Decolonial Feminism and Practices of Resistance to Sustain Life: Experiences of Women Social Workers Implementing Mental Health Programmes in Chile

Abstract

Feminisms have had a significant impact on social work discussions in Latin America in recent decades. However, the gap between academic discussions and professional practice remains wide. Based on a qualitative study that included 69 semi-structured interviews with social workers in Chile, in this article, we focus the analysis on the experiences of women social workers implementing mental health programmes. These are women – professionals facing extremely precarious working conditions – who work with other women who, while below the poverty line, are users of state health policy. The findings suggest that in these highly precarious spaces, the division between professional and the user is blurred, producing what feminist philosopher María Lugones calls ‘liminal space’. Professionals and users establish alliances and practices of resistance from that liminal space to challenge the oppressions they experience. Drawing upon a decolonial feminist perspective, we identify challenges for social work such as problematising professional bonds, incorporating structural readings of precariousness and feminised resistance, and repositioning the value of frontline social workers’ and users’ knowledge. We can learn from these women's experiences that question the deepest foundations of colonial and patriarchal capitalism still present in training and professional practice.

Introduction

When the first school of social work in Latin America was founded – Santiago de Chile in 1925 – overcrowding and poverty, alcoholism, sexually transmitted infections, malnutrition and infant mortality had reached horrifying levels in the main cities. The boom in the exploitation of saltpetre and other natural resources by European and North American capitals had attracted hundreds of thousands of indigenous people and peasants to live in the cities in search of work opportunities. Gradually, the unhealthy living conditions, coupled with the exploitation of the workers by the incipient capitalist oligarchy, turned into widespread unrest that resulted in massive protests by the workers, many of them quelled by ‘massacres’ conducted by agents of the state (Illanes, 2007).

In this context, upper-class, white women of Spanish descent, with a strong vocation for public service and social change (Aylwin et al., 2004) were trained as social workers at schools founded by the Chilean Ministry of Health. Social work training was led by European social work academics and the curriculum was underpinned by the foundations of the philosophical project of modernity: faith in rationality as the engine of change, the importance of identifying the causes of social problems and the use of the scientific method as a guarantor of professionalism (Duarte, 2013).

A radical shift in social work professional training, inspired by Latin American Marxism, took place in the 1960s. However, the Pinochet dictatorship (1973–1990) abruptly halted these debates. Due to its left-wing ideological orientations, social work was stripped of its university status and social work schools were closed, with many social work students, academics and professionals tortured, killed and/or exiled (Muñoz Arce, 2019). This ‘professional trauma’ resulted in intellectual stagnation and censorship of critical thinking in the profession (Del Villar, 2018), which in turn, reinforced the positivist approach that had dominated professional training in its early days. The epistemological separation between ‘intervening subject’ and ‘intervened object’, typical of modern-colonial Cartesian rationalism in which the subject is not ideologically ‘contaminated’ by the object and vice versa (Clarke, 2021), was functional to the dictatorship's aims of political neutralisation (Morales, 2021), limiting the possibilities of understanding professional practice as an action that is always political and exercised by ‘non-neutral’ but gendered, racialised subjects, located in a social class and in a network of overlapping privileges and oppressions (Cubillos & Zarallo, 2021). This link between the positivist scientific aspirations of the first schools of social work, and the political censorship of the profession in times of dictatorship, could explain why, for example, despite the Chilean feminist movement playing a very relevant political role in the struggles for resistance against the Pinochet dictatorship, there is no record of feminist contributions in the social work writings of the time or later (Cortés, 2021).

Thus, the silence around the contributions of either feminism or decolonial thought in the social work literature produced in Chile in its almost one hundred years of history is not surprising, unlike the prolific feminist productions in other schools in the Latin American region and other parts of the world (Martínez & Agüero, 2021). In Chile, the incorporation of feminist approaches in social work has only taken place in the last ten years (Duarte, 2013), very possibly thanks to the strength of feminist movements that in the recent period have installed a powerful critique of the precariousness of life as a result of the neoliberal, patriarchal and colonial capitalism of the Chilean model (Palacios-Valladares, 2022; Perry & Borzutzky, 2022; Vivaldi & Sepúlveda, 2021). Although in the last decade, the debates around violence against women, female labour inclusion, intersectional perspectives, masculinities and LGTBIQ+ identities have increased in terms of publications in scientific journals and book chapters in social work (Muñoz Arce et al., 2021), the gap between these intellectual debates and the professional practice of social work is still wide (Duriguetto & Madeiros, 2018). As feminist social worker and trade union leader Natalia Corrales (2021) has argued, there is still a disconnect between feminist practices and the feminism that is taught in schools of social work, resulting in many frontline feminist voices still being silenced in social work academia (Clarke, 2021; Deepak, 2019; Johnstone & Lee, 2021; Rasool & Harms-Smith, 2021).

