Back-to-back crises, days that end at 4am: Why some social workers in Singapore are burning out
Social workers have been seeing increasing caseloads due to the pandemic. But what happens with each case? And why does burnout occur despite measures to help the profession? Social workers helped CNA understand what their job actually entails.
SINGAPORE: After 10 years in the social work sector, Amelia (not her real name) believes that passion alone is not enough to get through a 9am-to-4am workday, juggling 20 cases of her own, eight supervisees with an average of 30 cases each, and back-to-back crises.
These crises can include receiving a text message from a client saying they ran out of milk powder for their child, or from another client about her husband beating her – which might come with a photo of a bruise or bloody wound attached to the message.
Sometimes, crises could involve bringing three children to the hospital, only to have them admitted at 4am – five hours before work begins the next morning.
“We can go in to work and our first client is at 9am. Wonderful if it ends at 10am. But when there’s a crisis, everything else that you’ve planned for the day just gets thrown out the window. ... God forbid any of your other cases go into crisis mode that day or your supervisees need an urgent consult, because you’re dealing with a crisis on hand,” the 34-year-old told CNA.
But the current conversation around social workers continues to focus on passion because people “don’t actually know what we do” on a daily basis, she suggested.
“It’s great for the fresh graduate to have passion because that’s what spurs them to stay for maybe the first one or two years. But I’ll be very honest – I think it’s very unrealistic to just rely on passion.”
Likewise, 40-year-old Linda (not her real name) said people might not know what social workers do, due to the tendency to quantify the number of work hours as a measure of burnout, rather than look at the work that’s being done.
She recalled an attempt to discuss burnout among teachers with people who worked in “non-helping” sectors and instead got told: “What do you mean? We also work these kinds of hours.”
Amelia and Linda were two of the five social workers from family service centres (FSCs) who spoke to CNA about the unseen demands of their career in a discussion with MP Louis Ng (PAP-Nee Soon). All the social workers requested anonymity.
Mr Ng said in his Budget speech on Mar 1 that he’d spoken to more than 120 social workers, who described their “heavy caseloads and exhaustion”.
He told CNA separately that the data collected was used to "see what the gaps are on the ground and whether the proposed solutions could help ease the pressures social workers are facing".
In his Budget speech, he proposed more help for FSC social workers: Setting a cap on the number of cases that each social worker takes on at any given time, and increasing the time, resources and headcount for research work at FSCs and community work.
“EXCESSIVE” CASELOAD, PAPERWORK
MSF data states that the average social worker at an FSC handles 22 cases a year, but many social workers who spoke to Mr Ng said they often have 30 to 50 cases at any given time, said the MP in his speech.
These “excessive” caseloads “directly hurt their ability to do a good job”, as they have less attention to give to each case.
These points were also illustrated by the social workers who spoke to CNA.
When Amelia first joined an FSC a few years ago, she handled eight supervisees, each with an average of 30 cases. As a senior staff member herself, she had 20 cases and juggled six other portfolios.
If a crisis were to strike, “you cannot choose between one client or another supervisee because they’re all equally important”, she said. "It’s just about getting the work done; ensuring that the children are safe, the elderly have a place to stay and families are not killing each other.”
Another social worker Brandon, whose childhood dream was to be a social worker, has been in social services for more than eight years, including five years at an FSC. The 38-year-old noticed that he ends up spending “so much time on his laptop” when a client who really needs someone to journey with them only gets an hour of his time.
“To give you an estimated ratio, contact hours (with clients) are maybe 5 to 10 per cent of my time at work. Shouldn’t we be going to their homes to visit them, have sessions? Shouldn’t we do that more?” he said.
And the stress from caseloads has only been exacerbated by the COVID-19 pandemic.
In Mr Ng’s speech in Parliament, he cited a study published in the Asian Social Work and Policy Review in July last year. The study found that nearly 60 per cent of frontline social workers were affected by anxiety at the height of the pandemic, with about 45 per cent facing depression.
The study also found that social workers in FSCs faced higher depression rates.
“COVID-19 probably caused more people to seek services because of loss of income, anxiety, stress. Due to the high demand for social services, and because people are more aware and learned about services and resources that are available, the social workers have to deal with high caseloads,” said Brandon.
The increased caseload could be also due to the fact that prior to the pandemic, “many families go to work for respite, and these marriages have sustained because they have that respite”, added Amelia.
In response to Mr Ng's request that social workers be given more help to manage their caseloads, Minister for Social and Family Development Masagos Zulkifli said FSCs are "resourced based on the number and complexity of active cases".
Speaking during his ministry's Committee of Supply debate on Mar 10, Mr Masagos said FSCs can hire more social workers if caseloads increase, and allocate cases based on the workers' experience and complexity of cases.
"FSCs can tap on their accumulated programme reserves to hire additional manpower. In FY2020, 68 per cent of FSCs had an average of at least one-and-a-half years of programme reserves," he added.
