Supporting the support services providers: exploring the invisible aspects of work extremity of social workers

Figures & data

Figure 1. Mapping social workers in relation to other occupations in the context of work extremity research.

Table 1. Demographic overview of interview participants.

Pseudonyms	Gender	Age	Marital Status	Dependents	Field(s) of Practice	States	Urban/Rural	Social Work Experience (years)
Anna	Female	29	Single	No	Child protection	VIC	Urban	5
Bianca	Female	35	Single	No	Family services	VIC	Urban	10
Claire	Female	51	Single	No	Disability	VIC	Urban	30
Ella	Female	41	Married	No	Family services	QLD	Urban	21
Emily	Female	35	Married	Yes	Child protection	NSW	Urban	8
Gemma	Female	55	Divorced	Yes	Youth protection	VIC	Urban	25
Henny	Female	34	Single	No	Mental health	NSW	Urban	15
Henry	Male	25	Single	No	Call centre	QLD	Urban	0.5
Jaime	Female	50	Divorced	No	Youth and family services	VIC	Urban	20
Jane	Female	44	Single	No	Disability	NSW	Urban	15
Jess	Female	25	Single	No	Disability case management	WA	Urban	0.5
Jo	Female	31	De facto	No	Mental health	VIC	Urban	8
Julie	Female	39	Married	Yes	Mental health and AOD	QLD	Rural	2.5
Laura	Female	22	Single	No	Aged care	QLD	Urban	2
Lena	Female	51	Married	Yes	Child protection, AOD, Policy, Counselling, Healthcare	WA	Rural	30
Lisa	Female	43	Married	Yes	Family services	WA	Urban	13
Mary	Female	40	De facto	No	Youth homelessness	VIC	Urban	7.5
Mel	Female	27	Single	No	Youth work	QLD	Urban	6
Nara	Female	49	Married	Yes	Child and adolescent mental health/Out-of-home care	NSW	Urban	22
Natty	Female	48	De facto	No	Practice supervisor (Counselling, FDV, Youth engagement)	QLD	Urban	17
Nicky	Female	24	De facto	No	Out-of-home care/Child protection	NSW	Urban	3
Pat	Male	42	De facto	No	Case management	NSW	Urban	18
Penny	Female	41	Single	Yes	Child protection	NSW	Urban	19
Rachel	Female	50	Single	No	Disability	NSW	Rural	20
Ray	Female	39	Married	Yes	FDV and homelessness	NSW	Urban	0.8
Rose	Female	56	Divorced	No	Family services	VIC	Urban	2.5
Shaun	Male	43	Married	Yes	Youth work	NSW	Rural	14
Sue	Female	58	Married	No	FDV	QLD	Rural	3
Terri	Female	38	Single	Yes	Mental health	NSW	Urban	18
Vic	Female	30	Single	No	Clinical	VIC	Urban	12

FDV: Family and domestic violence; AOD: Alcohol and other drugs; NSW: New South Wales; QLD: Queensland; VIC: Victoria, WA: Western Australia.

Figure 2. Invisible mundane extremity of social workers.

Table

Themes	Supporting quotes
System complexity	You’re working with the child protection system, police, mental health system… You got all those systems around with varying approaches… At the end of the day, you ask yourself: how do we manage this? The system… I find extraordinarily difficult to work in mental health with old people. The structural staff around the job… wasn’t there. You either stay and fight the system that you see is wrong or your leave… I cannot fight this battle, I do not have the headspace. I left. I love working in mental health. And I still love that client group like I still miss that client group. I had to log all the jobs that I did by the hour and submit that to my manager by the end of the day and I found that to be just another pressure and stress because you’ve got all this work to do when you have for, you know, show what you’ve done. It just becomes so much harder to do your job. Extra steps, extra documents, like making it more complicated along the way. Multiple agencies are involved…some participants or families feel [that they were] left out in the cold, because we can’t provide referrals, or pathways for the people that aren’t recommended. So they feel like they haven’t got help, but the system is complicated… we’re not resourced to help every person that comes through. They’ve got to be recommended and assessed as suitable [by other agencies]. And they might not be suitable because of a variety of things, a lot of the time it’s around legal issues.
Stakeholders hard to manage	The things that I get most stressed out is when there are constantly cancelling [the service which was booked by the providers]…[the system] can’t necessarily provide [service] consistency. This program is part funded by the Mental Health Commission, part funded by the Health Department, and Department of Justice. The aim is to support people with major mental illness from prison. So there is a variety stakeholders that provide the guidance. I’ve got a boss from the Health Department. Then we have an NGO out-care that work with us, and they’re located with us, but they have their own manager. There are several different agencies giving information on, what we need to do and not do… You can imagine how difficult to coordinate it can be. I’ll complain about structural stuff, like you know, we don’t have enough housing [for clients]. Centrelink really pisses me off. I scheduled meeting with XX [an office], but every time, they gave me different versions of excuses. You know, you’re trying to help these people but instead what you’re doing is dealing with conflict with other agencies.
Service inconsistency	[The overall system] not having enough funding, not having housing… we can’t provide or support our clients to get those outcomes. So those sorts of issues were very frustrating… We would be in touch with our counterparts around the States, and some States interpret the same policy very, differently. Some people said you can do this, but others said you can’t… and so this inconsistency was generally frustrating. So the unit was run by doctors. I’ve never been in an environment where I felt so under-supported by another bunch, I just never worked somewhere like that. That was probably the most burnt out I got because it was like you were doing on-call all the time. For hospital discharge, I will be liaising with multidisciplinary team from the hospital, an occupational therapist for evidence, a neuro-psych psychologist, a clinical psychologist everyone or reports; and the housing agency if its housing that I’m looking at, see, it is this lot of liaising built into the job. … is it not as smooth as planned. I cannot move on if one report is missing or without the housing is cancelled.