Seeking to break this trend, the findings of the study presented here seek to recognise the professional experiences of women social workers, proposing to understand the complexities of the frontline implementation of state interventions in Chile, a country internationally recognised as the laboratory of neoliberalism (Harvey, 2007) and currently experiencing constitutional change as a result of the 18-O movement – a sociopolitical uprising initiated in October 2019 in which feminist organisations had a prominent role (Hiner et al., 2021). In this article, we analyse the precariousness faced and the resistance exercised by women social workers in the implementation of a state mental health programme aimed to monitor and support impoverished, racialised women's adherence to mental health treatment. Drawing upon social work scholars’ contributions to the study of professional resistance (Baines, 2017, 2020; Carey & Foster, 2011; Fine & Teram, 2013; Strier & Bershtling, 2016; Wallace & Pease, 2011; Weinberg & Banks, 2019, among others), we propose in this article to look at women social workers’ professional resistance from the perspective of decolonial feminism and the approaches of sustainability of life (Carrasco, 2003) and feminised resistance (Motta, 2013), which have emerged as conceptual tools to comprehend the feminisation of poverty from patriarchal-colonial oppressions affecting women and dissident sexual orientations and non-hegemonic gender identities in the global south (Mohanty, 2010; Motta, 2018; Pérez-Orozco & Mason-Deese, 2022). This research is based on the assumption that despite the aspirations of scientific objectivity and political neutrality that since its origins and especially during the dictatorship have founded Chilean social work education, there are practices of professional resistance underpinned by the values of feminism that lead to a ‘border’ professional bond – a liminal space in Lugones’ (2021) words – that contains powerful strengths to challenge the everyday expressions of patriarchal-colonial capitalism in professional practice, but that are still silenced in the intellectual debates of academic social work in Chile.

Methods

The findings of the study presented in this article are part of a larger research on professional resistances exerted by social workers in frontline policy implementation in Chile, which is based on a mixed sequential exploratory design in three (qualitative–quantitative–qualitative) phases (Creswell, 2015). In this article, we discuss the results of the first qualitative phase drawing upon the contributions of decolonial feminist perspectives and focusing specifically on the analysis of women social workers’ accounts to explore their particular experiences and views on professional practice, as well as possibilities of a feminised resistance in the context of mental health programme implementation.

Context of the Study

The Acompañamiento Psicosocial en Salud (Psychosocial Support in Health) programme, designed and funded by the Ministry of Health, has been implemented by the Municipalities (local governments) since 2016. According to the guidelines of the Ministry of Health (2018), it aims to promote the right to health by providing psychosocial accompaniment to women who, living under the poverty line, experience postpartum depression, have attempted suicide, and/or who have been victims of violence (themselves or their children under 18). The main tasks of the social workers are to link the women with Primary Health Care services by facilitating access to psychiatric care appointments in the public health service, monitoring their adherence to treatment and supporting the strengthening of their family and/or community ties. This psychosocial support is provided through home visits and telephone calls made by social workers over 9 months.

The women users of the programme live in isolated or peripheral territories, many of them are descendants of indigenous peoples, Afro-descendants and/or migrants from other Latin American countries (Ibarra, 2018). As they are living in poverty, these women cannot afford mental health care in the private system – which is expensive but of better quality in terms of the speed of obtaining an appointment, or the friendly and efficient treatment of the health staff to service users, among other factors (Quijada et al., 2019).

Research Techniques, Fieldwork Procedures and Ethics

Sixty-nine semi-structured interviews were conducted with social workers implementing the programme in three regions (Atacama in the north, Metropolitana in the central zone and Ñuble in the South of Chile). These regions were selected because they present high levels of poverty and inequality affecting both rural and urban areas (Ministry of Social Development, 2020). Considering the influence of socioeconomic factors on mental health and the unequal availability of mental health services between central/urban and peripheral/rural areas in Chile (Domínguez-López & Torres-Avila, 2022), the study focused on six municipalities (one rural and one urban in each region). The potential participants were contacted by the research team through e-mail invitations, employing the e-mail addresses or telephone numbers publicly available on the Municipalities’ websites. The only criterion to select participants was being a social worker implementing the programme at the frontline for at least one year in any of the focused Municipalities. The consent form and further details to organise a date for an interview were provided for those social workers who answered the invitation. After conducting the first round of interviews, more potential participants were contacted using the ‘snowball’ technique (Bryman, 2021) until reaching saturation (Saunders et al., 2018). Of the 69 interviewees, 56 were women, 55 of them under 35 years of age, and with an average experience of 2 years implementing the programme at the time of the interview. They were employed by the municipalities for a fixed term (9 months according to the duration of the programme cycle). In this article, we analyse only women social workers’ accounts because when interviewed, men social workers did not problematise professional bonds from a ‘genderised’ identification with service users as women social workers did. Despite most men social workers pointing out structural readings of precariousness experienced in their professional practice, they did not refer to issues such as child care and domestic labour as something that either interfered in their professional practice or exacerbated precariousness. They did not refer to practices of ‘feminised resistance’ as a means to cope with such issues in daily life, either.

