Stress in mental health social work: a research review
Published by Community Care on 1st March 2012:
Social workers typically work with the most deprived and vulnerable people in society. In contrast to other human service professionals, such as nurses and teachers who work with a wide cross-section of social groups, social workers support those most marginalised by society. They are not generally held in high esteem by the general public and are frequently vilified when something goes wrong. This contributes to high levels of stress and burnout amongst social workers and a lack of determined action to tackle it, in spite of evidence highlighting the problem over the last 20 years.
Stress and burnout in social work is an international phenomena (see also). It is particularly associated with statutory functions in children and families and mental health settings, but it is by no means restricted to these groups.
Mental health social workers undertaking statutory duties under mental health legislation are particularly affected by stress and emotional exhaustion. Stress in these practitioners is related to the complexity of organising assessments and the emotional impact of their work. Low decision latitude and high job demands are associated with poorer mental health of mental health social workers, and the suicidal behaviour of the people they work with has also contributed to their high levels of stress. These problems are compounded by feeling undervalued by their employers and wider society.
Mental health social workers are remarkably resilient in the face of high levels of stress. Research has found that they use peer support and supervision to effectively create a supportive and containing environment for their practice. Developing effective support systems at work appears to help prevent burnout (see also) and both a positive work environment and good relationships at work help to promote subjective well-being. Mental health social workers value face to face contact with service users and their commitment to them is an important factor in job retention. However, as roles are being redefined in bureau-medicalised mental health services, mental health social workers need to find new ways to assert their professional identity.
Other mental health professions also experience stress and burnout, particularly mental health nurses (see also). However, social workers are more emotionally exhausted than other mental health professionals but experience more personal accomplishment. About twice as many social workers experience mental distress than psychiatrists (pdf), but they are less depersonalised. Occupational therapists appear to have the lowest levels of stress amongst mental health professional groups.
The opening up of the statutory role of mental health social workers to other professional groups may have a detrimental effect on their levels of stress. The 2012 Approved Mental Health Professional (AMHP) national survey will allow us to compare levels of stress and burnout amongst social work and non-social work AMHPs for the first time. The online survey is open until the end of March 2012 and we are particularly keen to hear from non-social work AMHPs to help us evaluate the impact of the new statutory duties on them.
Research evidence helps social work to articulate its professional agenda and to develop policy which, in turn, shapes its practice. Although surveys about stress in social work are not new, the data they provide are invaluable to remind policy makers and employers of the nature and extent of the problem. The 2012 national AMHP survey will help mental health social work define its own future at a time when its relationship with mental health services is again being re-negotiated.