The Washington PostDemocracy Dies in Darkness

Social workers are the unsung heroes of the pandemic

They staff the front lines of American medical care and public health. They get little glory — and they are burning out.

Social worker Maureen Saint-Cyr works with a third-grader at Patterson Elementary School in D.C. last February. (Evelyn Hockstein for The Washington Post)
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From the start of the coronavirus pandemic, America has noted and honored the sacrifices made by first responders and medical professionals on the front lines. We’ve all seen searing nightly news footage of PPE-clad EMTs answering emergency calls, of doctors and nurses struggling to provide humane care in understaffed emergency departments and intensive care units.

Another group of front-line professionals receives far less attention yet is no less essential — and has made no smaller sacrifice in this fight. Social workers have been finding shelter for homeless covid patients, providing treatment for people with addiction disorders made more challenging by pandemic-related social isolation, and comforting bereaved family members who have lost loved ones to the twin epidemics of covid and opioids.

So it’s no surprise that many social workers are burning out and leaving their roles. One article published by a Kentucky television station chronicles the departure of more than 600 social workers from that state’s Department for Community Based Services. “Our staff has a lot more opportunity to work at a bookstore or as a bartender, making a lot more money than they make working with us,” said Marta Miranda-Straub, commissioner of the department.

At Idaho’s Department of Health and Welfare, turnover among mid-level social workers roughly doubled this past year. To fill the resulting gaps, remaining child-welfare workers have roughly doubled their normal caseloads. Meanwhile in Seattle, social worker Laura Woods succinctly described what many front-line social workers are feeling: “Everyone is quitting. … Our staff is so burned out. We’re just so tired.”

Social workers staff the front lines of American medical care and public health. Within our hospitals, they evaluate the needs of families, enroll patients in public assistance programs and address food-insecurity and transportation challenges. Social workers are the glue to connect patients and families with essential services, the grease that lubricates key bureaucratic processes we and our loved ones depend on in our hours of need.

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Given their training in talk therapies, caring and advocacy, social workers are people we turn to for painful or difficult conversations — of which there have been so many during the pandemic. They provide comfort to the dying and counsel grieving families. They get people home from the hospital, after their bouts with covid-19, who otherwise wouldn’t have transportation — and arrange appropriate at-home care.

Outside the medical setting, social workers confront the mental and physical toll that social isolation has wrought on so many. Some have spent the past two years helping children with disabilities and helping their parents navigate school closures, addressing heart-rending problems over smartphones or on Zoom.

One of us (Jason) is a trained social worker. We recently reminisced about his first assignment, in the early 2000s. The task at hand was to find community-based care for a teenager diagnosed with bipolar disorder along with psychotic features. AD, as we’ll call him, had been recently hospitalized twice after he stopped taking his medication because he didn’t like the side effects. He had threatened his little sister and was rehospitalized after running naked down the street in the middle of the night.

Jason and his partner went to the cramped family apartment in a run-down Brooklyn housing project to provide supportive services after AD was discharged. The building’s main door was unlocked. Drug dealers ran one of the staircases in the building. AD’s parents struggled with mental illness. AD hadn’t been to school in years, but he still really wanted to get his GED, to connect with the wider world outside his family apartment.

Jason and AD spent countless hours shooting pool and listening to music at a local billiard hall. The social-work team connected AD to local group therapy with peers who faced similar challenges. The team helped find better psychotropic medications. AD signed up for a GED program. While his relationship with his parents would remain strained, his relationship with siblings improved.

Imagine the obstacles a social worker managing a similar assignment today would face. Because of the coronavirus, the billiard hall might not be a safe option. Given increased need and decreased staffing, the agencies providing this service are overwhelmed with clients. Perhaps Jason could connect with AD over Zoom, but clients such as AD generally don’t own laptops and may struggle to find an Internet connection. They may also lack a cellphone plan. Anyway, he has no private space to really talk.

One thing hasn’t changed. Jason’s modest salary in New York City was considerably less than one could earn waiting tables at most respectable Manhattan restaurants. Then, and now, one could make more money by stocking shelves at Home Depot. The average salary of social workers with a master’s degree is about 30 percent less than the comparable figure for registered nurses. Given the financial realities, it’s no surprise that many social workers leave their roles.

Philanthropists such as Mike Bloomberg and Bill Gates are now giving billions of dollars to support public health training, research and infrastructure. It is well known that social circumstances shape health, yet, with notable exceptions, the profession specifically charged to address these determinants is excluded from such philanthropy.

Nor does American popular culture pay much attention to social workers. Nurses and doctors, not social workers, are invited to throw out the first pitch at Major League Baseball games. Even in TV medical dramas, there is rarely a social worker in sight. Shows such as “Chicago Med” portray social workers through insulting stereotypes (the welfare caseworker who doesn’t know the name of her client) when they aren’t ignoring them (depicting ER doctors visiting patients in homeless encampments — a job that in real life would be performed by social workers).

Better public policies can stanch the flow of social workers from the field. Student loan forgiveness for care workers can be strengthened. Public agencies can provide better pay — and not just for social workers on the covid front-lines but also for those doing hard and difficult work every day related to HIV, violence prevention, child welfare, homeless services or other issues.

Social workers are dealing with every hot-button challenge in American life. We should honor that, not with a patronizing “pink ghetto” pat on the head but by genuinely understanding and valuing the craft of social work. As we take stock of American professions strained to the breaking point by the pandemic and look for ways to actually help those on the front lines, let’s give social workers their due.