Each interview lasted approximately 45–60 min. The interview script comprised three dimensions of enquiry: a general contextualisation of the conditions of implementation, an exploration of the main tensions they face in implementation, and an approach to the ways in which they cope with or contest these tensions, exploring potential resistance practices.

Fieldwork was conducted between August 2020 and January 2021. Given the health constraints at that time in Chile, interviews were conducted online, recorded and transcribed verbatim when authorised by the interviewee. Participants who did not authorise the recording of the interview did authorise note-taking during the interview. All participants signed an informed consent form. The study was approved by the Ethics Committee of the sponsoring institution. Pseudonyms have been used in this article to identify participants in order to protect their identities when presenting the findings.

Data Analysis and Interpretation

The corpus of data was analysed following the steps of the thematic analysis proposed by Braun and Clarke (2017) using Atlas Ti software. Based on this analysis, broad themes were identified that allowed us to identify the tensions in the implementation and resistance of women social workers: precarious working conditions, low interest of female clients in addressing mental health problems, lack of social support to address multiple material needs of female clients, discrimination and disrespectful treatment of male doctors and psychiatrists towards female clients, identification and affects between female social workers and female clients, resistances in the form of interdependence and co-care practices.

Once the themes were identified in the analysis, a workshop was held in July 2021 with the participants of the study, in which the emerging themes of the analysis were presented and discussed. This workshop was a very valuable space for sharing interpretations and exchanging experiences between the participants and the researchers from a perspective of reciprocity, reflexivity and situatedness (Curiel, 2015). From the conversation between participants and researchers, the themes were refined and re-grouped, allowing the organisation of findings to be reconfigured into three new themes: (i) the precariousness of life as common ground, (ii) the ‘liminal’ professional bond and (iii) the formation of coalitions for a feminised resistance.

We are aware that the research participants were probably shaken by the pandemic at the moment of the interview. Reconciling the demands of work and home life in times of remote intervention, or having to continue doing front-line intervention exposing themselves to the risk of contagion, configured a complex scenario, in which some of their views about precariousness, professional bonds and professional resistances may have been exacerbated by feelings related to risk, fear and uncertainty. However, and despite the fact that the interviews were conducted via Zoom, several of the interviewees explicitly thanked the researchers for the space for quiet conversation that the interview allowed. We, the authors, as researchers who conducted this study during the pandemic – also taking care of young children and domestic work while doing remote academic work – were touched and moved by the interviewees’ accounts. Hence, the analysis we present here is a situated one, which means that it is underpinned by an embodied ‘objectivity’ (Haraway, 1988), also underlain by reflections on our own lived experiences including both our oppressions and privileges (Curiel, 2015).

Exploring Professional Praxis From Decolonial Feminist Perspectives

Discussions on feminism in Latin America, as in other regions, have many nuances (Martínez & Agüero, 2021). Despite the different currents, we can find some common threads where perspectives from indigenous peoples and Afro-descendant communities dialogue to elaborate a shared critique of the hegemony of ‘white feminism’ – ‘white’ not in terms of skin colour, but white in the sense of the ‘unassumed geopolitical privilege’ that is associated with what comes from Europe or Anglo-America (Espinosa et al., 2014).

These perspectives – which draw on the contributions of decolonial thought emerging from the Modernity/Coloniality project (Lugones, 2008) and from Afro, indigenous, lesbofeminist, autonomous feminist movements in Latin America, among others (Cabnal, 2018; Curiel, 2015; Tzul, 2015) – make up the so-called decolonial feminism, a current of Latin American feminism that gives maximum importance to the intersection of sex/gender, class and race conflicts, relating it to the cultural institutions and categories imposed by colonialism first and reproduced by coloniality later (Lugones, 2011). The concept of coloniality is key to understanding the proposals of decolonial feminism. Coloniality, according to Quijano (1993), is the maintenance of the coloniser's domination once colonisation ended. In other words, this means that the ‘formal independence’ of the colonies does not end their condition of ‘colonised’. A colonial rationality – the coloniality of power, knowledge, sexuality, gender, work, relationship with nature, and ultimately, of being – continues to be reproduced thanks to the internal colonialism exercised by the political, religious, military and media elites within the ‘formally independent’ nation-states (Grosfoguel, 2016).

The protagonists that give meaning to decolonial feminism are women: poor, immigrant, physically or mentally disabled, ‘indian’ or ‘black’ women, and people with dissident sexual orientations (Montanaro, 2017; Rodríguez, 2011). They are those who experience colonial domination through prejudice, mistreatment and humiliation both in their daily interactions at school, in the hospital and on the street, and in their experience of structural injustice in profoundly unequal societies such as those in Latin America (Espinosa et al., 2014), where vast sectors of the population, but especially women of indigenous descent, have been brutally stripped of their resources, impoverished and precarised (Barbosa et al., 2022; Cuero, 2019; Fernández et al., 2020; Preciado, 2019).

