823Suicide of welfare and care support workers: a retrospective mortality study in Australia 2001-2016

Background Emerging evidence suggests that people working in the welfare and health care industry have poorer mental health than other occupational groups; however, there has been little examination of suicide among this group. In this study, we examine suicide rates amongst welfare and care support workers and compare them to rates among human service workers, and all other occupations in Australia. Methods We used data from the National Coroners Information System (NCIS) to obtain records of death due to intentional self-harm between the years 2001 to 2016. We calculated age-standardised suicide rates and incident rate ratios to compare the suicide rates across different occupational groups. Results The age-standardised suicide rate of males is the highest amongst welfare and carers (24.1 per 100,000). After adjusting for age and year of death, we found that men working as welfare workers and carers have a significantly higher suicide rate than men working in other occupations (IRR 1.43, CI 1.2-1.7). Furthermore, male human service workers have a slightly lower rate of suicide than those working in other occupations (IRR 0.73: CI 0.66-0.82). The finding was similarly noted in female suicide deaths, however, the higher suicide rate in female welfare workers was not statistically significant (IRR 1.12 CI 0.9-1.39). Conclusion The suicide rates of welfare and care-related occupations are as high as occupations which are identified as at-risk occupations for male suicide in Australia. Key message There is a need for targeted programs to improve the suicide health literacy among welfare and care support workers.

The Rise of Managerialism in the US: Whither Worker Control?

This chapter investigates the impact of managerialism on the work of non-profit human-service workers in New York City, drawing on survey data to paint a portrait of a sector that has been deeply restructured to emulate private-market relations and processes. It uses the Social Structure of Accumulation (SSA) theory to explain the rise of neoliberal austerity and identify five neoliberal strategies designed to dismantle the US welfare state. The chapter also focuses on the impact of privatization, a key neoliberal strategy; shows how privatization has transformed the organization of work in public and non-profit human-service agencies; and details the experience of nearly 3,000 front-line, mostly female, human-service workers in New York City. It argues that austerity and managerialism generate the perfect storm in which austerity cuts resources and managerialism promotes 'doing more with less' through performance and outcome metrics and close management control of the labour-process. Closely analysing practices for resistance, the chapter concludes that in lower-managerial workplaces, workers had fewer problems with autonomy, a greater say in decision making, less work stress, and more sustainable employment, suggesting that democratic control of the workplace is an alternative route to quality, worker engagement, and successful outcomes.

‘No Coughing for Me, but I'm Okay!’: A Human Service Worker's Narrative Exploration of Her Own and Other Workers’ Body Stories Told in a Domestic Violence Service

Relational, body-oriented and brain-based approaches to recovery and change are increasingly popular modalities for working with traumatised children and adults. However, although these approaches encourage the awareness, and the harnessing of workers’ visceral experiences, there is little in the literature to describe how practitioners navigate their own somatic maps. In a research project undertaken from 2008–16, I invited nine human service workers to tell and explore stories about their own experiences of the body that emerged during, and/or in relation to, their own professional practice. A narrative methodology was used to help facilitate a depth of understanding of how the participants used their own bodies as a source of knowledge and/or as an intervention strategy with those with whom they worked. In this paper, I explore one of many stories told by Coral in which she describes the processes she uses to navigate her own somatic map as she interacts with clients and workers in a domestic violence service. I conclude that creating spaces for workers to explore embodied experience in the professional conversation is important, but is difficult without an acceptable discourse or narrative template. Nonetheless, given the opportunity, including the ‘body as subject’ encourages better outcomes for clients and provides richer accounts of human service workers’ professional experience.

Interpersonal interactions, workplace violence, and occupational health outcomes among social workers

Summary Primary emphasis within the literature on mechanisms to address the prevalence of negative occupational well-being outcomes among human service workers has tended to focus on individual self-care efforts or organizational level policies aimed at improving work–life balance. While these are important areas of research, the workplace setting itself can also create negative outcomes, suggesting the need to adapt characteristics of this setting. One aspect of this workplace setting includes the dynamics of interpersonal interaction within the workplace. This study reports a multivariate analysis of the relationship between negative workplace interpersonal interactions (generally defined to provide a more holistic assessment of ways in which violence is manifested in the workplace) between workers and service users and between workers themselves and human service worker occupational outcomes. Findings In 2012, data were collected from a sample (n = 674) of human service workers in Alberta, Canada. This study finds a high prevalence of negative workplace interactions between workers, and that these experiences have consequences for worker experience’s with burnout and life satisfaction, and contributes to intentions to leave the workplace. Compounding negative interpersonal interactions between workers are particularly significant across all measured occupational outcomes. Applications These findings suggest the need for a workplace ‘settings-based’ approach to improve occupational well-being among workers. Utilizing a workplace ‘settings-based’ approach would place more emphasis on the processes and structure of day-to-day work within organizations to help alleviate negative occupational outcomes among workers.