Unequal access and treatment disengagement in mental health: Implications for social work practice

Treatment disengagement in mental health is often framed as an individual problem linked to lack of insight, low motivation, or ambivalence toward care. However, this perspective overlooks broader social conditions. This brief note argues that, from a social justice perspective, disengagement is understood not as “treatment refusal,” but as a consequence of structural barriers and unequal access affecting marginalized populations, including immigrants, refugees, and ethnic minorities. In this view, disengagement reflects limitations in accessibility and cultural responsiveness rather than individual unwillingness. Social work practice—through outreach, relational engagement, and structural advocacy—plays a key role in addressing these barriers and promoting more equitable mental health services.