Managers can no longer ignore the human and financial costs of stress, especially as workers are beginning to take action - and win - in the courts, writes Henrietta Bond.

Janet Ballantyne, a former residential social worker in Strathclyde, received £66,000 last month in an out of court settlement after being forced to take early retirement because of stress-related illness. John Walker, a former senior social worker with Northumberland, made history when he became the first worker to sue his employer successfully for stress and overwork. He won compensation of £175,000 earlier this year.

Stress has long been regarded as part of the job. But, in an environment of ever-increasing workloads and reduced resources, for how much longer can employers ignore the human and financial costs, now that workers have proved they are prepared to fight back?

Though cases of legislative action against social services and social work departments are still rare enough to warrant media attention, since the Walker case hit the headlines Unison has witnessed a huge increase in numbers seeking help for stress-related problems.

Many of these problems are handled locally, through stewards who receive regularly updated guidelines. But the union makes clear that it will take whatever action is necessary to combat unrealistic demands on its workers.

'The message coming through to us is that people are fed up with work pressures at every level of social services and social care,' says John Findlay, Unison's national officer for social services. 'The main areas of concern are staffing levels, reduced resources, increasing demands and the changing nature of clients' needs - whether you're a social worker, a home help or a care assistant.

'Under community care legislation, social workers may find themselves with a doubled case load working for clients with complex problems, who would have received care from other services. Workers in residential units for elderly people may be caring for people who previously would have been in hospital units. And while we hear increasing reports of workers facing threats of violence or verbal abuse from clients, we have a situation where more staff are going to home visits alone. It's no wonder so many face burn-out.'

Some authorities have tried to find remedies for stress, responding with staff care programmes or by instructing staff only to undertake the amount of work they are capable of handling. But Findlay says there has been an upsurge in complaints from other departments, which are pursuing punitive policies on staff sickness, some of which arise from stress. Rather than ask why the levels of absence may be rising, some senior managers are taking disciplinary action against workers who are considered to be taking too much time off.

Together with the British Association of Social Workers, Unison is launching a policy statement on violence, abuse and stress. 'We hope to generate a wider debate,' Findlay says. 'There are plenty of individual cases and everybody is moaning, but so far we haven't said clearly to managers, enough is enough.

'Our members should not have to tolerate punitive responses to problems caused by too much pressure. We may have to say to members, if your caseload used to be half its current size and is now far too large, then you must insist that you will not do more than a certain amount.'

Worst of all for staff is the failure to acknowledge that they are working with greater demands and less time to meet them, says Bob Lewis, senior vice president of the Association of Directors of Social Services. Managers have a responsibility to help staff cope with the pressures and to give priority to working methods which avoid making unrealistic demands. At times, he says, this may involve informing a social services committee and other elected members there are certain areas of work which cannot be performed.

A written supervision policy is crucial if the type of situation which occurred in the Northumberland case is to be avoided. It was claimed managers knew about stress but did nothing to alleviate it. Lewis says: 'When you are under pressure to deliver, it's easy to say you can't do anything. But, through supervision, you have an opportunity to look at ways of supporting your staff, either by helping them develop coping strategies, developing their skills or diverting work away from them. I won't claim we always practise what we preach - but it's definitely something we must aim for.'

Jeff Hopkins, head of staff care at Keele University and a consultant with BASW, believes no one can afford to ignore the effects of stress on the workforce. 'With the increasing focus on the primacy of the customer, we are seeing an increase in client complaints and possible litigation, which has recently become a problem for health trusts. And with these pressures from clients come pressures on staff, who must deliver these services and who in turn may resort to litigation.

Insurance companies are looking to employers to show they have addressed employees' grievances about overwork before they insure against big compensation pay-outs of the kind made to Ballantyne and Walker. 'We have seen the role insurers can play, in the case of Clwyd and the report which was blocked,' Hopkins says.

According to Hopkins, most counselling programmes for stressed employees carry the wrong emphasis. Many of them have been imported from America and were designed to help staff cope with alcohol- and drug-related problems. Instead, Hopkins argues, employers should develop the 'staff care' approach, a comprehensive programme which makes prevention rather than cure the priority.

'Picking up the casualties is not enough and, without the will from managers, any service will just be fractured,' Hopkins claims. 'Surveys show the most stressed people in social services are managers who know they are asking the impossible of their staff, because they, in turn, are responding to unrealistic expectations from government. That way the stress just goes on down through the organisation.'

Services to clients are likely to suffer unless there is a change of heart. The prevailing mood is one of, 'if you can't cope with the heat, get out of the kitchen', says Mike Evans, a consultant in management organisation at the National Institute for Social Work. 'We need to say that if the heat is too great, then let's put in air conditioning.

'To do this we need to develop a competent workplace, which is able to listen and learn from its workers. The only thing which really matters is the interaction between front-line workers and users; everything needs to work towards supporting this work and developing the quality of that service.'

Evans feels the emphasis in some departments is placed on the wrong aspects of service delivery, generating unnecessary stress for workers and little benefit for clients. Performance targets imported willy-nilly from the commercial sector do not dovetail with the social worker's role, he says.

Consequently, bureaucracy mushrooms around the minutiae of the job, stipulating, for instance, that the phone is answered by the third ring, which often means the caller is put on hold or answered by the wrong person. 'Most service users would rather wait and be answered by someone who can really help them, rather than getting the "have a nice day" approach.'

Just as front line workers are required to have strong professional principles involving openness, honesty and a spirit of partnership with clients, Evans believes managers must demonstrate the same principles in the way they treat staff. 'Some authorities have a long way to go in achieving these aims, but generally there's an interest in creating a culture which is responsive rather than prescriptive,' he says.

Sandwell social services department has an in-house staff care service which offers training, consultancy and counselling. Anne Gilbert has been with the service since it started in 1989 and there is now a vacancy for a worker with black staff. Gilbert says there is no shortage of takers when courses are offered on topics such as stress management, assertiveness and planning for retirement, from staff at every level in social services.

'My work is about removing the stigma around stress and providing an independent service which staff can use and managers can refer people to,' Gilbert says. 'The number of people coming to us remain fairly consistent from year-to-year, but sometimes there are higher numbers from an area where restructuring is taking place.

'Disciplinaries, inter-personal conflicts and problems at home are all issues which people bring to us, and there is also frustration about feelings of responsibility staff have towards their clients when services are cut.

'As an in-house service we are able to feed back to senior managers if we see particular problem trends occurring. We see ourselves as part of an overall support system, including individual support groups, for example for black workers and disabled workers, with support from management, line managers and unions. We are raising awareness and encouraging everybody to be involved in caring for staff welfare.'