Social Work in the Time of the COVID-19 Pandemic: All in This Together?

Abstract

With the benefit of hindsight, our last Editorial (‘Working on the front-line: what war are we talking about?’) might appear ill-judged, as, in the space of a few weeks, the language of combat has come to dominate our news programmes. Across the globe, nations find themselves in lockdown in order to fight the spread of the coronavirus (COVID-19), with social work and social care being no exception. Problems caused by isolation in residential care for older people; the exacerbation of anxiety and paranoia for those with long-term mental health problems; families prohibited from embracing their loved ones at the end of life; the operation of social distancing in prisons; how to survive, never mind self-isolate, at home for people who have no home; the risks posed to social care staff who all too often do not have adequate personal protection equipment nor are they able to use touch as they communicate with vulnerable people in these very particular circumstances—this is indeed the stuff of ‘front-line’ practice, as we write and for the foreseeable future. Is this not, indeed, a battle, one which, as our political leaders constantly remind us, we are all in together, the virus being no respecter of persons? Despite this, the essential messages of our last Editorial hold good in this world in which keeping a balance between realism or denial, panic or fortitude, shifts from day to day. The truth is that some are much better placed than others to get through this and, as ever, social work must look out for and speak for, the most marginalised and vulnerable in our society. Now, more than ever, we must take the lead in building coalitions that will share and adapt existing expertise to address issues of well-being and survival for those who do not have the resources to do this for themselves. 1 While our attention has turned to life in the ‘new normal’ state of emergency and the discussion over critical care beds and ventilators dominates the news, it is easy to overlook the other reality that people continue to experience breakdown and crisis and need routine support services. The first three articles in this issue, all from the UK, concern three groups for whom this is particularly relevant. It might also be the case, without stretching this too far, that we can take lessons learned from these articles into our new reality, perhaps none more so than in mental health services. In the first article, Wickersham, Nairi, Jones and Lloyd-Evans report a mixed methods study in which they examined the risk factors that underpin compulsory admissions to psychiatric hospitals in England. As they point out, there has been a significant increase in admissions in England and Wales over recent years when compared to other European countries. Although there might be many explanations for this (including the paucity of alternatives—one result of austerity) the approved mental health professional (usually a social worker but not always) as the initiator in the formal compulsory admission process needs to be sure that admission is the best available option for the individual and society. The second article by Mason and Evans examines how social workers work collaboratively with other disciplines and agencies in the field of adult self-neglect. This is an idea that will resonate with many of us in this time of crisis. The importance of cooperation as a dynamic process needs, they suggest, to be understood, as the complexities involved are fundamental to the integration of services. The final article in this section is by Chan, Vickers and Barnard, who describe a qualitative study looking at long-term informal caregiving in the UK. By using the notion of ‘finding meaning’ in caregiving they provide insights into the range of understanding and knowledge that informal carers described as being their motivation to care long term for family members. The demands on carers often result in sacrifices in work and informal social life being made by the carer. Finding meaning may well be an important concept in the context of additional restrictions and self-isolation instigated in the bid to prevent the spread of COVID-19. The next block of five articles is chosen around professional issues and themes. The first article by Hidalgo and Úcar takes an ambitious look at social pedagogy and the current meaning given to this concept globally. They undertook work that used the Delphi method to tease out international perspectives about social pedagogy and the commonalities and differences that exist in the academic, training and professional spheres. Next, in a large-scale study conducted in the People’s Republic of China, Wenjie Duan, Qiujie Guan, Junrong Sheng and Bo Qi describe how they developed the Social Work Core Competency Inventory in the PRC, used to determine social work core competencies. From Finland, Maija Mänttäri-van der Kuip writes about ‘moral distress’ and how different conceptualisations appear in the social work literature. The author sheds light on the complexities and dynamic nature of moral distress, which, it is claimed, have not been adequately recognised even though it can be an important tool for understanding the tension between knowing what the right action is to take while being constrained by factors largely outside of one’s own control. Next, from England, Kinman, Grant and Kelly also pick up on the work-related stress that social workers may experience. By using a mixed method study, they examined the impact that a course in mindfulness had on the development of greater resilience to help social workers to manage the demands that the job placed on them. Associated with this, from Scotland, Fogarty and Elliot evaluate the use of humour by social workers to reduce stress. Long considered a stress-busting technique, the appropriate use of humour can have, it seems, its place on the professional social work scene. The authors used an Interpretative Phenomenological Analysis approach to investigate the positive and negative consequences of the use of appropriate humour in the social work workplace, reporting that humour can serve an important function within social care. The next five articles focus on