In February, Lynn Stanley, LICSW, executive director of the NASW New Hampshire and Vermont chapters, testified before Vermont’s Senate Committee on Health and Welfare. Her testimony came nearly a year after a Vermont social worker—the second in eight years—was killed while on the job.
The state’s Department of Mental Health, in consultation with NASW-Vermont and numerous other organizations, is seeking to amend an established bill to create a work/study group to review the research around the safety of social service providers.
“We’ll be setting the table, bringing all of these people together,” says Stanley, to try to determine what can be done. “Is [the solution] around training? Is it around resources? Is it around technology? What are some of the things that could be done to improve safety?”
Increasingly, yet most commonly, after a fatality, social workers and the organizations that employ and support them are recognizing that personal safety, while important, is an often-overlooked issue. Social workers, whether in the community or office-based, face risks to their physical and emotional well-being. However, few are prepared with the tools and resources they need to remain safe.
Prevalence of Risk
Social work can be a risky profession. In fact, health and social service workers are nearly five times more likely to incur a serious workplace violence injury compared with professionals in other fields, according to the Bureau of Labor Statistics. Risks to safety may come in the form of physical violence—a direct assault—or verbal abuse, including threats of harm.
For instance, Tara Moser, LCSW, RPT-S, C-AAIS, Registered Play Therapist-SupervisorTM, Certified Animal Assisted Intervention Specialist and owner/therapist of Delta Family Counseling LLC, in Fort Meyers Fla., conducted with a colleague a survey of mental health professionals throughout the country. Of the 277 respondents, 25% were in social work, 17.5% were in marriage and family counseling, 11% were in psychology, and 41.9% in a mental health field not otherwise specified. Prefacing that this was not a formal research study, Moser shared that 52% of respondents had been threatened by a client or relative of a client. Of those, 41% had received more than one threat, both direct and indirect.
An indirect threat is more ambiguous than a direct threat and will likely not include a plan or other details of the proposed harm. Moser described an indirect threat that she received by way of example: “A child walked into my office and said, ‘My mom wants you to know that your son has blonde hair and blue eyes.’” The child, a client, then told Moser where her son was at that moment.
Such threats not only suggest (and can lead to) physical harm, but also affect an individual’s emotional safety—their ability to feel secure while in their office or during a community visit. Feeling emotionally safe allows a social worker to effectively provide services with confidence and comfort, and without fear of harm. However, emotional safety, like physical safety, often is not taken into account.
“Discussions around emotional safety often encompass topics such as self-care, compassion fatigue and vicarious trauma. While these discussions are prevalent in social worker training, ethical standards and best practices, my experience suggests that emotional safety and actualization of these concepts are sometimes overlooked as social workers become more accustomed to navigating the challenges of being first responders to trauma or re-experiencing critical incidents,” says LaTasha Roberson-Guifarro, CWEL, MSW, LCSW, vice president, chief and innovations officer at Lutheran Child and Family Services of Illinois and an NASW-Illinois board member and secretary.
“Many seasoned social workers tend to assert that they are coping well and demonstrate resilience by taking on more responsibilities, shifting focus to the next task at hand or sometimes avoiding addressing the emotional toll of unsafe situations,” she notes.
The risks social workers face and the ability to feel safe, or not, in their working environment are further impacted by the unique nature of many social work positions. For instance, it is not uncommon for social workers to have appointments, both in the office and in the community, at untraditional hours.
“That’s one of the things that I hear anecdotally from social workers and social work students,” says Stanley. “For social service providers who are doing work in the community, if you’re going to somebody’s house, you’re going after hours in the evening, when the office is closed. Nobody knows if you got there. Nobody knows if you left.”
When a social worker does leave a visit, the risk may extend to safety on the road, with or without a client, and other hazards of travel. Additionally, social workers face the possibility of contracting illnesses, as evidenced by the COVID-19 pandemic, exposures to pests, and other public health concerns.
