Social workers’ mental health

The NASW Code says social workers should take measures to care for themselves professionally and personally. NASW describes this self-care language as a goal to strive for, not a rule that is enforced.

Worldwide, the IFSW Global Social Work Statement of Ethical Principles (2018) says social workers have a duty to care for themselves at work. It also says social workers and their employers should create workplace conditions that support these principles.

The U.S. Bureau of Labor Statistics notes that understaffing and large caseloads may make social work stressful. These are workplace problems. Self-care helps, but it can’t fix an impossible workload on its own.

In a national study, the median child welfare caseworker handled 55 cases a year and had been in the job about 1.8 years.

The National Child Traumatic Stress Network (NCTSN) says child welfare staff are at very high risk of secondary traumatic stress. They can also face trauma first-hand.

About 15% of U.S. social workers work in outpatient healthcare and about 10% in hospitals. Healthcare social work is one of the areas expected to grow.

Hospital social workers often meet people on the worst day of their lives, then must plan next steps quickly. See also the Healthcare workers guide.

Mental health and substance use social work is expected to grow. Hearing trauma stories day after day is the main path to secondary traumatic stress.

If you also provide therapy, see For therapists & counselors: caring for the carers.

Social workers in hospice, nursing homes and aging services support people through decline and death. Grief can build when there is little time to pause between losses.

Giving yourself small rituals to mark each loss can help. See Compassion fatigue for ideas.

About 10% of U.S. social workers work in educational services. School social workers may be assigned to more than one school and travel between them.

Child, family and school social work growth may be limited by state and local budgets, which can mean stretched teams.

The NCTSN notes that many caseworkers join to help children, but spend much of their time on heavy paperwork and on fighting for access to services. Focusing on compliance can pull attention away from the real mission.

Feeling frustrated by this gap is common. Naming it with your team or supervisor can help.

When work never feels finished, rest can feel undeserved. Over time, skipping breaks and working late can drain the energy you need for clients and for yourself.

Small protections

• Decide on a “good enough” end point for each day
• Protect a real lunch break when you can
• Write tomorrow’s top three tasks before you leave

Some social workers work evenings, weekends and holidays, or are on call.

The NCTSN warns leaders against talking about home-work boundaries while still expecting routine emails at night and on weekends.

Possible signs

• Avoiding reminders of past clients
• Being short-tempered over small things
• Feeling numb or detached
• Intrusive thoughts about client stories
• Staying on high alert

Some people start to see danger everywhere. For example, seeing a father and daughter in the park and worrying about abuse instead of seeing a happy family.

A national study of 539 licensed clinical social workers found that trauma exposure at work affected their wellbeing through secondary traumatic stress. It touched many areas of life, including family, social and physical health.

In the same study, workers with more children under 13 on their caseload reported more secondary traumatic stress.

The NCTSN says receptionists, drivers and other support staff may be at higher risk, because they hear stories without a clinical supervisor to help them process.

Many people enter helping work because of their own past trauma. This can be a source of strength and empathy, and it can also raise risk. Access to support matters.

In the median U.S. state, 14–22% of front-line child welfare caseworkers leave each year, and about 20% of supervisors.

Losing a trusted supervisor or teammate is a real loss. It is OK to grieve it.

The NCTSN says agencies affected by secondary trauma may become very reactive or avoidant. Communication can break down, and staff may not feel psychologically safe.

Some agencies have a “stiff upper lip” culture that discourages talking about the emotional side of the work. Leaders should notice and address this.

In child welfare, attention often goes to what could or did go wrong, while the many things that go right are overlooked. The NCTSN calls this a “negative lens”.

Noticing and sharing your wins, even small ones, is a healthy counterweight.

Examples

• A family needs help that no program will fund
• Policies that feel unfair to the people you serve
• Too little time to do the work the way it should be done
• Waitlists for services your client needs now

In the UK study, these kinds of constraints explained about a third of the differences in moral distress between workers.

Ideas

• Bring it to supervision or a trusted peer
• Join with others to raise concerns as a group
• Name the value that feels blocked
• Notice the parts you can still influence

The NASW Code asks social workers to promote ethical practices in the organizations they work with. Speaking up can be a way of honoring your values.

Possible effects after violence at work

• Changes in relationships with coworkers and family
• Fear of being blamed by managers
• Fear of returning to work
• Feeling guilty, powerless or not good enough
• Short- or long-term trauma reactions

NASW says social workers have the right to work in safe environments. Those who report safety concerns should not fear blame or having their competence questioned.

The NCTSN adds that a sense of physical safety is essential to preventing secondary traumatic stress.

Watch for

• Dreading the start of the week
• Getting sick more often
• Headaches, tight shoulders or stomach trouble
• Sleep that doesn’t feel restful
• Tiredness that a weekend doesn’t fix

Watch for

• Cynicism about clients or the system
• Feeling hopeless that anything can change
• Feeling numb or detached
• Losing the sense of why you started

Watch for

• Avoiding certain calls or clients
• Drinking or using other things to switch off
• Pulling away from friends and family
• Snapping at colleagues or loved ones

These are signals, not a diagnosis. Use the worksheets to track them, and talk to someone you trust.

Compassion satisfaction is the positive feeling that comes from helping others. The NCTSN names it as a protection against secondary traumatic stress.

Remembering why you chose this work, and noticing the difference you make, can help keep it alive.

The NCTSN recommends regular supervision that covers not only cases and tasks, but also the effects of the work on the worker.

Feeling more skilled at your job is also linked to less secondary traumatic stress.

Formal peer mentoring can support newer staff whose expectations of the work don’t match the reality. Mentors can help notice unhealthy changes and point toward more support.

How coworkers can help

• Check in after a hard visit or call
• Cover for each other so breaks happen
• Notice and name each other’s wins
• Respect different ways of coping

Confidentiality means you can’t share client stories at home. Loved ones can still help by asking how you are, giving you space to decompress, and planning things that refill you.

Ideas for loved ones

• Ask “What would help tonight?”
• Don’t take a quiet evening personally
• Gently mention changes you notice
• Plan time together away from screens and work

What the NCTSN suggests agencies do

• Have a plan for staff wellbeing after critical incidents
• Model breaks and work-life boundaries, not just talk about them
• Recognize staff and team achievements
• Share information about secondary trauma and support at orientation
• Train supervisors to spot and respond to secondary trauma