Table

Themes	Supporting quotes
Inflexible procedures	They want you to follow frameworks and plans … I can see how they are meaningful and how valuable they are, but they do not help my work. [There are] so many ‘spot fires’ coming up. I just put out that one and then another one comes out …. The things [new procedures according to the new plan] that I needed to do haven’t been done and now they are overdue. The sort of procedures, they do add stress particularly when you have a lot going on.
System disruption	These sort of new procedures, they do add stress particularly when you have a lot going on. Structural changes and you know here’s a new system that we’re going to implement, or we’re going to be doing it this way so no other issues with that. But because it just happened so quickly, it was so overwhelming information overwhelming… I notice the cases were piled up here, and my anxiety levels were going up. I get really frustrated when I feel like there hasn’t been consultation I think that adds to the stress when you think hang on who put together this system did they actually talk to any case workers people who are working on the ground who gonna need to use this every you know every hour of the day did they sort of give this any thought because the moment the system just looks so complex and I can imagine people who work in the more crisis focus work they would be a lot more stressed out trying to do this. I think that that’s a stress for me. We were directed to use a new app for all our telehealth. It is a program that never made it on the open market because it was that useless but was the one that we were required to use. It is constantly not working, just almost always never worked. It took a good six months before they started saying, ‘Actually, you can use Skype’, and it’s only now that they’re starting to say we can use Microsoft Teams or Zoom. How much pressure we experienced in those 6 months? To put it in the context, the organization was going through an audit as well as a whole new restructure. I had a two-day-a-week contract, and then they offered me five days [contract], and I felt maybe then I should not have probably taken the five knowing that I probably wouldn’t be able to manage the new requirements.
Staff shortage	We’ve all been managing really high caseloads …with only half the stuff that we need to do the job. I don’t think there is any recruitment now. We need to have two to three recruitments during the year to keep our staff numbers high, so that if people need to take leave, we always have enough coverage. If there’s a high volume of work, we’ve always put enough coverage. So, I think we’re struggling in that sense. We probably have been understaffed for many years. We’ve all been managing really high caseloads and responding to pressure from within the hospital setting and the community setting with only half the stuff that we need to do the job and that’s been ongoing.
Insufficient support	I come from child and family [service], where you get trained before you step into client’s home… Now, all my worker had no training in mental health. I was trying to get training for particularly 20 workers because they were stepping into the family home so they could have been in an unsafe situation without any mental health training. I was trying to get them to get at least the mental health first aid training done. However, I kept getting blocked from higher up. Oh, no, we don’t have the money. I was astounded by that. It [the support] probably sits around a four or five [on a scale of 10]. I believe that there was much more than they could have done to support us, but I also respect that their hands are tied. If we had a request, it still had to go through a higher level of approval. So at the end of the day, even they don’t have a say.

