Comes with the job?

Alison Taylor explains why social work can
exact a heavy toll on practitioners’ mental health – yet another
reason why government, councils and the voluntary sector must spend
more on it.

There are six universal emotions: fear,
sadness, anger, surprise, disgust and pleasure, and experience of
all six is vital for a full and effective life. Workers in certain
occupations become familiar with fear, disgust and sadness while
having few opportunities for pleasure. Without access to support
systems, they, and a wide range of people within their orbit, may
suffer considerable damage.

Social work is not widely recognised as a high
stress activity for its demands are less obvious and less
sensational than those, say, of policing or the emergency services.
That, and its perceived lack of universal appeal, doubtless account
for the absence of television social work drama.

The social work perspective is long term; so
too is the price exacted from its practitioners. Most see their
fair share of blood and violence. But what is likely to prove more
disturbing and scarring is the constant rubbing of shoulders with
despair, poverty, depravity, degradation, squalor, cruelty, mental
illness and suicide – and the practitioner’s inability to do more
than scratch the surface of the misery.

Mankind’s survival depends on a capacity for
infinite adaptation. From conception, the brain is hard-wired to
develop remorselessly in response to biological influences and
external stimuli, making perpetual physiological, psychological,
emotional and behavioural accommodations. Neuroscience can
demonstrate how childhood exposure to dysfunctional domestic
circumstances provokes dysfunctional patterns of thought, behaviour
and response; and there is evidence that exposure to chronic stress
can damage brain circuitry and may result in psychosis. Social
workers, no matter how resilient, inevitably internalise much of
the wretchedness they encounter in order to normalise the abnormal,
and in the absence of opportunities for pleasure, digest a surfeit
of negative emotion.

Chronic, pernicious anxiety, feelings of
hopelessness, despondency and helplessness, are the likely outcome,
and rather than functioning effectively, practitioners may become
depressed to the point of inertia, their personal and professional
equilibrium deeply compromised, their ability to sustain a range of
appropriate responses grossly impaired. Perhaps this is one
explanation of the actions of some of those responsible for
Victoria Climbie’s welfare.

Social workers routinely make far-reaching
decisions and carry daunting responsibilities, but work, for the
most part, in a hostile climate, beset by external and internal
pressures and conflicting demands. Lack of resources delays
interventions until a crisis arises, militating against successful
outcomes; case management is dictated by expediency; what few
successes are achieved are qualified by an awareness of their
fragility. It is almost impossible for practitioners to take pride
and pleasure in their work because a finished product so rarely
materialises. Instead, they become conditioned to expect
disintegration and failure, and to take the blame.

It is remarkable that more social workers are
not killed in the line of duty, given how often they face
confrontational situations, walk unprotected into unknown and
dangerous territory. During my own career, I undertook countless
nights on call, alone, in large units housing the mentally ill and
adult male offenders, entered places where the police had refused
to set foot, encountered people armed with knives and cudgels, a
drug addict brandishing an axe, a desperate farmer with a loaded
shotgun, and lived with those to whom despair and violence were
second nature. Habituation to these extremes had a poor effect on
my thought processes and even self-image. I compensated by becoming
very detached, becoming ultra-cautious, suspicious, prone to
intellectualise rather than to feel, and to this day, my capacity
for spontaneity in human relationships remains blunted.

Social work is a very lonely occupation. Its
painful rites of passage are suffered in silence and solitude
because employers interpret the need for support as a fatal
weakness. Some professions understand the impact of the job and
provide counselling and mentoring, but this will not happen in
social work unless its status is vastly upgraded. Recruitment
levels are desperately low while those in post desert in droves, no
doubt because of untenable pressure. Professional and personal
morale are inter-dependent, but social workers, aware that they are
depressed by the job, dare not seek help. No one knows better than
they the terrible stigma attached to mental illness.

Alison Taylor is a novelist, a former
senior child care worker and the winner of the 1996 Community Care
Readers’ Award.