From Medicalization to Structural Response: Reimagining Nursing Practice Through Community-Driven Models of Care

Area of Science:

• Social Determinants of Health
• Community Mental Health
• Nursing Practice

Background:

• Biomedical models of mental health often prioritize diagnosis and pharmacological interventions.
• Social, structural, and community factors significantly influence mental distress.
• Existing mental health services may not adequately address the root causes of distress.

Purpose of the Study:

• To synthesize non-medicalized approaches to mental health care in an urban Canadian context.
• To examine community-based models that address social determinants of mental distress.
• To inform nursing practice towards more socially responsive and equity-driven care.

Main Methods:

• Synthesis of non-medicalized approaches to mental health care services.
• Analysis of diverse service organizations in an urban Canadian context.
• Drawing on examples of housing supports, peer-led programming, and addiction-specific interventions.

Main Results:

• Non-medicalized models integrate housing, daily living assistance, peer support, community services, and addiction interventions.
• These approaches challenge biomedical paradigms by focusing on social determinants like poverty and discrimination.
• Mad Studies frameworks inform models that prioritize lived experience and challenge dominant recovery narratives.

Conclusions:

• Nursing practice should expand beyond individual, symptom-focused models to embrace socially responsive, relational, and equity-driven care.
• Nurses can integrate community knowledge and advocate for structural interventions to support non-medicalized mental health pathways.
• Reorienting nursing towards social and community-based models addresses biomedical limitations and promotes more just, contextually grounded care.