Addressing Precarity From Precarity: Survival and Resistance

Decolonial feminism understands the multidimensional violence experienced by women and other subalternised groups in Latin American countries as the result of the action, but fundamentally of the omission and negligence of the state – a capitalist, the patriarchal and colonial state, where these three axes intersect and mutually reinforce each other (Cabnal, 2018). In these countries, the omissions of the state show their maximum expression in the processes of precarisation of life: the reduction of humanity to the experience of living to work and working to survive, in conditions of exploitation, insecurity and lack of protection, exposed to multiple oppressions of sex, gender, race and social class (Butler, 2009; Darat, 2021; Spivak, 2005), and subjugated by mercantile logics that reward competition, individualism, depoliticisation, value acceleration and productivity and have a disregard for ancestral memory and nature (Espinosa et al., 2014; Rodríguez, 2011).

The precariousness of life is the initial theme that appears as a starting point for the reflections of the participants in most of the interviews. This precariousness of life is manifested in at least three domains experienced by both users and professionals: material conditions of existence, alienation or meaninglessness, and lack of protection due to deregulation or absence of the state in state intervention itself.

The material precariousness in which the clients find themselves - as already mentioned, most of them descendants of native peoples and immigrants, all of them below the poverty line and experiencing mental health problems – is recognised by the social workers as a structural obstacle to achieving the programme's objective. At the same time, the majority of the social workers stated that their own professional status is also precarious. All the interviewees were employed on a fixed-term contract for the 9 months of the programme's intervention, and the type of contract under which they work did not guarantee their rights – for example, sick leave, maternity leave or holiday entitlements. This lack of rights contrasts sharply with the rhetoric of rights that underlies the programme's objectives. Thus, social workers claim to be in a constant paradox: on the one hand, their role is to ‘empower’ clients to claim their mental health rights, while at the same time their rights as workers are violated. As Marcia (31 years old) comments:

We [social workers] are in the most precarious situation, all of us [hired] on fixed-term contracts. One colleague had COVID and they told her that as she didn't have a long-term contract, she couldn't take medical leave. You can't get pregnant because they take your job. These are rights that are not fulfilled for workers and service users. Their families also live in the most precarious conditions, living in overcrowded conditions, unemployed or with miserable jobs, with children with alcoholism problems, drugs, suicide risk … an appointment with a psychiatrist can take several months in the public health system and it is very expensive to pay for one in the private system. The programme is about mental health, but how can you work on mental health if families need material help, milk for their babies, nappies, medicine for their elderly? The list of needs is endless.

Patriarchal–colonial capitalism and its economic and moral rationality are not only expressed in the violation of workers’ labour rights or access to quality mental health care for clients, but expands more broadly as a form of sociability based on individualistic and alienated practices of survival, on stark competition and the exploitation of human capacities that allow its functioning and reproduction (Álvarez et al., 2021; Motta, 2013; Soto, 2022). As a result, social workers face, in addition to a generalised precariousness, significant resistance on the part of the users to get involved in the development of the programme. With so many unmet needs and at the same time so much pressure to ‘keep functioning’, mental health is not a priority, says Andrea (30 years old):

Mental health is important in more developed countries, which have more resources. Here, we women worry, hopefully, about physical health, and having the minimum to live on. We don't have the concept of ‘being well’, but of ‘surviving’. That's the system we live in. No client comes to you and says ‘I need mental health care because I’m overwhelmed’. They have to go on and on, work to survive. Women clients punish themselves when they can no longer function. The same thing happens to us as women social workers. One thinks ‘I have the problem because I am weak, because I don't have the capacity’.

Related to alienation as a survival mechanism, the emotional exhaustion related to the implementation of the programme and the lack of institutional care policies from the organisations that hire them appears often in the accounts of several interviewees, which reinforces their precariousness. In addition, despite the high level of complexity of the situations faced by the clients, the social workers indicated that they did not have any type of orientation or protocol to approach the intervention. In fact, the programme guidelines only establish the objectives to be achieved and the goals to be reached (number of home visits and phone calls that the social workers have to make each week), leaving a great void in terms of ‘how’ these objectives and goals are to be met. This lack of guidance, coupled with the lack of supervision for social workers, reinforces the situation of precariousness, generating a sense of ‘abandonment’ of their role by the state (Cuero, 2019; Ibarra, 2018). Some professionals reported ‘feeling left to their own devices in the professional intervention’ (Karina, 32 years old), dealing with complex mental health situations faced by clients with the resources they have and based on their professional discretion. This, in the words of Ema (39 years old) ‘constitutes irresponsibility on the part of the programme, because the emotional burden is very high, you are affected and you can make a mistake with a client, and that is very serious’.

