Thesis Abstract

                       ABSTRACT 

The mental health social worker experiences unique challenges on a daily basis. A social worker’s well-being affects not only the social worker at the individual level; but also directly affects agency and client outcomes, which in turn impacts the mental health system. Adequate support is crucial in maintaining social workers’ positive well-being (Graham & Shier, 2014). Current rates of burnout among mental health professionals range from 21-61% (Morse, Salyers, Rollins, Monroe- DeVita & Pfahler, 2012). This suggests that there are gaps in adequate support for mental health social workers. A blend of systems theory, the strengths perspective and an empowerment model was used as the foundation from which to explore the individual, agency and community impacts of social worker well-being and adequate support. Semi-structured qualitative interviews were used to explore the following questions 1. What is the impact of working within the mental health field on social worker well-being?, 

2.What types of supports do mental health social workers find to be the most helpful? and 3. What gaps do mental health social workers feel exist in level and type of support that they receive in their work? Seven interviews were conducted. A grounded theory approach was used to analyze the data to identify major emerging themes. The findings suggest society’s dominant cultural values and attitudes stigmatize mental health care, which results in an inadequate mental health system. The stress associated with working within an ineffective system, as well as, lacking effective responses to self-care leads to both physical and mental impacts on personal well-being. Although mental health social workers have developed effective coping skills to positively maintain their well being, participants suggested the adoption of a systemic response to self-care and social change to influence mental health policy as primary ways of improving support for mental health social workers.

Thesis Overview

The National Alliance on Mental Illness (2013) reports that there are approximately one in four American adults living with a mental illness. The Substance Abuse and Mental Health Services Administration (2008) reported that 13.4% of adults in the United States received some type of treatment for a mental health issue in 2008 (as cited in National Institute of Mental Health, n.d.). Social workers are one of the leading professions in the field of mental health care and treatment. In fact, clinically trained social workers make up 60% of mental health professionals nationally (National Association of Social Workers, 2015). Social workers provide mental health services in a number of different settings including hospitals, rehabilitation programs, schools, military services, disaster relief and community mental health organizations (National Association of Social Workers, 2015). Clearly, social workers have the ability to influence the success of mental health treatment and services at a systemic level (National Association of Social Workers, 2015). Cohen (2003) expands on this idea by suggesting there will be a large increase in mental health services provided by social workers due to the growth of managed care programs in health insurance. This is due to managed care plans providing increased reimbursement to clinical social workers due to lower cost as compared to psychologists and psychiatrists (Cohen, 2003). The specific tasks and skills of social work, such as the use of case management, also more closely align with the goals of managed care programs than those of psychiatry/psychology (Cohen, 2003). Therefore, it is reasonable to expect mental health services to be provided by the social work profession at in increasing rate.

It is clear to see that social workers are responsible for providing a significant number of services across a wide variety of settings. However, research also shows that there are many factors associated with working in the mental health field that have been linked to high levels of stress and burnout (Huxley, et al., 2005). When job stress becomes unmanageable it often leads to burnout (Brunsting, Sreckovic, & Lane, 2014). Morse, Salyers, Rollins, Monroe- DeVita & Pfahler (2012) report that rates of burnout among professionals in the mental health field range from 21-61%. Some themes identified that contribute to high stress among social workers include lack of resources, pressure to work long hours, covering for open positions, high volume of work and not feeling appreciated by employer nor by general society (Huxley, et al., 2005). High rates of stress and burnout threaten not only the well-being of the professional, but also the success of their work with clients (Kim & Stoner, 2008). According to Kim & Stoner (2008), a primary effect of burnout is employee turnover. Social workers who are dealing with burnout have higher absences from work and higher turnover rates (De Croon et al., 2004 as cited in Kim & Stoner, 2008). Social worker turnover negatively impacts “quality, consistency and stability of client services” (Mor Barak, Nissly, & Levin, 200 as cited in Kim & Stoner, 2008, p. 6). Furthermore, turnover can result in clients experiencing a lack of confidence regarding social services (Geurts, Schaufeli, & De Jonge, 1998 as cited in Kim & Stoner, 2008). Replacing the staff that does turnover is also a financial burden on the organization and a stressor on the staff that must fill in for open positions (Powell & York, 1992 as cited in Kim & Stoner, 2008). This analysis demonstrates the micro, mezzo and macro effects of job stress. Job stress clearly has a negative effect on the individual social worker’s well-being, the organization and the community as a whole.

Literature Review 

There is a multitude of literature, which discusses social worker well-being; specifically in regards to influential factors and outcomes. Common themes found throughout the reviewed literature will be presented. First, themes including the current state of America’s mental health system, the diverse roles of social workers and the value of social work as a profession are provided in order provide context to the importance of a successful mental health system as facilitated by the profession of social work. This is followed by a discussion on the importance of well-being related to job performance. Exploring specific stressors will provide insight into the factors that impact well-being. A theme regarding potential solutions as identified by previous researchers is reviewed as an important aspect of the literature. Following the presentation of those themes which focus on the challenges of maintaining wellness, themes from the literature that discuss positive aspects of social worker well-being will be included. The factors that increase well-being are discussed in order to provide a well-rounded picture of social worker well-being. Subsequently, gaps in the literature will be examined, along with the direction suggested for future research.

 Definition of Terms 

In order to provide a thorough and accurate understanding of this study it is necessary to provide definitions of important terms in order to know what is meant by such expressions. The terms needing definition for the purpose of this study are mental health social worker, well-being and burnout. Mental health social worker. The National Association of Social Workers (2015) describes the work of mental health social workers as, “combining psychological, social and practical elements. They have special skills in assessing, treating, and preventing psychological, behavioral, emotional, social and environmental problems affecting individuals negatively” (para. 2). For the purpose of this study, the term mental health social worker refers to a licensed social worker that has 2 or more years of employment with the purpose of providing services to individuals who are receiving services due to her or his diagnosis of a mental illness. The services may be provided through a variety of contexts including but not limited to residential services, case management, and crisis services or within psychiatric/behavioral health units. Well-being. In a report by Schulte et al. (2015) regarding integrating well-being into policy for work environments, they defined well-being as, “a synonym for health and a summative term to describe a flourishing worker who benefits from a safe, supportive workplace, engages in satisfying work, and enjoys a fulfilling work life” (p. e31). In a more broad definition, Diener (1984) and Lu et al. (2001) described well-being as, “an aggregative psychology parameter consisting of the three aspects of life satisfaction, positive effects, and negative effects, which reflect overall quality of life and are, thus, integral and comprehensive” (as cited in Li, Lan & Ju, 2015, p. 1244). A very similar definition of well-being was provided by Proctor, Linley, & Maltby (2009) which states, “well-being is more broadly understood as the feeling of being happy, satisfied with one’s life, and having positive affect” (as cited in Barczyk, 2014, p. 172). 

Lastly, in a study regarding personality traits and well-being among employees, Deci & Ryan (2008), Diener (2000), and Diener et al. (2005) contributed to an operational definition of well-being to mean, “experiencing a high level of positive affect, a low level of negative affect and a high degree of satisfaction with one’s life” (as cited in Jibeen, 2014, p. 158). In review of these definitions and recognizing their commonalities, well-being is defined for the purposes of this study as, a healthy state of mind in which an individual views her or his life with a perspective of positive emotions and satisfaction.