Getty Images iStockphoto says Mélanie Bourque, full professor in the social work department at UQO.
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.
< p>“Exhausted and psychologically distressed social workers tell us: they lack the 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 Devoir to reveal the preliminary results of a study not yet published.
With colleagues, over the past year she has conducted research 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 social workers again. “We found a field in a worse state than it was in the period of upheaval in 2016 and 2017,” she said. “The distress is the same everywhere.
Several participants 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 have made superstructures that are managed from above, so top-down, where the ground, that is to say the workers, does not participate in decision-making and is imposed all these management measures. »
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 exemplifies the number of interventions they can do as part of a follow-up. “In X number of encounters, the problem is supposed to be solved, when sometimes you know it can take longer or less time.
This would lead to a loss of meaning in these workers, observes Ms. Bourque. “You're told what to do all the time. »
“Under pressure” and in competition
During research interviews, Mélanie Bourque and Mylène Barbe heard many times about accountability “under pressure”. “With the new public management, in youth protection, workers can spend 50% of their time and more doing accountability, while 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're trained for it.
Many denounce being put in competition with each other by their superiors, says Ms. Bourque. “They're told, 'How come 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 report to the Ministry [of Health and Social Services] 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 little professional support received by new social workers 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 are coming in 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.
At the end of the day, 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: 'There's a family that's leaving my office and I'm afraid 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 points out.
Contacted by Le Devoir, the Ministry of Health and Social Services said he does not want to comment until he can see the study when it is published.