At the highest level of risk, social workers face death—a rare yet not rare enough occurrence in the profession.
Legislation
When fatalities do occur, the focus on social worker safety increases. Social workers, their organizations, and often legislators look for opportunities and ways to decrease risk, as evidenced by Stanley’s testimony and the proposed workgroup.
Other states have similarly taken action after a fatality. For example, in 2010, then- Kansas Gov. Mark Parkinson signed into law a bill requiring social workers to have safety training as a part of their continuing education requirements for licensure. The mandate came more than five years after the murder of a social worker. The movement for it to pass was spearheaded by the social worker’s husband.
However, not all attempts to make changes at state levels are successful nor should they be. While a fatality may spurn a drive to act quickly. Effective change must be well thought out.
For instance, in 2022, an Illinois social worker was murdered during a home visit. She was the second social worker in Illinois to be killed in four years, according to Roberson-Guifarro. In the two years since, there have been efforts to prevent future tragedies. Some efforts have been welcomed while others have not been.
Roberson-Guifarro explains that the Illinois Department of Children and Family Services (DCFS) as well as Child Welfare Contributing Agencies (CWCAs) have surveyed staff about equipment and other protections that may help staff feel safer. “DCFS has employed officers in each site statewide, purchased optional wearable personal protective equipment,” she says, “and put in place self-defense classes for their staff. There is also a $4.3 million investment for additional safety enhancements for state workers, according to the DCFS proposed budget for FY25 (fiscal year). Child Welfare Contributing Agencies have been offered first aid trauma training and are assessing infrastructure and similar techniques to deploy as they are able to resource.”
Legislation also has been proposed. Roberson-Guifarro listed three state House bills and two Senate bills that have been presented. “However, many have not passed. NASW-Illinois opposed several of these bills, citing concerns that they do not effectively make social workers safer,” she explains. The opposed bills include recommendations such as reinstating the death penalty for an assault on a social worker and arming social workers with firearms.
Legislation—whether passed or simply introduced—does not solely follow a fatality and is not limited to state initiatives. Nationally, the Workplace Violence Prevention for Health Care and Social Service Workers Act was created in response to an increased understanding of the violence health care and service workers face.
“In 2013, I requested that the Government Accountability Office (GAO) study trends of workplace violence in the health care sector and identify options for the federal government to curtail it, says U.S. Rep. Joe Courtney, D-Conn. “The report showed an alarming trend. Workers in health care and social assistance sectors experience substantially higher estimated rates of nonfatal injury due to workplace violence compared to workers overall. Unfortunately, workplace violence in this sector has only become more prevalent since this initial GAP report.”
The act, which Courtney sponsored with U.S. Sen. Tammy Baldwin, D-Wis., would require the Occupational Safety and Health Administration (OSHA) to create a standard that would ensure employers are offering and maintaining safe work environments. “Importantly, this would help ensure that social workers don’t go into dangerous situations without the knowledge, tools and support they need to stay safe,” Courtney says.
The bill has been introduced several times and passed in the House with bipartisan support. However, it has not yet passed in the Senate. Courtney is hopeful it will do so in the near future.
“The growing advocacy from groups like NASW as well as increasing awareness around this bill makes me hopeful the Senate will follow the House’s bipartisan lead and take up the bill,” says Courtney, adding that the bill has been introduced in multiple congressional sessions. “In the 116th Congress, the bill passed the House on 11/21/2019 by a vote of 251-158. In the 117th Congress, the bill passed the House on 4/16/21 by a vote of 254-166. The bill has been introduced in the 118th Congress, but has not yet been brought up for a vote by the Republican majority despite record bipartisan co-sponsors. In each Congress, Sen. Tammy Baldwin has introduced identical legislation in the Senate, but it has not yet been brought for a vote.”
Shifting Perspectives
The process that Courtney describes is not unique to the Workplace Violence Prevention for Health Care and Social Service Workers Act, nor is it unique to the national stage. Legislation is complex and takes time and a great deal of work from all involved parties. During that time, however, social workers remain at risk and must look for solutions elsewhere. Even when laws are created or amended, they will never be a cure-all.
