Professor Jennifer Zelnick
“This NYC study is the first-ever survey of 3,000 human services employees in a major U.S. city about their jobs and working conditions. We discovered disturbing patterns in the workplace that are impeding the ability of social workers and other human services workers to do their jobs,” said study co-author Jennifer Zelnick, ScD, a professor at the Graduate School of Social Work at Touro.
The COVID-19 pandemic has laid bare and intensified these issues, according to the authors. More economic stress and a greater a toll on the health and mental health of individuals and families is expected. Observes Dr. Zelnick, “As social workers struggle to meet these needs, our agencies need to be all the more committed to their missions and the complex needs of the clients they serve.”
In their study, published in the August issue of the journal Social Work, Drs. Zelnick and colleague Mimi Abramovitz, DSW, of Silberman School of Social Work, Hunter College, found high numbers of respondents to their survey reported that increased documentation requirements took time away from working one-on-one with clients (79%) and that focus on the “bottom line” interfered with quality of service (70%). Over half of respondents reported they had no time to build trusting relationships with clients.
Wanting to “Make a Difference” in Social Work
“I went into social work to make a difference. For many years I felt I did. However, with the new rules, strict billing requirements, budget cutbacks, increasing reliance on documentation and outcomes, treatment emphasis is no longer client-centered. It is driven by the bottom line,” wrote a survey participant.
Emphasis on outcomes like productivity and efficiency have long been migrating from the business world into human services agencies, the authors explain in their report, “The Perils of Privatization: Bringing the Business Model into Human Services”. In it, they detail how this approach, known as “managerialism”, is a key element of the privatization of the welfare state that began in the Reagan years. Supporters say using a market-driven approach to deliver human services cuts costs while improving quality, whereas critics claim that it can “strip the care out of social work.” While “too much paperwork” is not a new complaint in agencies given the need for public accountability and compliance, managerialism shifts the need for paperwork into overdrive.
Over 3,000 Workers Surveyed
To investigate how workers in the field experience the forces of privatization, the authors surveyed 3,027 employees at a wide range of human services settings across New York City, including mental health, health, child welfare, education and public assistance. Participants included frontline employees, supervisors, program managers and directors. Respondents rated the degree of managerialism at their own organizations based on four areas: productivity, accountability, efficiency and standardization.
Employees who said their agencies had the strongest degrees of managerialism were more likely to say that their agencies did not prioritize their mission, were less committed to vulnerable clients, and chose clients based on their perception of their abilities to succeed. These employees also said they lost professional autonomy, time for supervision, and were expected to deliver routinized services compared with employees working at agencies with the lowest level of managerialism. At the same time, staff at agencies with lower degrees of managerialism reported far fewer problems with agency measurement of performance, program cuts and closures, and practices that undercut their ability to build trust and relationships with clients.
“A clear consensus emerged in our findings — managerialism requires human services workers to do more with less: fewer staff, less time, and fewer opportunities to build trust with clients,” Dr. Zelnick said. Not surprisingly, more workers in high managerial than in low managerial agencies reported problems with job-related stress, ethical conflicts, morale and burnout as well as turnover and job satisfaction. Dr. Abramovitz noted, however, over 90 percent of the human services workers still indicated that they ‘like to help people’ and ‘think their work makes an important contribution to society’.
“In our work, it is important to recognize that not everything can be quantified. Funders and others calling for accountability need to acknowledge the qualitative nature of our work,” commented a survey participant. Wrote another, “we can’t help our participants if we are constantly stressing about productivity.”
“This report is a wake-up call,” Dr. Zelnick concluded, “The field has rightfully been adopting changes to better evaluate the impact of services on clients. But some of these changes may produce perverse incentives, constrain advocacy and result in mission drift.”