For more than 100 years, American social workers have been a critical part of the U.S. healthcare system, but there are big problems with the way they are currently perceived and utilized within healthcare.
First, too often social workers are not working at the top of their professional licenses and skillset.
Second, they are given unmanageable caseloads with little chance of adequately providing the services people desperately need, like helping to set up long-term support for people with chronic illnesses.
Finally, there is still widespread misrepresentation of social workers in television and films as disheveled, smug women who revel in stealing children and denying services.
These factors contribute to the devaluation of the profession which makes social workers vulnerable to cost-cutting, burnout, and leaving the field. This is problematic because having social workers on your team improves outcomes for both the people we serve and the healthcare teams we work with. We can all help social workers and clients by contacting our Senators and urging them to co-sponsor the Improving Access to Mental Health Act and include the bill in the forthcoming Senate mental health package, but more on that later.
Social workers may lower overall health care costs by helping patients navigate complicated systems and obtain necessary care, such as locating transportation so they can get to follow-up healthcare appointments for dialysis or chemotherapy. Although clinical social workers are the largest providers of mental health services in the U.S and are recognized as specialists in social care, there are federal, state, and institutional barriers that make it difficult for them to practice at the top of their skillset. These barriers include a lack of reimbursement options despite a great need for our services, leading to decreased access and low wages.
While physicians and nurses focus on medical needs; social workers are specifically trained to address everything else that contributes to health and well-being, including the social determinants of health. This refers to the environmental conditions where people are born, live, learn, play, work, worship, and age that impact health and quality of life.
Social workers work to ensure that people have access to essential services, from food to medicine to shelter. So, why would we want to hamper their ability to perform at the top of their license and skillset? Although patients are generally referred by physicians and nurses because they have a number of perceived resource needs, social work services should be offered to everyone dealing with health concerns, in particular those with complex and chronic illnesses.
There is a lot of variability within healthcare and social workers are involved in different levels of care in traditional and non-traditional settings, including hospitals, community agencies, and physicians’ offices. In each setting, the social worker’s role may look different. However, their primary role is to explore how people interact with and are impacted by their environment, and how these interactions affect health. At adequately staffed institutions where social workers are encouraged to work at the top of their professional license, they provide a mix of services that can include both care management and clinical counseling with clients and their caregivers. Many social workers have earned a master’s degree and received two years of additional training to become a Licensed Clinical Social Worker. The training includes learning the clinical skills necessary to provide mental health counseling, making social workers well-equipped to provide mental health support to individuals experiencing trauma or anxiety.
On the other hand, under-resourced social work can have a far-reaching negative impact. When essential services are not provided, people suffer needlessly and end up back in the hospital or dead.
In healthcare systems that are not well-staffed, there may be one social worker covering an entire hospital and they spend the bulk of their time arguing with insurance companies and providing minimal care coordination. When adequate staffing is not maintained, social workers have unmanageable caseloads, meaning they see more patients than they are able to provide adequate care for. When an experienced social worker leaves, so do the valuable care networks, such as contacts within community-based organizations that they have cultivated outside of the walls of their system.
We need to keep social workers in health care, but until there are clear funding pathways and a better understanding of what they do, their current role is tenuous.
Please call your elected representatives to co-sponsor The Improving Access to Mental Health Act (S. 870/H.R. 2035), introduced by Sen. Debbie Stabenow, MSW (D-MI), Sen. John Barrasso (R-WY), and Rep. Barbara Lee, MSW (D-CA). Use this link through the National Association of Social Workers to generate an email to your representative.
If passed, this legislation will increase reimbursement rates for clinical social workers and increase access to mental health services for people coping with the social, emotional, and economic aspects of having a medical condition. With this legislation, we will have a clear funding pathway to keep social workers in health care which benefits all of us when we need support the most.
About the Author: Teresa Moro is an Assistant Professor in the Department of Social Work at Rush University Medical Center. She is also the Research and Communications Coordinator, for the Rush Center for Health and Social Care Integration and a fellow with the Op-Ed Project.