There’s little debate over social work’s status as a stressful profession. Social workers practise in an increasingly difficult environment characterised by rising demands, diminishing resources and negative scrutiny from the media.
Recent surveys by the British Association of Social Workers and Community Care suggest workloads have increased, working conditions have deteriorated and stress levels have escalated as a result.
Stress is associated with both short and long-term health problems. On the one hand, it can contribute immediately to ill health by promoting damaging behaviours such as excess alcohol consumption and drug misuse. On the other, chronic stress is known to produce metabolic changes relating to cholesterol levels, obesity and an increased risk of coronary heart disease, as well as having other knock-on effects such as depression and poorer immune function.
It’s therefore important to acknowledge the health risks of social work, a profession that has long been associated with stress, depression and burnout.
As part of our recent research, we have examined responses to stress by 427 social workers employed in England across 88 local authorities as well in the private and third sectors.
Participants were asked whether they had used alcohol or illegal drugs, or turned to emotional eating, over the past 12 months in order to cope with stress. We also asked whether they had displayed characteristics (difficulties in sleeping, emotional exhaustion, burnout) of chronic stress.
Emotional eating is defined as the tendency to eat unnecessary food as a response to negative emotions or psychological stress. Known health risks of such ‘binge’ eating include raised blood pressure, cholesterol and triglyceride levels and an increased risk of heart disease, type II diabetes mellitus and gall bladder disease.
Fifty-seven percent of respondents said they had used emotional eating as a mechanism to cope with work-related stress, a similar proportion to that found in previous research (60%) by Community Care. Neither individual (such as gender and age) nor team/client group characteristics were particularly associated with emotional eating.
Over a third (35%) of social workers in our sample reported using alcohol to cope with work-related stress. Practitioners aged 40-49 had the highest usage (39%) and men reported higher levels of alcohol use (45%) than women (33%). Sector-wise we found the highest levels of alcohol consumption among those working in learning disability (54.5%) and children’s services permanency and transition teams (52.6%).
Six percent of respondents had used drugs in the past 12 months to cope with work-related stress. The most popular drug was marijuana with 15 participants stating they had used it. Other drug choices included MDMA (ecstasy), cocaine, and codeine.
Neither individual characteristics nor team/client group ones were positively associated with drug use. The results may have been affected by social desirability bias – respondents being cautious about admitting to what may be construed as ethical misconduct.
Asking questions about drug use among respondents’ colleagues may present a different picture. One social worker who agreed to a semi-structured interview told us they were aware of their manager and several colleagues using marijuana in the past.
Excessive and prolonged stress is a risk factor for longer term chronic disease. We found high levels of chronic stress according to a range of indicators. Nearly two-thirds (63%) of respondents had difficulties sleeping, 56% said that they were emotionally exhausted and 75% said they were concerned about burnout.
Worryingly, 35% already felt unable to cope at work and 15% currently take, or have taken within the past 12 months, anti-depressant medication as a result of their social work role.
These research findings suggest that there are significant levels of chronic stress among social workers and of emotional eating and alcohol usage as a mechanism to cope with work-related stress. Although some drug use was reported among practitioners, it appears to be low-level and in line with national estimates (drug misuse findings from the 2015/16 Crime Survey for England and Wales, for instance, revealed that 8.4% of all adults aged 16-59 had used an illicit drug in the past year).
Social workers’ employers have a duty of care to protect them from work-related stress and the associated health risks. Our study suggests far more needs to be done to fulfil this obligation.
Sheena Asthana is Professor of Health Policy in the School of Law, Criminology and Government at University of Plymouth.
Her research programme spans four broad areas: NHS resource allocation; health care equity; health inequalities and evidence based public health; and health services evaluation.
She has also been involved in research examining education and equity in the UK and on local government resource allocation. External responsibilities include: Membership of the Technical Advisory Group (TAG) to the Advisory Committee on Resource Allocation (ACRA) (DH); Steering Group Member, Rural England; and Council Member, Royal Society for Public Health, 2012.
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