However, the precariousness of life can also be understood as the engine of resistance, recognising the power that underlies all vulnerability (Butler, 2009; Darat, 2021; Gil, 2014; Precarias a la Deriva, 2004; Preciado, 2019). Assuming vulnerability as power allows us to understand the precariousness of living as a possibility of counter-conduct, collectivising and re-politicising life through solidarity as a form of feminised resistance (Motta, 2012). In the words of María (42 years old), we observe that the lack of guidance and supervision leads to negligence that has dramatic consequences for the lives of users. This feeling of lack of protection and precariousness leads to resistance:

A 14-year-old girl, pregnant, was in the programme because she had a lot of mental distress. The pregnancy was the result of sexual abuse. I got angry because the male doctor knew about the abuse, but he did not report it. I said, ‘You should have reported it,’ and he said, ‘No. If I did, I would have to report it in almost every case. We argued a lot. I had to bring him the law; I underlined the paragraphs and said ‘read it’. You should have made the complaint. I asked for a meeting with the Regional Director of the Health Service, I reported what had happened, and from that day on, training courses on the law on sexual abuse began to be given so that doctors are obliged now to fulfil their responsibility.

In María's story, we can clearly see how she defies the male doctor and reaches out to the Regional Director to ask for fundamental solutions to this negligence, which reinforces the violation of rights and the precarious situation of the users. For María, precariousness gives rise to resistance: she feels affected by what the user experiences, she does not conform, and directly confronts the authority of the male doctor, a significant issue in the Chilean context where medicine is not only a class-based space but also a masculinised and racialised one (Quijada et al., 2019). María's resistance arises from ‘affects’ – or ‘afectación’ in Spanish, which means being touched or moved by emotions – (Motta, 2012), which is directly related to the way in which the professional bond takes shape in this context of precariousness.

Bonding ‘otherwise’: Shared Experiences and Liminal Space in Professional Practice

Assuming that precariousness, and the affects involved in the face of it, can be a driver of resistance, the notion of bonding becomes central. In this line, the sustainability of life approach (Carrasco, 2003; Pérez-Orozco, 2011; Tovar Cortés, 2022) offers important insights to reflect on how we can establish bonds that challenge capitalist–patriarchal–colonial rationale. This approach, which emerges from the praxis of feminist movements in Latin America, posits that patriarchal–colonial capitalism has shaped a fundamentally ‘extractivist’ type of social bond (of commodification and destruction of human and non-human life) with respect to the environment, people and knowledge (Grosfoguel, 2016). This ‘extractivist’ link has resulted in overlapped economic, environmental, political, health, exclusion, discrimination and violence crises, where what is ultimately at stake is life: the human life of subalternised groups, the life of animals, the life of the whole planet (Pérez-Orozco & Mason-Deese, 2022).

The question then arises as to how it is possible to sustain life in conditions of humanity based on a network of links ‘otherwise’ (Carrasco, 2003), links that allow life to be sustained in a harmonious, connected and affected way, as the worldviews of the original peoples of Latin America have claimed for centuries (Curiel, 2015). From this perspective, the social bond of interdependence is key, and implies abandoning the pretence of being able to exist without depending on others and ceasing to undervalue those who are labelled as a dependent (Pérez-Orozco, 2011). This leads to questioning the dichotomous ideas of dependence/independence and the overvaluation of individual autonomy so typical of the discourse of patriarchal-colonial capitalism (Butler, 2009; Gil, 2014; Pujal & Amigot, 2010).

As can be seen in the interview extracts presented in the previous section, a constant comparison emerges in the accounts, a point of felt connection – sometimes even identification – between workers and users, where precariousness and the understanding of mental health as ‘a luxury in a neoliberal country like this’ (Andrea, 30 years old) form a common ground that places them in a shared space of alienation, survival and also resistance. The professional bond, then, seems to take shape in a space where boundaries are blurred, a ‘liminal space’ in Lugones’ (2021) words. For María Lugones, to be in a liminal space is to be on a threshold, between something that has gone and something that is yet to come. It is a borderline position, one of ambiguity and openness, which precisely allows us to let go of institutional constraints and move from one condition to another.

Claudia (38 years old) lets us see this common ground and how this liminal space is being constructed, which is expressed, for example, in acts of resistance to the power of biomedical rationality (Nogueira, 2018) and the dehumanising treatment of psychiatrists towards users of the programme:

I have been on the other side of the table. When I was a child my family was very poor. I also know what it means to be a user with a severely disabled child. So when a service user tells me that the psychiatrist did not treat her well, I ask him for a meeting. And I treat him by his name, I don't say ‘Mr. doctor’. No, because he doesn't say ‘Mrs. social worker’, he just says ‘Claudia’. So I say to him: ‘I would like to talk to you because you have not treated the user properly. Please have the decency, the minimum of respect, to explain to the woman the diagnosis and what the medicine you are prescribing is for’ […] He treated the woman badly because he saw her badly: dark skin, poor, badly dressed, shy.

