was assigned a social worker who gave a damn.
That's not a small thing. Since I was eight I'd been in and out of therapy, programs, groups, and offices, and almost every time it ran on a fixed number of sessions and then stopped. Through my 40s I'd given up on the whole thing for well over a decade. So I didn't walk into 2022 expecting much.
This person was different. They helped me get real support. They got me to a diagnosis: Autism Spectrum Disorder (ASD), at 50. And they helped me set up tools so I could deal with things in a more structured way, instead of lurching from one crisis to the next.
So, how can a social worker help with mental health, and how do you get one in Québec? A social worker looks at your whole situation, builds a plan with you, connects you to services, speaks up for you, and can offer counselling. In Québec, the main doors are your CLSC and Info-Social 811 (option 2), both free. If you want to go private, the professional order has a directory.
What does a social worker actually do in mental health?
Before 2022 I'd have told you social workers are the people who show up when things go really wrong with your family. That's part of the job, but not most of it.
The Canadian Association of Social Workers lists what social workers do in mental health. In plain words:
- Assess how you're doing, including your mental health and your life around it.
- Offer counselling, and in some cases psychotherapy, for individuals, couples and families.
- Make referrals and deal with other agencies and services on your behalf.
- Advocate for you when the system isn't working.
- Run support groups and work as part of a team with doctors and nurses.
In Québec, the Ordre des travailleurs sociaux et des thérapeutes conjugaux et familiaux du Québec (OTSTCFQ) describes the core of the job as assessing your social functioning and building an intervention plan with you. To use the title "travailleur social" in Québec, a person needs a social work degree and a permit from the Order.
The part that mattered most to me was the middle of that list. Somebody who knew how the system worked, who'd make the call I wouldn't make, and who'd still be there the following week.
How do you get a social worker in Québec?
Your CLSC. Every public health and social services establishment in Québec offers mental health services for free, according to Québec.ca. Ask for the psychosocial intake (accueil psychosocial). Someone will assess your situation and steer you to the right services. That first person might be a social worker, or another psychosocial professional. Either way, it's the door in.
Info-Social 811, option 2. Info-Social is free, confidential and open 24 hours a day, 365 days a year. Psychosocial professionals answer, give advice, and can refer you to services in the public network or a community group. In a crisis, they can send someone to you.
Your doctor or GMF. If you have a family doctor, they can refer you to mental health services in the public network.
Private practice. The OTSTCFQ has a find a professional directory. Private sessions cost money, so check whether your insurance covers social workers. Some plans do. Some only cover psychologists. Ask before you book.
A warning: public services often mean a wait. Ask how long. If things get worse while you're waiting, call back and say so.
What about outside Québec?
In other parts of Canada, start with your family doctor, a community health centre, or your provincial 811 health line where there is one. In the UK, the NHS says a GP can refer you to a community mental health team, which often includes social workers. In the US, ask your doctor, a hospital or a community mental health centre about seeing a social worker.
Why one person who cares changes things
I've had a lot of help over the years. Most of it was fine. Some of it was good. Very little of it stuck, because it kept ending.
In 2022 I didn't suddenly find the perfect therapy. I found one person who decided to keep track of me. They didn't treat me like a file number. They pushed for the things I would've let slide, like getting assessed. And they stayed long enough for a plan to actually turn into something.
I've written about the on-again, off-again therapy cycle in in and out of therapy since I was eight. If you're stuck in it, my advice is simple: when you find someone who gives a damn, tell them. Then ask them to help you build something that lasts past the last session.
And if the cost is what's stopping you, I broke that down in what therapy costs in Québec.