social work with children and families, but the first three also draw out an aspect of social work that is core to the profession: its ethical base and how that plays out in particular contexts. First, from Belgium, van Haute, Roets and Vandenbroeck look at the (international) trend for inter-organisational and multi-professional working when dealing with children at risk through poverty and neglect. Drawing on their ethnographic study of three local networks, they focus on the ethics of information-sharing as social workers use ‘professional discretion’ in mediating the tensions (identified in the literature) created by top-down regulation. The authors conclude that a rights-based approach is a crucial reference point when exchanging private information about families in poverty. Next, from the UK, Kelly and Green argue for a raising of the profile of social workers in health care settings, suggesting a model of ‘interprofessional supervision’ in child protection, which would utilise social work’s well-developed models of professional supervision (which they term ‘Super Vision’) with its focus on the whole context of the child. The third article (Featherstone and Gupta), like the first, looks at families in poverty, this time in relation to the increase in adoptions in the UK, most of which are without the parents’ consent. Pointing out that, in the context of austerity and declining support for families, there are human rights issues at stake, the authors present their data from the Enquiry commissioned by the British Association of Social Workers, which shows that social workers made no explicit reference to codes of ethics or specific ethical theories in relation to their decision-making. However, recognised themes from the study of social work ethics, such as ‘moral distress’ and ‘ethical trespass’ were evident in responses and the authors suggest that social workers should receive better training in ethics-in-practice and be supported by ‘ethically enquiring’ work cultures if they are to more satisfactorily manage these tensions and dilemmas in adoption work. By contrast, local authority children’s services in England are very alert to the regulation and inspection requirements imposed by The Office for Standards in Education, Children’s Services and Skills (Ofsted). Starting from the suggestion that falling quality ratings in recent years do not take sufficient account of levels of deprivation and spending levels, Wilkins and Antonopoulou analysed the association between deprivation, expenditure and performance levels and Ofsted judgements. Their conclusion is stark: while high levels of deprivation should not be an excuse for poor practice, it is much harder to intervene effectively in this context. The authors call for ‘a holistic inspection regime’ which takes this into account. Staying with this theme, Hood, Goldacre, Gorin and Bywaters also examined national data-sets for statutory children’s social care services in England and found that high levels of deprivation were strongly linked to increased child protection activity. The article goes on to examine the mechanisms which shape the way in which local authorities manage demand on their services. From our perspective as Editors, there is a body of research building about Children’s Services in the UK and other European countries, which challenges the profession of social work to press for policy that incorporates analysis of poverty and social deprivation as a significant framing factor. We would be interested in international comparisons. The final group of articles demonstrates the continuing breadth, depth, responsiveness and innovativeness of social work research and practice. From Australia, Wells and Heinsch discuss female infertility in socio-political context, highlighting how patriarchal structures can impact on women’s experience. Their scoping review revealed three dominant themes—the ‘women as mothers’ discourse; medicalisation and the ‘female biological fault’; and ‘deviant’ mothers and infertility—and they call for social workers to raise awareness of these stigmatising social factors. As one of us (Margaret Holloway) who in the 1980s was a hospital social worker attached to obstetrics, gynaecology and paediatrics, it is sobering to reflect how long and hard is the struggle for women’s empowerment in this critical domain of their lives. The next two articles add to the growing body of work on asylum seekers. From Australia, Belinda Green argues that critical policy practice requires interrogation of the discourses of dangerousness, illegitimacy, othering and burden which underpin neoliberal responses and encourages social work education to grapple with these, while from the UK, Kelly Devenney brings in one counter-strategy, when she suggests that social workers with unaccompanied young asylum seekers should see themselves as ‘co-navigators’ across the difficult journey which these young people face, with all the emotional support which a companion may bring to the journey. Finally, Terare and Rawsthorne also plead for a new way of understanding and working with another stigmatised group, in their discussion of health inequalities experienced by Australian First Nations People. They argue that social workers whose world view may be very different, must recognise the deeply embedded connection to place and the trauma which results from disruption to that connection, as well as embracing a different cultural model of healing, in which story-telling (‘yarning’) plays a major part. Today, the world over, we hear that these are ‘unprecedented times’ in which nations, communities, families and individuals must dig deep into resources and strengths which they may not realise they have. Social workers are having to find new ways to support and nurture these strengths in themselves and others. It is timely that we are able to publish in this issue Beth Humphrey’s Critical Commentary on Spirituality and Social Work. We also include, with great sadness, an obituary to our friend and colleague Bernard Moss, a pioneer in the study of social work and spirituality, who continued until his sudden death in January 2020 to reach out with humanity to social work students, colleagues, service users and parishioners alike.