A revealing generosity

Amore daunting introduction to social work is hard to envisage
than starting a placement as a social work student on September 11.
This was the unique position that students at New York’s
universities found themselves in.

At the same time as struggling to cope with their own shock at what
had happened, the students were being called upon to help others
who were experiencing problems of a type and on a scale for which
no one, not even those with a wealth of experience, could be
prepared.

Unsurprisingly many of the 100 students due to start their
placement dropped out, says Mary Pender Greene, chief of social
work at the Jewish Board of Families and Children, the largest
not-for-profit provider of social services in New York and major
provider of social work training.

But for those who did turn up, they experienced social work as a
“trial by fire” and learned quickly that most important of social
work skills – flexibility.

“The first cases students dealt with could have been somebody who
had lost a family member or friend in the World Trade Center. The
week before it probably would have been parents who were struggling
with a troublesome teen.”

Students were not of course the only people tested by the problems
caused by the disaster. Even those with many years of practice
behind them were forced to draw on every professional and personal
resource they had to cope with what faced them. And there were
lessons too for the social services system overall, which was
overwhelmed by the disaster and had some of its weaknesses
exposed.

So huge was the scale of the disaster – more than 3,000 dead and
many thousands struggling to cope with its economic, emotional and
psychological aftermath – that scarcely a part of the system has
been left untouched by it.

Bea Plasse is a professor of social work and teaches a social
policy course at Fordham University, which has the largest social
work department in the US. She was struck by the ease with which
victims of the attack were able to get financial assistance from
the government compared with the normal recipients of government
help, who find themselves stigmatised as the undeserving
poor.

“In America we have a meagre allotment of social welfare because we
try to discourage dependence on it. We are a capitalist country and
we stigmatise people on welfare. After 9/11 I began to teach the
course differently. The ease with which I [Plasse had been
evacuated from her home] could get money from the government was in
stark contrast to the people who normally go to welfare
centres.

“I’ve seen social work clients with nothing, having to prove to
officials that they have looked for jobs. If they fail to do this
they risk losing their welfare. After 9/11 it seemed like a
wonderland of riches, everything we look for in an ideal social
welfare system. We were rewarding people because they were working
people,” she adds.

Cash assistance and other forms of help were open to all who had
been victims of the disaster without the usual demands for proof of
entitlement. The authorities even turned a blind eye to the fact
that some of those making claims were the families of undocumented
workers.

Plasse used what she saw as a graphic illustration of the stigma
normally faced by those helped by the government as a way of
teaching her students about cultural sensitivities.

Many students were impressed by the generosity, efficiency,
comprehensiveness and accessibility of the help offered to the
victims. But others, says Plasse, were “intrigued by the
differences and found irony in this and a confirmation of our
preferences for the working people who lost their lives and
epitomised our notion of the American every day citizen”.

The “wonderland of riches” welfare system described by Plasse
proved short-lived. Whether it has had any affect on the social
treatment of those “on welfare” is hard to judge. But evidence is
emerging that the fact many of the victims were middle class people
led to other changes such as simplifying welfare processes.

Senior vice president of United Way, New York’s biggest funder of
not-for-profit agencies, Lilliam Barrios-Paoli, explains: “The
interesting thing to me is that poor people when they go to access
welfare fill out application after application with the same
information. And because they are poor nobody objects to that too
much. A lot of the September 11 victims were middle class people.
There were some wealthy people there too and the families were so
offended by the fact that they had to go through this scrutiny and
were asked so many questions and had to fill out so many forms that
there was a huge impetus to simplify and co-ordinate better.”

Unfortunately there are signs that the government is ignoring this
lesson, possibly because it is proving too costly. David Chen is
the executive director of the Chinese-American Planning Council, a
not-for-profit organisation based in Chinatown, an area next to the
financial centre left devastated by the attack.

He explains: “Take Medicaid [a government programme to help with
health care bills]. The paperwork was so burdensome that many new
immigrants simply stayed away from it for fear of infringement of
privacy and civil liberties. Before 9/11, there was talk that maybe
the poor didn’t need it anymore.

