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Social workers devote their lives to helping others. Why aren’t they receiving help themselves?

Behind the shortcomings of the mental health care industry

Shauna McGinn

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Years ago, walking through downtown Ottawa made Amanda Rocheleau anxious. As a social worker at The Ottawa Mission, one of the city’s largest homeless shelters, she knew almost every homeless person by name, and they knew hers. She listened to their stories every day—of childhood abuse, neglect, struggles with addiction and mental disorders. It didn’t feel right, she thought, to let herself stroll along carefree. “I used to laugh as I watched people walk through Rideau Centre and down the street with their shopping bags and big smiles on their faces,” Rocheleau, who has lived in the city since 2002, says. “And I would think, ‘You’re so oblivious to what is happening right around the corner, but I know.’”

Rocheleau, only in her late 20s by that point, was beyond burnt out. She was almost a decade in to her career with three young children at home, and the emotionally taxing work was wearing on her. Her immune system was weak; she suffered pneumonia, two kidney infections, and constantly felt exhausted. Traumas from her job began to seep into her personal life—when her son had his first male teacher, it triggered skepticism; she couldn’t stop thinking about the countless clients she knew who were abused by male authority figures.

Something had to change. But when she sought help and answers, resources were either unhelpful or nonexistent. So, in her exhaustion-addled state, Rocheleau did her own research. Slowly, she found the language to describe what was happening to her. Burnout: a state of total physical and mental exhaustion caused by prolonged exposure to stress. Vicarious trauma: a slow absorption of traumatic information that causes unwarranted hypersensitivity and anxiety. Compassion fatigue: a condition resulting from untreated burnout and vicarious trauma that affects your capacity to feel empathy. “It’s this gradual erosion of your compassion,” she says. “And compassion is the fuel that keeps social workers going.”

Rocheleau was experiencing the trifecta of psychological hazards potent in social work. And she is far from alone. A 2009 paper published in the Canadian Social Work Review, referencing a 2006 study that surveyed more than 1,000 Ontario social workers, found over 60 percent reported stress in their workplace; about 40 percent indicated feelings of depression and frequent illness. Despite difficult working conditions and low wages, the study concluded that the majority of social workers remained committed to providing care, “even if it contributes to their own exploitation.”

In the eight years since, research across the field suggests those working conditions haven’t gotten easier. Wages haven’t caught up with the cost of living. And yet social workers remain willing to stretch themselves dangerously thin. This can have a domino effect that hits vulnerable populations the hardest. The national conversation about mental health is growing, but effective resources for those on the front lines of everyday crises remain sparse.

***

Many of us have probably encountered a social worker at some point in our lives. They’re embedded in many major institutions: schools, prisons, hospitals, and in our communities, providing counselling, supporting youth, working in shelters, writing policy, and advocating for child welfare. A defining feature of the profession is providing support; identifying the services people need, and connecting them to those services.

But when it comes to supporting social workers, many find the options lacking, ineffective, or downright unavailable. Anna Przednowek, a PhD candidate in social work at Carleton University in Ottawa with more than a decade of experience in the developmental services field, says strategies she’s heard of to address psychological hazards for social workers are largely surface-level. The conversation, she says, is always about selfcare, like taking a hot bath or practising “mindfulness.”

Przednowek says these quick-fix strategies aren’t practical. Throughout her career, she’s seen how many jobs in her field are shifting from stable and salaried to more precarious, lower-paid contracts without benefits. Those jobs make it difficult to take sick days or afford a private counsellor. Couple that with service conditions where there is a reduction in service funding and shifting expectations that families will provide the bulk of care for those in need, and social workers end up working in high-intensity conditions that put them at risk of mental health challenges. “The support is shrinking and we’re being asked to do more with less all the time,” Przednowek says. “And then we’re just supposed to manage our anxiety with mindfulness?”

Meanwhile, social workers unintentionally perpetuate this flawed system by pushing themselves far beyond what is expected, according to Sarah Pekeles, a former master’s student at Carleton’s social work program who did placement work for her Bachelor of Social Work in Surrey, B.C. They are willing to work 50 hours a week instead of the mandated 35, knowing they won’t be paid overtime. Or check their email at 2 a.m., worried about what may have happened overnight to one of the children on their caseload. Or buy coffee and sandwiches and deodorant for their clients, knowing it will never be reimbursed.