Claudia challenges the power of male psychiatric doctors by questioning the dehumanised, standardised, and cold treatment of mental health care, and the implicit discrimination against impoverished and racialised women. This is a form of explicit resistance (Baines, 2017; Strier & Bershtling, 2016; Weinberg & Banks, 2019), a challenge to the heart of the system from their own professional position, which questions the biomedical logic that has underpinned social work since its beginnings as a profession in 1925 (Duarte, 2013; Illanes, 2007; Martínez & Agüero, 2021). This liminal space, where shared experiences lead to a blurring of the boundaries between professional and client, opens up the professional bond, ‘making it vulnerable’ to being affected, as we have said, and thus humanising it (Motta, 2012).

But also this blurring of boundaries – especially when there are no guidelines, protocols or supervision of the professional intervention as in the case of this programme – allows the configuration of a professional subjectivity that is materially surpassed and emotionally exploited. The programme does not have the material resources to satisfy the basic needs of the clients and their families. In these cases, some social workers report collecting donations to buy food or medicine for the clients, something that exceeds their professional role and the objectives of the programme – a sort of ‘social glue’ in the context of neoliberal policies, as Baines et al. (2020) have argued. Associated with this, the emotional burden of the intervention is, for many social workers, overwhelming. This is how Daniela (33 years old) puts it:

I have a family, where there is a 6-month-old baby. His 16-year-old mother is a drug user. Her family tells me at 3 o’clock in the morning that she has left, that she came home on drugs, that she is going to commit suicide […] my colleagues tell me ‘you can't accept that’ and I say OK, what if something happens to her? They warned me and I did nothing, where is my conscience?

The entire responsibility for the results of the programme, and ultimately for the well-being of the clients, rests with the social workers, according to the perceptions shared by several interviewees. Carla's (29 years old) analysis is clear: ‘What will happen if I leave this organisation? I feel that if I am not here, nobody will care about the dignity of the clients’. This is a matter of concern if we consider, as already mentioned, that the programme does not have care policies for their workers. Most of the interviewees state that care is understood by the programme as an individual responsibility of each worker – an orientation very consistent with the capitalist–patriarchal–colonial logic that underlies state policy (Darat, 2021; Montanaro, 2017; Vivaldi & Sepúlveda, 2021). In fact, several participants report that in the face of the strong emotional burden of the professional intervention they have had to pay for therapeutic processes with their own resources, something that has been referred to by Baines et al. (2020) as the emotional/personal costs of the intervention. None of the interviewees reported any care initiative by the organisation towards the workers, but there were numerous experiences of co-care – as the opposite of individual ‘self-care’, which we will discuss in the next section.

Forming Coalitions: Finding Conjunctures for Feminised Resistances

From a decolonial feminist perspective, coalition building with feminist movements is crucial. Decolonial feminisms emerge from and are based on political practice, where thought and action are one, where ‘street theorising’ – the act of producing knowledge from the lived experience of resisting ‘in the streets’ (circulating, struggling or protesting) –, as proposed by Lugones (2021), is crucial to build feminist ‘praxica’. It is from these street theorisations that resistance to patriarchal–colonial capitalism can be strengthened. As Mohanty (2010) has suggested, a ‘feminised resistance’ has emerged in the countries of the global south that is closely related to the ‘feminisation of poverty’. The struggles of feminist movements, formed by subjects living with multiple oppressions, allow for re-envisaging emancipatory politics, producing and embodying difference, to create and experiment with new subjectivities (Seppälä; 2016), which has the potential to challenge ‘masculinist conceptualisations of political and social transformation’ (Motta, 2013). When we raise the idea of ‘feminised’ resistance we do not mean a characteristic of a particular sex body. As Motta (2018) has asserted, ‘feminised’ resistance means collective ways of sustaining everyday life, involving affectivity, vulnerability, tenderness, and the acceptance of failure as a point of learning and the possibility of embracing each other in discomfort in opposition of the politics of mastery, control and dominance. In this sense, it is about putting life at the centre, as proposed by life sustainability approaches (Carrasco, 2003; Pérez-Orozco, 2011), understanding the politics of life in opposition to the politics of disposability and dehumanization (Tovar Cortés, 2022).

As the findings suggest, the professional practice of the interviewees is precarious due to the working conditions and the implementation of the programme, but at the same time, an interpretation of precariousness also emerges where it is understood as a power. The vulnerability associated with precariousness implies ‘feeling incomplete, needing others to take care of oneself and others’, that is, the opposite of the image of the self-sufficient and competent individual imposed by the prevailing capitalist–patriarchal–colonial rationality.

