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

This article synthesizes non-medicalized approaches to mental health care services within an urban Canadian context, emphasizing models that respond to the social, structural, and community-based conditions shaping mental distress. Drawing on examples from diverse service organizations, the analysis illustrates how housing supports, daily living assistance, peer-led programming, community services, and addiction-specific interventions collectively offer alternatives to biomedical paradigms that prioritize diagnosis, pathology, and pharmacological intervention. These models foreground social determinants-including poverty, discrimination, displacement, precarity, and limited access to resources-as central drivers of distress, aligning with Mad Studies frameworks that challenge dominant constructions of illness, insight, and recovery. For nursing, these findings underscore the need to expand practice beyond individually oriented, symptom-focused models and toward socially responsive, relational, and equity-driven forms of care. Nurses are uniquely positioned to integrate community knowledge, advocate for structural interventions, and support non-medicalized pathways that center autonomy, cultural safety, and lived/living expertise. This synthesis demonstrates that reorienting nursing praxis toward social and community-based mental health models can meaningfully address the limitations of biomedicalism while promoting more just and contextually grounded care.