Research only amplifies these concerns: A 2006 “quality of work life” survey conducted by the Ontario Association of Social Workers found many workers feel undervalued because they often make significantly less money than those in adjacent professions, such as nurses or psychologists. A joint research project by a U.K.-based community care organization and the public service union UNISON found this March that of the more than 2,000 social workers surveyed, 80 percent reported that they felt emotional distress every day in their work, and nearly half felt they were being pushed to the limit by the number of clients and caseloads they had been assigned. And an overall review of research on burnout in social work from the University of Queensland in 2002 reported that across the board, social work is “a profession that is at high risk of stress and burnout.”

Pekeles says scant resources and the concentration of vulnerable populations leads to a staggering number of cases at once—in child protection services, caseloads can sometimes be upwards of 40 per worker, when the benchmark is usually about 25. This has a direct impact on children, she says, because critical cases involving them can slip through the cracks when workers are overwhelmed and can’t keep up with their workload. “You feel deeply responsible if something happens to one of the kids on your caseload,” Pekeles says. “It’s a huge risk situation.”

It’s well known in social work circles that child protection has some of the highest turnover rates in the field—in Pekeles’ experience, the average time spent in it is about two years. In the first six months of Pekeles’ career, one co-worker who had started alongside her had to take stress leave, and another later went on permanent leave due to anxiety and post-traumatic stress disorder related to the job. Pekeles wasn’t surprised by this—separating yourself from the work can feel impossible. “You try, right, because that’s what everybody tells you to do,” she says. “But you can’t.”

Jaime Hobbs, a social worker currently completing a placement in Alberta for her Master of Social Work, also experienced these issues firsthand. The Nova Scotia native worked in a hospital for sick children for nearly a decade, and witnessing the inequity in how children accessed resources was one of the most difficult parts of her job. Since many charities for sick children tend to focus on well-known illnesses, such as heart disease or cancer, Hobbs says children with more complex or rare health problems are often left out—and people in her position are usually the ones dealing with the fallout.

“The [charities] have events to fundraise money for these kids who are in the hospital, like raising money for their parking passes—but it’s only for a specific group of kids,” she says. “Meanwhile, I’m going into one room and I’m like, ‘Oh, you have this diagnosis therefore you get a parking pass,’ and I go to the next room and have to say, ‘Oh, you have this diagnosis, but nobody knows about this diagnosis, so I’m not going to give you anything. Because I literally have nothing to give you.’”

Hobbs says that while frontline work in that kind of setting can be emotionally taxing, it’s the deeper systemic issues that can be most frustrating, especially for social workers who, as she puts it, are always trying to advocate for equal treatment for everyone. “As much as we want to give everybody the same amount of resources, it’s just not there. And that’s a far more complicated thing to address than just dealing with something stressful,” she says.

While frontline workers may shoulder much of the day-today stress, those in management roles often struggle to motivate workers, meet demands, and grapple with limited resources. Todd Leader, a registered social worker and psychologist in Halifax, has spent much of his career managing teams of social workers in mental health and addictions services. One of his top priorities was preventing burnout among his staff—something he says is linked to a pervasive culture of working overtime and burdening frontline staff with menial, time consuming tasks like paperwork. When Leader was managing a team of mental health social workers, he used simple fixes like giving staff more choice in their hours. When management opened their clinic to evening appointments, he allowed staff to volunteer to work evening hours—if they did, he gave them a half day off, any other day of the week. He also ensured that his staff only worked their allotted hours; no more, no less.

“Staff end up feeling guilty if they don’t [work overtime] because there are so many people who need their services—and it’s not that that’s not true,” Leader says. “But if they’re all constantly working extra hours, or working at home, or on weekends, then management cannot make a really good argument to [the] government that we need more staff.”

Changes can only happen, Leader says, if the system shifts to prioritizing front-line, face-to-face work as the bulk of a social worker’s tasks. “And that’s strictly up to management at all levels, going right up to government levels,” he says. But that all depends on who’s calling the shots. The type of government in power—especially in the province, which regulates health care—can play a big role depending on how much they prioritize supporting social services. The lower that is on their list, the less funding is likely to be doled out, resulting in less workers and services available—but not less demand.

