Ethical dilemma, pressure, lack of staff: the level of exhaustion of social workers in the public network is today “incomparable”, warns a Quebec researcher, while pointing the finger at the Barrette reform.
“Social workers who are exhausted and in psychological distress tell us: they have a lack of resources to do their job,” says Mélanie Bourque, full professor in the social work department at the Université du Québec en Outaouais (UQO). The shortage of personnel creates an overload of work, she adds, during an exclusive interview granted to the Duty to reveal the preliminary results of an as yet unpublished study.
With colleagues, she has conducted research over the past year with some sixty social workers across Quebec. She had carried out a first study in 2016 and 2017, in the wake, a few months earlier, of the adoption of Bill 10 by former Liberal minister Gaétan Barrette. This reform of the health system grouped most of the hospitals, youth centres, residential centers and other health establishments into 13 CISSSs and 9 CIUSSSs.
Ms. Bourque wanted to take the pulse of the social workers again. “We found land in a worse state than it was during the period of upheaval in 2016 and 2017”, she underlines. “The distress is the same everywhere. »
Several participants also burst into tears during the study, adds Mylène Barbe, research professional and doctoral student in social work at the University of Montreal.
According to Mélanie Bourque, the Barrette reform crystallized a change in management that had begun during previous reforms of the health network. “We made superstructures that are directed from above, so top down, where the field, that is to say the workers, does not participate in decision-making and sees all these management measures imposed on them. »
Social workers are at their wit’s end, because they find themselves faced with a “constant ethical dilemma”, laments Ms. Bourque. “We force them to go in different directions in their types of interventions and for her, that completely calls into question their professional autonomy. »
Ms. Barbe gives the example of the number of interventions that they can make as part of a follow-up. “In X number of meetings, the problem is supposed to be solved, whereas sometimes we know that it can take more time or less time. »
This would lead to a loss of meaning in these workers, observes Ms. Bourque. “You are told what to do all the time. »
“Under pressure” and in competition
During research interviews, Mélanie Bourque and Mylène Barbe heard many times about reporting “under pressure”. “With the new public management, in youth protection, workers can spend 50% or more of their time doing accountability, when there is a lack of people in the field,” says Ms. Bourque. It is absurd. »
Social workers, however, want to be with the population, she continues. “They are trained for that. »
Many denounce the fact of being put in competition with each other by their superiors, says Ms. Bourque. “We tell them: ‘How is it that your colleague did six interviews, but you only did four?’ It’s an incredible pressure on the interveners, because it can depend on the cases and their complexity. »
“And all this to be accountable to the ministry [de la Santé et des Services sociaux] who wants to know what the results are,” she laments. However, human distress is difficult to quantify, according to the principal researcher of the study.
Lack of professional support
The lack of professional support that new social workers receive is also problematic, says Mylène Barbe. Managers have teams that are too big for their responsibilities, adds Mélanie Bourque.
Many experienced professionals choose to retire earlier because of unsustainable conditions, notes Ms. Bourque. “All this expertise that is leaving means that those who arrive have no support. It’s a sort of vicious circle with no end in sight. »
Some social workers also decide to change positions within the network when they can’t take it anymore, adds Mélanie Bourque. “They know that for people who are in distress, for example, changing social workers regularly is not beneficial. But at some point, I would say that they save their skin. »
Ultimately, many social workers are concerned about the population. They feel that she is not receiving the required services, reports the UQO professor. “They tell us: ‘A family is leaving my office and I’m afraid that the pot will blow up in the evening because they need services, but I can’t offer them any. And I can’t refer them because there’s no more room”. »
According to Ms. Bourque, the state of the public system was already a problem before the COVID-19 pandemic, but it has made the situation worse. The health crisis has “exhausted social workers like all other workers”, she underlines.
Contacted by The dutythe Ministry of Health and Social Services said it did not want to comment before it could consult the study when it was published.