Unfortunately, much like the way legislation is largely proposed after a fatality, personal and even organizational awareness often stems from a negative experience. Personal safety does not rank high on the list of things social workers and social work organizations discuss regularly.
“I suspect that a lot of people don’t think about safety training until they have a situation,” says Elise Beulieu, PhD, MSW, LICSW, a clinical consultant in Massachusetts. “This isn’t forefront. Ninety-five, maybe 98%, of people are safe. It’s only those very few circumstances when you have a problem. But when you have a problem, you’d better know what to do.” Beaulieu is a facilitator for a safety training that was initially developed by Eva Skolnik-Acker, MSW, in conjunction with the NASW Massachusetts Chapter.
There also can be a struggle with perspective—how social workers view themselves, the role they are there to fill, and the reception they may receive as a result. Beaulieu says that when she first started out in social work, she assumed she would be safe simply because of the reason she was there. “I thought everybody was going to be OK with me because I was there to help. Being there to help is not something that can guarantee [safety]. Your intentions are great, but you have to be aware and alert.”
Adds Stanley: “I think social workers often have the false belief that if they’re a good social worker, they can talk their way out of anything. If they’re a good social worker, they should be able to de-escalate. However, you can’t live thinking it’s all on you.”
“We are also the only species that will ignore warnings that our brain and gut are sending to us because we don’t want to hurt other people’s feelings,” she said. “Especially as social workers, we are concerned about the impact of leaving a dangerous situation.”
Organizations share this concern. Social service providers need to provide services to remain in business. While employers want their employees to be as safe as possible, prioritizing safety can fall to the wayside, replaced by any number of other concerns.
For example, Roberson-Guifarro says the human service sector is currently facing a national workforce crisis characterized by limited resources, insufficient staffing, high caseloads, and social workers often working in isolation. “In the context of child welfare, social workers must navigate complex legal and ethical considerations, including policies governing contact requirements, visitation, removal or return of children from homes, and making safety assessments for children experiencing abuse and neglect. These decisions carry serious and consequential outcomes. Finding a balance, or sometimes the lack thereof, between personal safety and fulfilling our professional duties can present barriers to ensuring our safety in the workplace.”
Personal Safety Tips
Barriers or not, new legislation or not, social workers need to take steps to remain safe while they are working, and much of that responsibility will unfortunately fall to the individual’s awareness not only in specific situations, but also what to do when in them. There are many tips for social workers to help them stay safe, including not allowing anyone or anything to block them from the door/exit, being aware of what may be used as a weapon, and parking with the car facing out so that the social worker can leave without backing out or being blocked in.
Moser advises always having a cell phone nearby in case an emergency call is needed. “The other part we talked about with a cell phone is make sure it doesn’t have your kid’s picture on it or that your credit card isn’t hanging out from it. A lot of times people don’t recognize what (personal information) can be seen.”
In situations outside of an office or a home, social workers should plan for all possibilities. “When people are transporting, you should always drive on the righthand side of the street. You should have the person in the backseat always and on the opposite side from the driver,” says Beaulieu. “Before you put somebody in your car, think about what does the appointment or where you’re taking the person mean to that person?” Someone going to court, for instance, may be frightened or anxious and, depending on the individual and the situation, those feelings could heighten risk to the social worker.
Most importantly, trust the gut. “When somebody is shouting and raging at you, you have to make a decision. ‘Am I going to continue with this or are my skills telling me this isn’t working?’” says Beaulieu.
And allow for the possibility that a social worker may sometimes need to receive rather than give support.
“Nobody realizes the helpers also need help,” says Moser. “Your safety has to come first. You have to protect yourself and your family above your client. If you’re dead, you can’t help your client.”
Sue Coyle, MSW, is a freelance writer and social worker in the Philadelphia suburbs.
References
NASW—Social Work Safety