Table

Themes	Supporting quotes
Incompetence	The problem was that her social skills were absolutely zero…She couldn’t manage two staff, let alone thirteen. He [new manager] did not fully understand how much we need to do for a case, but he introduced changes. Our workload became even higher. Lin was a fantastic colleague. She went on unpaid stress leave just because too much, the tasks were too much. After she came back, he reduced her workload to part-time, but didn’t really reduce her caseload. She ended up quitting. If, during that time, I had one more spot fire or one more crisis, I really think that I would have tipped over the edge. One of my clients, whose mental health really declined badly last year. It was really stressful for me not knowing if she was going to be OK. My team leader was not being helpful. His response was that: It was more important for him to know that I did the risk report than thinking about how we could support the young person, and how he could support me…It was just really unhelpful. That added to my stress…I just don’t feel like he has the sensitivity to really deal with the issue…I feel awkward as he didn’t really know what to do.
Lack of empathy and care	It feels a bit like: you’re going off on your own without that support. I worked in disaster recovery, but I don’t have a good line manager who can sort of the processes. It was a new director… She was my direct report. When travelling, I needed to report to her frequently, but she seemed to not care. I can understand that she was working out the priorities, and trying to get them settled, but I need instructions. It’s like bringing your solution to your own role. Although I sought help from my manager, he expects me to have a solution. I was so helpless.

Table

Themes	Supporting quotes
A lack of care for social workers	I’ve tried to discuss issues [I had with my colleagues]. No one really cares. It’s like he’s ticking the boxes most of the time rather than thinking about how like he can put himself in others’ shoes. If I was a supervisor, I’d be thinking about what the different needs of each of the workers are, how should I approach them, what’s their work style. It sounds like you would want to just go in and solve the problem but instead what you ended up with is this extended conflict. The person in charge was absolutely atrocious, incompetent, a horrible person….One of the ladies, unfortunately, went on stress leave six months because of him.
Tension at workplace	Poor work relationships: I’m over the team the way they behave, so and they are not going to change. The relationship was bad. No proper professional relations, you know, the kind of relationship, you able to lean on them for support and then you’ll do the same in return. Good work relationships: We’ve got a really nice team, so yeah. That’s probably the benefit. I stayed because of them. There were a couple of staff members that I was working with. They were really good at empathy, good at support. When things were getting difficult, I would go and have a chat with them. I don’t know what I would have done if they weren’t around. I could just quit, but no, I didn’t. I don’t want my team to have to absorb that caseload because they are struggling just as much as I am.

Table

Themes

Supporting quotes

Paperwork takes up time, diverting attention of helping

Paperwork eats the time I can use to help others. It’s the sort of work that I hate. We have certain paperwork we have to do for each client which is as well be toilet paper. It’s irrelevant, useless and time-consuming. It prevents me from doing the actual meaningful work that I want to do. My current stressors are being behind in my file notes, not having them up to date, so that if management review them if something happens on a weekend or night time. To write this huge case note, I needed an hour. I spent 180 minutes with the client and I traveled for 90 minutes… Actually, you know planning takes place before you do a session with a client. I have to log this and that. I spent two hours 120 minutes planning before my session to deliver parenting information and parenting strategies. And you know, preparing charts and support. ‘I don’t think they [supervisors] put the requirement [of paperwork]. The requirement really comes from [a higher level organisation]… It’s all very, you know, covering your bum. What is your good moment? That is the one hour, you’re there, in the home visit. However long you stay there afterward, and then driving back to the office. Just no one interrupting that little bubble. Then, as soon as you get back to the office, it just bursts because one thousand things [admin work] are waiting for you. I feel like so much of my time is just so much paperwork and bureaucratic shit, and I feel like I spend less and less time with kids than I would like to… When that boy picked that dandelion and gave it to me, I just felt really happy. It was all of those moments to me, a very, very sweet…Just so many things popping up that you didn’t like…My whole job is basically writing reports, and putting out spot fires. It prevents me from doing the actual meaningful work that I want to do. Yep and paperwork and paperwork irrelevant useless paperwork, waste of time. Intrinsic motivation to join the social work sector: I like having a caseload. It’s nice seeing people through to the end of the six-month periods. So that’s quite satisfying and working with people the way you want to work, identifying the agencies that would be good to work with them, working with the out-care staff, that’s always really enjoyable. So many people come into this field because they want to make a change and they want to make a difference….You either get so overwhelmed that work becomes your entire life and you spend your weekends working in. … You stress out or you just let it crush your soul and…. You just turn up, get paid and go home. When I feel as though I have achieved an outcome that I’ve been working really, really hard on, that can be quite satisfying. That is what I wanted to do by becoming a social worker.

Data availability statement

The participants of this study did not give written consent for their data to be shared publicly, so due to the sensitive nature of the research supporting data is not available.