From this position of vulnerability, it is possible to form coalitions, support, and care networks (Lugones, 2021) that allow for closer links between clients and workers. Some social workers report, for example, that they have ‘joined together to confront the macho culture’ that prevails in health services (Catalina, 35 years old) and which manifests itself, for example, in sexist jokes against female social workers or racist and homophobic comments against users. It also aims to install, in a subterranean and progressive way, a feminist perspective in professional intervention. The programme ‘aims to be gender neutral, it does not problematise how emotional stress affects women or sexual dissidence differently in a patriarchal country like this one. Although slowly and not without obstacles, we are trying to install that in mental health’, says Karina (32 years old). Marcela (43 years old) comments on an experience of coalition building that shows ‘feminised’ resistance in professional intervention:

I introduce a feminist gaze in everything I do, in the conversation with the clients in the home visit, I approach everything always from a situated perspective. We are women taking care of women, in a patriarchal system that measures us by our successes and tramples us if we get mentally ill, because to get ill is to fail. Women are blamed for everything, if the son is abusing drugs or attempting suicide, the mother's role is immediately questioned, not the father's. I learned that from a woman worker who is retired now. Thanks to her I started to participate in feminist organisations, to think about how to bring feminism into my professional practice and to understand that this is to be done with others, never alone.

Co-care practices between social workers appear very strongly in most of the interviews. These are coalitions that make it possible to resist in the face of job insecurity and the vulnerabilities of everyday life, which make it possible to cope with the ‘accompanying’ work, as Katia (34 years old) comments.

We [the three female professionals who implement the programme in this municipality] are very close. You tell me that your child is sick, I tell you: don't even think about coming. You stay with your child; you tell me what you have to do. I’ll help you. If you need me to go to your house to pick up the reports, I’ll pick them up, I’ll leave them for you at the municipality. That's how we all help each other, not just those in the programme. I was very bad for a week. Very bad. And my colleagues covered everything. ‘Rest, recover and then come back. We’ve been there too, we understand you, we help you’.

These co-care practices, according to Daniela (33 years old), are fundamental to deal with the material precariousness and emotional exploitation of professional intervention in a programme with few financial resources, no orientation or protocol and no institutional care practices for the workers. When asked about the ways in which she deals with the emotional stress involved in responding to a call from a client in the early hours of the morning, given the life-threatening situation experienced by a member of her family, she shares:

Of course I was distressed, I couldn't sleep, I was very affected, I couldn't stop thinking about that client and her daughter. If it wasn't for my colleagues I couldn't have resisted. We have that practice here: we affect each other, we cry, we share that over coffee, we hug each other. Sometimes it's one's turn, sometimes it's another one's turn. We are all women, only one man. Together we accompany each other, we encourage each other, and that is why we continue to resist in this work.

Discussion and Conclusions

The findings presented here allow us to observe how the logics of patriarchal–colonial capitalism are experienced and contested by social workers implementing a mental health programme in Chile. The emphasis on functioning (working, to generate the money to survive) in the framework of neoliberal capitalism that is still at the heart of the Chilean model (Palacios-Valladares, 2022; Vivaldi & Sepúlveda, 2021) means that mental health is not a priority for users and workers. Nor does the programme, paradoxically, put life at the centre: it works at the expense of the material and emotional resources of the social workers. They, as individuals, end up being responsible for the outcomes of the programme, reinforcing a weak and disaffected state role, neglectful, focused on goals rather than processes – an issue also identified in other contexts where managerialism has affected the professional intervention of social workers (Baines, 2017; Garrett, 2021; Ioakimidis, 2021; Pollack & Rossiter, 2010; Weinberg & Banks, 2019, among others). The findings of this study suggest that the patriarchal dimension of capitalism is reinforced by holding women (Federici, 2004; Giaconi, 2021), and ‘women taking care of women’, as Marcela (43) put it. This responsibilisation is reflected in the exhausting emotional burdens, the lack of institutional support and in the general precarisation of the material condition of existence of clients and social workers, where there is huge extra, unrecognised and unrewarded work – the unpaid work, as Baines et al. (2020) have asserted. The colonial dimension of capitalism is expressed, in turn, in the hegemony of the biomedical discourse (Nogueira, 2018), which features male psychiatrists surrounded by an aura of superiority granted by their class, gender and race. It is a depersonalised discourse and a treatment that violates the dignity of the users, women in poverty, many of them with the mark of class and race manifested in their skin colour and physical appearance, as shown in the studies by Federici (2004), Álvarez et al. (2021), Soto (2022), among others.

Some of the interviewees counteracted the manifestations of patriarchal–colonial capitalism observed in the programme's intervention. For example, some social workers questioned male doctors for their lack of humanity or ethical responsibility, problematised the ‘machista’ culture prevailing in labour spaces and introduced feminist perspectives to deconstruct those ‘blaming’ discourses against women underpinning some mental health interventions. Other forms of ‘feminised’ resistance can also be observed in those practices of emotional support among colleagues, that ‘hugging each other’ in the face of overwhelming situations, which allows for the resistance to be encarnadas (‘enfleshed’) or acuerpadas (‘embodied’) and to regain strength to fight for the rights of users in a system that permanently violates subalternised subjects, as other research has also shown (Giaconi, 2021). These are ‘feminised’ resistances (Mohanty, 2010; Motta, 2013; Seppälä; 2016), which place life at the centre and which arise from the liminal space that is expressed in identification with the lives of the users and which allows us to challenge the distinction between ‘intervening professional’ and ‘intervened subject’ that traditionally founded the epistemological bases of the teaching of social work in Chile and which were reinforced with the intellectual censorship in times of dictatorship (Cubillos & Zarallo, 2021; Duarte, 2013; Illanes, 2007).

