Columnist Sara Weinberger: A diminishing social worker supply chain

Published: 4/17/2022 1:01:33 PM
Modified: 4/17/2022 1:00:15 PM

After several years of post-baccalaureate indecision, my daughter, Rachel, informed me she had decided to pursue a graduate degree in social work. Admittedly, I felt ambivalent.

I am grateful for my own rewarding career as a social worker and proud to be part of a profession that facilitates both personal and systemic change.

Still, my frustrations are also memorable. As an master of social work student interning alongside psychiatry residents and psychology interns, knowing that they were compensated, while my internship hours were unpaid; graduating with a pile of student debt; productivity requirements that left little time to change the oppressive systems that negatively impact my clients; and that, as a former colleague put it, social workers are valued in direct proportion to how society values their clients.

As Rachel’s mother, I worried that the dictum used to justify keeping wages low — “doing good is its own reward” — would lead her to regret her career choice. I remember seething inside with rage hearing the words of the director of the outpatient psychiatric hospital where I was an intern: “We get the most bang for our buck by hiring social workers.” Social workers should be sought after because of their knowledge, values, and skills, rather than viewing them as a budget bargain.

After receiving her undergraduate degree, Rachel took a job as a direct care staff person in residential treatment. The job was emotionally and physically taxing. She was bitten, spit on, and sworn at, but still she loved the adolescents she worked with. She also realized she would have made more money pumping gas at the station down the street. Later, as an outreach worker providing intensive services to children and families, she was drawn to social work, with its focus on understanding the person within the context of their environment.

After her first semester, the rest of Rachel’s master of social work education turned virtual in response to COVID, but she rose to the challenge. After graduation, she accepted a clinical social work position in the community mental health center where she interned. She was delighted with the position in spite of the $45,000 salary that came with it.

One year later, she is frustrated and angry. She loves community mental health, but she can’t plan for the future she wants with her current salary. The gap between direct care and administrative salaries is frustrating. In her words, “I can’t tell you how many staff meetings I’ve sat through where executives making six figure salaries talk about how dedicated we all are to the work, and how things are hard, but they appreciate our ongoing care.”

She tells me professional competence, an ethical mandate for social workers is challenging for new workers. Agencies struggle with staffing shortages, and the most difficult clients are often assigned to the least experienced workers. Training opportunities that foster competence are lacking, because the money isn’t there

Social workers’ ethical focus on self-care, ironically, increases Rachel’s stress. The “commercialized” view of self-care as taking a mental health day or a yoga class is unsustainable. “I can’t self-care my way out of being underpaid, (having) an unwieldy caseload and productivity expectations that don’t leave enough time to do due diligence for my clients. I can’t self-care my way to a balanced life when job expectations deplete me without providing the emotional, financial, and physical resources to take care of myself.”

Some readers may view Rachel’s frustrations as whining. After all, teachers and nurses are underpaid too, so why complain? Suggesting the status quo is OK contributes to huge staff turnover leaving clients feeling abandoned, while others in need of help are unable to access services. In a mental health crisis, inability to access care can lead to death.

The clinical social work supply chain is diminishing. Once licensed to become independent practitioners, increasing numbers of social workers are leaving community work for private practice, which is often inaccessible to low income, uninsured, and/or non-English speaking people.

The public is largely unaware that social workers represent the largest group of mental health providers in the nation. The past two-plus years have and continue to exact a heavy toll on people’s mental health. We are in a mental health crisis, where the vast need for treatment clashes with staff shortages.

Despite the extraordinary contributions social workers make, they continue to be de-valued. Social workers perform essential services, providing care and support wherever it’s needed. Yet, those signs that sprung up during COVID, thanking health care workers, never include social workers. In these dark times, social workers are struggling with many of the same concerns, grief, and fears for the future that impact their clients.

Legislatures need to allocate funding to agencies for adequate salaries, staffing, and supervision. Health insurers must increase reimbursements for social workers. Loan forgiveness programs are crucial.

Investing in social workers is also an investment in the human beings they serve. “Amid a growing mental health crisis, we can’t keep relying on the goodness of people’s hearts.” (Felice Freyer, Boston Globe, March 28)

Sara Weinberger of Easthampton is a professor emerita of social work and writes a monthly column. She can be reached at columnists@gazettenet.com.
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