***

in a cramped office on the second floor of the Shepherds of Good Hope, a shelter and social services organization in Ottawa, Mika Barrington-Bush sits at a desk piled high with file folders. Her walkie-talkie blares constantly with communication from other social workers—a safety measure that keeps the team aware of what’s going on. Every few minutes, she waves and smiles at people—mostly her clients—who pass by the small window.

Barrington-Bush works with individuals who are chronic alcoholics, and helps them become stable enough to move on to The Oaks, a hard-reduction-based supportive housing program. She manages about 25 cases at Shepherd’s, and 60 at The Oaks; she says that caseload is relatively manageable compared to many other social workers she knows, not counting her caseload at The Oaks. Still, she says, “I think there’s an expectation that we’re superhuman.”

She describes a scenario similar to other social workers: There’s a lack of resources, limited employee supports, low wages—she brings in about $2,700 a month after taxes, which she says is enough for a single person, but wouldn’t be if she ever wanted to have children.

Of all the things that contribute to mental health issues for social workers, Barrington-Bush says the most troubling is stigma. Having increased mental health awareness hasn’t necessarily encouraged social workers to reach out, or changed how upper management supports them. “I still think people are trying to hide as much as possible any issues that are going on, because they don’t feel they’ll be looked at the same way.”

Przednowek echoes her sentiments. She knows a lot of social workers who live with depression or anxiety, “but they don’t ever say it out loud, because they’re looked upon differently,” both by co-workers and superiors. She says this fear is often intensified when someone is asking for accommodations, like counselling or time off work.

It seems ironic that after dealing with such intense challenges—constant worry, mountains of work, cases of severe trauma—a social worker would find it difficult to ask for help. But Ottawa’s Rocheleau says that’s largely due to their caregiving instincts. “Social workers are used to being in this role of, ‘I’m the rock, you [the client] are the one who’s vulnerable.’” She says this kind of thinking is known as the “Superman complex,” and occurs when a social worker thinks of themselves as the fixer, and as a result feels like a failure when they can’t “fix” a client.

When a social worker’s mental health becomes strained, Rocheleau says their first thought is often, “What’s wrong with me?” rather than, “I need help.” This cycle of shame and guilt is what can hold them back from reaching out.

Rocheleau believes that even in an ideal world, where caseloads are manageable and staff support is abundant, many social workers would still feel this shame. It’s about acknowledging, “What can we do, even in that ‘un-ideal’ world?” She says this means having better self- awareness about limitations and boundaries, and accepting that you simply can’t do it all. After all, there is something deeper that drives many social workers: an innate desire to help and care for others.

As Barrington-Bush says, it bothers her when people outside of social work always say “Oh, that must be such hard work,” or, “Oh, you must feel scared doing that,” because it misses the depth of importance behind what she does. “Our clients are really special people. They’re the people that never fit into the boxes, and so there’s a level of realness to them that we don’t often get in other people,” she says, “Being in their midst makes life so much more meaningful.”

***

After years of research and learning how to cope with stress and trauma, Rocheleau found her way to healing. Along with her most recent job as a counsellor at an addiction treatment centre for men, she provides therapy to those who are going through something similar to what she did years ago. She also runs compassion fatigue and wellness workshops for professional and personal care workers, where she teaches coping strategies such as “self-compassion”: acknowledging when a difficult moment happens and how it affects you, instead of pushing emotions away. Rocheleau says these are things that, unlike hot baths or a Netflix marathon, can be realistically incorporated into everyday workplaces.

“If we go out there as a healthy community of care providers, that’s how change happens systemically,” she says. Her goal is to help people realize it’s okay to be vulnerable and reach out, because so many social workers feel isolated in their pain.

At her workshops, she always poses the same question: “How many of you have ever thought, ‘I’m always there for everyone, and no one is there for me?’”

Each time, she looks around the room. And each time, without fail, she sees that someone has broken down in tears.


UPDATE (04/13/2018): A previous version of this story incorrectly stated that an OASW study was from 2009, when the paper was in fact an analysis of a 2006 study’s results, not a follow-up with new or updated information. This regrets the error.

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