“In post 9/11 days, it was renamed Emergency Medicaid. Several
pages of applications were reduced to just one page, so hundreds of
thousands applied within the first six months. The federal
government is now talking about returning to the old process but
people are calling for the government to learn from that experience
and stay with the simplified modelÉ to no avail at this
point.”

Elsewhere, however, other effects may be a little more enduring.
Jessica Klaitman is the manager of community relations and advocacy
at the United Services Group, an organisation set up in the wake of
September 11 to better co-ordinate agencies.

It was established because the many agencies responsible for
distributing vast sums of money, £1.5bn of which was given in
charitable donations, were having problems setting priorities. Its
mission was to work with “social services agencies [to help] them
be more effective in serving people [and] to co-operate better than
they might have”. Part of this involved setting up a database of
all agencies with the help of IT giant IBM.

Klaitman says: “I have seen social services agencies where people
never use computers learn how to search for things for their client
and be that much more up-to-date, effective and efficient. We have
also seen some agencies get technology that they never had before.
Some of our staff now go on roadshows to the individual agencies
and show them how to use their technology tools. It can be anything
from people who barely know how to turn on their computer to people
with more skills. But that can really mobilise social work.”

The co-ordination between agencies since September 11 has been
“astonishing”, she says. “That working together has really helped
them, just from the smallest things like we have a lot of contact
lists so that if people have a question about another agency’s
policy or programme they know who to call. I hope that things like
that will endure; whether a large level of co-ordination will
endure I don’t know. We are investigating that now. We certainly
hope so.”

A fortnight after September 11, Madelyn Miller, chairperson of the
Disaster Trauma Working Group at the New York Chapter of the
National Association of Social Workers, designed a five-week course
to train social workers on the effects of trauma, traumatic loss
and terrorism. Several hundred social workers attended the free
course.

It was a difficult time because many of the social workers were
themselves traumatised. Miller recounts a story illustrating the
effect the disaster had had. “One day, I was teaching around 19
social workers when in the room above someone moved a chair across
the floor. Everyone in the room jumped at the same time. I’m not
saying they flinched, everyone, including myself, literally jumped
out of their seat. Everyone was so hyper-sensitive.”

Part of the difficulty for social workers lay in judging how much
of their experience they should share with their client. It was a
unique situation because on one hand it was important for them to
disclose feelings in order to help clients realise that their
feelings were normal. But it was also important to preserve
professional boundaries. With no experience of, or training in,
trauma many found it difficult to make that judgement.

Trauma training is not a standard part of social work training but
Miller says it ought to be. She dismisses the argument that
September 11 was such a unique event that future routine training
in trauma for social workers would be largely irrelevant.

“I absolutely feel that social work education should include
teaching in trauma, traumatic loss, disaster and terrorism,” says
Miller. “Social workers more than any others are working with
trauma survivors. New York is a city of immigrants. Many of the
people who social workers are dealing with may have fled countries
where they were persecuted and for many of those communities,
September 11 traumatised them again.”

Plasse is one of the social workers who undertook trauma training
in the wake of September 11. She agrees and believes in time there
will be a push for more trauma training to be included in social
work training, arguing it would be helpful when dealing with a
range of clients.

As well as lessons about practice, there are broader issues about
the infrastructure of social services in New York. Research into
the responses of agencies to September 11 released earlier this
year revealed serious flaws in the way social services responded to
the emergency.¹

Thousands of frail and disabled people in Manhattan were left
without help because home care workers in the other four boroughs
of New York – the Bronx, Brooklyn, Queens and Staten Island – were
unable to cross the river to Manhattan because the bridges linking
them were closed.

The report says that the failure of the system to provide services
to people who were confined at home proved the need for back-up
systems including “adequate transportation of people, services and
supplies such as food and 360-degree communication between all
involved”.

The impact of September 11 on New York social work highlighted a
number of lessons that can be more broadly applied. It will be
interesting to see which ones the authorities take note of and
which ones fall by the wayside.

¹ D Rosner, G Markowitz,
September 11 and the Shifting Priorities of Public and
Population Health in New York, Millbank Memorial Fund,
2003