The participants in this study share a critical reading of the capitalist-patriarchal-colonial system, the role of the state, the programme and its possibilities to address the mental health of users in a country where the structural conditions are not yet in place for vast sectors of the population to achieve minimum standards of living. Despite this critical reading, resistance operates in a face-to-face space with colleagues and direct management, but does not have a broader collective scope, for example, through action in trade unions or workers’ organisations that implement frontline programmes. Certainly, the precarious working conditions – especially the fixed-term contracts for the duration of the programme cycle – leave women workers in a situation of uncertainty and defencelessness that hinders the possibilities of developing forms of resistance on a macro-political scale, at least in an explicit way (Carey & Foster, 2011; Fine & Teram, 2013; Garrett, 2021).

Those social workers who are linked to feminist movements try to incorporate feminist principles into their daily practices, either underground or subtly, as one of the interviewees pointed out. The link between the collective action of social movements and the professional intervention of social work is still a pending task from a decolonial feminist perspective, which, as we have asserted, arises precisely from the praxis with women and subalternised identities, to irradiate all spheres of human development, including the labour space (Barbosa et al., 2022; Cuero, 2019; Fernández et al., 2020). These practices of professional resistance are still little explored in the academic world of Chilean social work, where feminist approaches are still dominated by the coloniality of knowledge prevailing in the neoliberal university. Although academic productions on feminism and social work – books and published papers – have increased recently and have conceptually captured the value of feminist debates for the profession, they still have little connection with the lived experience of social workers who are on the front line of professional intervention and who embody the principles of decolonial feminism in their daily practices. Academic social work has much to learn from the feminism at play in frontline practices, from a perspective that values ‘weak talking/deep listening’ (Lugones, 2021; Motta, 2013; Seppälä; 2016) and that allows, for example, macro readings of the structural mechanisms that give – or not – meaning to our labour practices and problematise the links that we establish in these spaces and the extent to which they reproduce the logics of patriarchal-colonial capitalism, and/or challenge them from the practices of affectivity, interdependence and collective agreement (Gil, 2014; Pérez-Orozco, 2011; Pujal & Amigot, 2010). Promoting a decolonial feminist turn in the academic and professional social work training implies including theories and concepts in the curricula, but especially its application and guided supervision in practice. If we are unable to develop a ‘praxica’ as Lugones (2021) says, although structural mechanisms change, social workers’ interventions will continue reproducing positivistic, colonial and patriarchal values.

Challenging coloniality and patriarchy by creating resistances that put life at the centre means also reshaping our links – entangling ourselves in shared experience – and expanding the web of caring connections, containment, and constant support, in a formation of a sense of community – which, as Latin American original peoples’ worldviews have argued, is profoundly harmonious between humans and between humans and non-human live beings. Building coalitions to confront multiple oppressions, as Lugones (2021) argues, also means thinking of ourselves in a weaving of broader links with feminist, academic and activist movements and organisations not only locally, which recover the ancestral knowledge of our native peoples, but also with those decolonial feminist initiatives on a global scale (Curiel, 2015; Espinosa et al., 2014; Pérez-Orozco & Mason-Deese, 2022).

We believe that academic social work has the responsibility not only to make visible experiences of precariousness and resistance exercised by frontline social workers from the ‘border thinking’ proposed by Lugones (2021) and the ‘theorising from the everyday’ suggested by Motta (2018), but also to advocate for the fulfilment of their labour rights and improvements in support systems (guidelines, protocols and reflective supervision) that allow them to better develop their professional intervention. Chile is at a propitious moment in these struggles, in which academics, workers, activists and students can voice their concerns and proposals in the framework of the construction of a new constitution (Perry & Borzutzky, 2022; Hiner et al., 2021). An example of this is the presentation of a proposed regulation of the working conditions of frontline professionals that we as a network of researchers presented to the Constitutional Convention in January 2022. At the time of writing this article, the Constitutional Convention has produced a first draft of the new constitution, which, among other aspects, integrates mental health as a right to be guaranteed and the recognition of care as work that contributes to the country's economy and is essential to sustain life. We are still waiting for the plebiscite that will ratify this new constitution, but we do not lose hope that these structural transformations will take place, in order to advance the dismantling of the patriarchal–colonial capitalism historically rooted in Chile and the promotion of institutions and practices that allow us to ‘sustain life’ in another way.