"MSF works closely with FSC leadership to monitor the caseloads and hiring, and adopt supervision practices that support the welfare of our social workers. In this manner, MSF balances between being prescriptive and allowing FSCs the flexibility and autonomy to respond to needs, while looking after our social workers' interest."
To help CNA understand how a social worker's caseload is determined, Ms Tan Sze Wee, president of the Singapore Association of Social Workers (SASW), shared that there isn't a "magic number" for cases, as agencies have their own criteria. For instance, specialised agencies working on "very complex" cases might have a different caseload from agencies that handle cases about financial needs.
Furthermore, "low level" cases that social workers engage with once a fortnight might suddenly spring a crisis, which could then lead to engagement once every few days. One can't always predict the complexity of the case, she added.
As an organisation, Ms Tan said SASW hopes to help individual social workers learn how to prioritise and manage casework through management and supervision. She also admitted SASW can do more to engage with agencies to promote an understanding of what exactly social workers do.
"PASSION" AS DRIVING FORCE
Placing too much emphasis on passion as a driving force in caregiving sectors can be “harmful”, said the social workers who spoke to CNA.
This point is also often discussed on Instagram account @SGSocialWorkMemes, which is known in the industry for its realistic portrayal of a social worker’s life through memes.
“It becomes an excuse not to pay social workers better … By repeatedly setting the expectation that social workers are in it for the outcome, not the income, they can peddle the idea that any improvement to wages is a bonus that social workers ought to be grateful for, and not at all our entitlement for our efforts and hours,” said the anonymous founder of the account, who has worked in social services for more than seven years.
The overemphasis on passion also “undermines other aspects of our profession, like our competencies, skills and knowledge”, and ultimately feeds the myth that social work is a job that anyone can do or that we’re just “paid volunteers”, they added.
“Burnout is not just burnout with social workers. ... There is also vicarious trauma because the cases we work on can be traumatising. We also have compassion fatigue,” added Brandon.
But social workers also highlighted the various ways they’ve learnt to mitigate potential burnout and why they remain in the industry.
Pamela, 34, acknowledged that while social workers cannot effect changes overnight, they can "identify small, actionable areas and work with people who are aligned in our values".
A senior social worker Kevin suspects he has already hit burnout. The 45-year-old, who has been in the industry for 19 years, said he’s unable to keep up with deadlines, avoids certain emails and has grown impatient in some interactions with clients and colleagues.
Dealing with burnout means recognising that "we're all made differently", and that different people have different thresholds, said Ms Tan.
"We are always constantly tapping on that reservoir that runs very low because we're in a profession that requires a lot of ourselves. ... I don't think you can ever tell a passionate person to be less passionate, but I think what has worked for me is working towards a more harmonious passion."
EXPECTED TO FIX ALL PROBLEMS
Social workers are sometimes made to feel like they are “fully responsible for the safety and well-being of the families they work with, and in ‘sighting’ them”, Pamela said.
"Sighting" a family means doing a video call or home visit to ensure children are physically seen by the social worker to ensure their safety. This usually happens in cases with safety and risk concerns.
“I think the impact of this is that it doesn't quite gel with the social workers’ values and ethics of social justice. We work with the marginalised not for the sake of monitoring them ... although that may be part of our job sometimes because of protection issues,” she said.
Sometimes, "personal aspirations or personal desire for a certain type of work" may not fit with the kind of work that social workers have applied for, Ms Tan explained to CNA.
"Currently, many of our programmes that are funded have quite clear boundaries. For example, if you are working with a particular group of people to look at employment, then your outcomes are just finding employment or work for that person," she said.
"But as a social worker, we will look at that person, look at their family. We want to look at things holistically. And maybe that is what frustrates social workers (who might ask): 'Why are you just concerned for employment when actually there are so many other issues in the family?' You have to then go back to the design of the whole programme."
Echoing Ms Tan's sentiment, Linda said social workers tend to think about problems "not just in terms of individual issues but also in terms of how systems interact and impact our lives".
For example, society can start by moving away from the narrative that “low-income families can’t plan for themselves and are dependent on the state or social workers”, she said.
“To assume that low-income families manage money poorly may not be a narrative that’s always true. Some of the issues surrounding low-income are issues related to underemployment or earning lower than living wage. Despite this, I’ve seen low-income families who plan their money well, given the limited resources.”
As part of preparations to run a funded financial literacy workshop, Linda interviewed a group of clients. One of them spoke about her experience with previous financial literacy workshops.
"She said: ‘Come on, we’re good at budgeting. The problem is we just don’t earn enough. So, if we don’t earn enough, can show me examples of how I can make more money?’”
Yet, despite having one foot out the door on a 16-year career, Linda still remembers the reason she became a social worker.
“In my teens, we had to do a community service project. It was very hard for me to realise that there were people who may not have the same privilege as I do in life, and that it’s important to be able to contribute more if we have more,” she said.
“After I entered the industry, the more you do, the more you can’t look away.”