GLASS CEILING

Mickey Skidmore, AMHSW, ACSW, FAASW

The glass ceiling for Social Workers in Australia is in no danger of being broken anytime soon. As I reflect on my recent professional experiences, whether it be in my clinical practice or in academia (teaching in tertiary Social Work programs), I continue to see an ongoing abundance of real life examples supporting this observation.

CLINICAL PRACTICE

Recently I was invited to interview for a Social Work position in a private psychiatric hospital service. I was initially excited given I have long attempted to get my foot in the door of numerous private psychiatric hospitals only to be advised that they typically do not hire Social Workers. They hire only Psychologists to provide the clinical counselling services and group programming. I related my hopes that perhaps this service would welcome the extensive clinical experience I bring  (including a recent Fellow credential from the AASW) and embrace such an opportunity.

From the outset of the interview however, they indicated they were looking for more of a “traditional” Social Work role (a code word apparently meaning non-clinical), which they explained as: “managing child protection reportings; homelessness; and NDIS issues”. I began modelling how I might demonstrate leadership in a multi-disciplinary team in such a scenario, which quickly lead to the unraveling of the interview.

I took a deep breath, and related that my previous experiences with public inpatient psychiatric services were horrible. I did not want to assume that their typical way of operating was similar. However, I calmly stated that if their expectation was an attempt to administratively delegate child protection reporting duties to the Social Worker — then I wanted no part of that. The interviewer stopped writing at that point and with straight (yet mildly shocked) face inquired: “why?”

I explained for starters that such a practice violated current NSW law, which identifies a range of professionals (doctors, nurses, social workers, psychologist, occupational therapists, teachers, ministers, lawyers to name a few) as “first responders” that have professional duty and obligation to make appropriate reportings to the proper authorities in such circumstances. I further noted that these obligations were not something that can be administratively delegated to Social Workers (only). I also pointed out from considerable experience how such an effort is likely to go: “… so did the child share these allegations with you?” “Well … no …” “Then why am I talking with you? … This is essentially second hand information …” Thus, almost always such an effort is ineffective and a complete waste of time for nearly everyone, and actually undermines the entire system.

I’d like to think that in such scenarios given the Social Worker’s expertise with family systems, knowledge of abuse, child protection background and what to look for, that the service may want to refer the Social Worker for additional evaluation to ascertain if any subsequent or supportive reporting may be indicated or appropriate. And finally, there may also be a collaborative role for the Social Worker to skill up and/or support the other multi-disciplinary staff in order to better navigate the complex user-unfriendly child protection system. (However, given current realities of multi-disciplinary teams, it would not be surprising that such efforts would be rebuffed or unwelcome anyway).

I went on to respond to the other two domains she highlighted at the outset. I expressed some confusion about how an individual who met the criteria for admission to a private psychiatric hospital service might actually be homeless? Leaving room for the possibility of an atypical circumstance, I again from many years of experience conveyed that the issue of homeless (or unstable accommodation for that matter) are never adequately addressed/resolved from a hospital emergency room or psychiatric hospital; and furthermore, requires no magical or special tertiary knowledge to refer and link someone upon discharge to the individual’s closest Department of Housing agency — a federal organisation devoted exclusively to this issue.

Finally, regarding NDIS I stipulated that I want everyone who may be eligible for such services to be identified. However, with some degree of certainty I could state that an inpatient psychiatric admission was not for the purposes of undergoing NDIS evaluations from hospital staff to determine their eligibility. NDIS is allocated a large financial scheme second only to Medicare. While there was much confusion when initially rolled out, enough time has past where patients can be referred to their closest NDIS service to organise and arrange to undergo their evaluation process following discharge from their inpatient psychiatric admission to determine NDIS eligibility and facilitation of identified services.

My interviewer persisted with poor excuses to justify the practice of ignoring the mandatory reporting law: “nurses are just so busy … they are task oriented … and don’t have time for such things”. So by implication then, the indirect suggestion is that a nurse’s time is more important and valuable than a Social Worker’s. Frankly, it is not much of a stretch for the unspoken implication that everyone’s time (doctors, nurses, psychologists, etc) are more valuable than a Social Worker’s.

These recent experiences should be disconcerting to any medical professional that practices with multi-disciplinary teams in hospital or medical settings. While it is couched in the context that hold expectations for a “traditional Social Work role” in a private inpatient psychiatric service, why is it okay to disrespect, devalue, degrade, and demoralise the Social Work discipline, and when did it become an accepted expectation to view the Social Work role in this manner? (Perhaps it has always been this way — or at least in place for a very long time).

It’s one thing for such pervasive dysfunction to become the status quo within organisational systems — especially medical ones who tend to dump anything in the lap of Social Work that is not clearly “medical” — whether appropriate or not. It is even more alarming for me that that the AASW would acquiesce to the “wink and nod” and looking the other way rather than take more agency to advocate for its own profession. If any other professional discipline were treated this way — imagine outrage and consternation.

It is not surprising that I never received any follow-up communication after this interview. I understand that few approach job interviews the way I do. I value stability when it comes to employment. I do not take the prospect of changing employers easily or in a cavalier manner. I would not apply for a position where I am not confident about my experience, skills or ability to perform the duties of the job. What I am looking for is to determine if this position improves or enhances the circumstances of my work-life balance — in accordance with the professional values that are important to me. In short, this is every bit of an opportunity for me to interview them, as it is for them to interview me. This was an opportunity to model my professional values I was able to demonstrate professional integrity. If they took issue with that, I lost nothing by their not making follow-up contact. There silence conveyed all I needed to know about this opportunity.

ACADEMIA

Increasingly in my teaching I am approached by students who are seeking prescriptive and definitive pathways towards clinical roles within mental health services. Many are beginning to experience the artificial glass ceiling that separates them from psychologists, but have yet to fully articulate the frustration of the “professional racism” (Skidmore, 2019) that they are beginning to experience.

My own view is that the educational structure and framework for preparing and training Social Workers is a likely contributor to the glass ceiling barriers in Australia. I find it disheartening that after completing their Bachelors of Social Work degree when professionals want to further enhance their knowledge and training they typically have to turn to another discipline or degree altogether (Masters of Counselling; Psychotherapy or even Psychology) rather than provide them with a subsequent pathway towards an MSW. It is worth noting that in most other places in the world a Masters degree is the minimal standard to be recognised as an independent (clinical) practitioner. Australia does not seem to adhere to this standard. 

There is also considerable inconsistency in academia between undergraduate an MSWQ programs. Having first hand experience in teaching for both programs, my observation is that there is very little parity between these programs. In my view, those who complete the undergraduate program are far better prepared for beginning professional Social Work practice than those who complete the MSWQ program. Too often the focus for Universities is not aimed at the strength or parity between it Social Work programs, or whether they are admitting more students than they have placements for, but rather on the cash cow that the premium international tuition fees command.

At some point in time the penny will drop for an increasing number of students who will choose alternate courses of study rather than contend with the these glass ceiling barriers. And who could blame them? For the future health of the profession, it would be wise to address these issues sooner rather than later — and by employing multiple strategies.

AASW

Sadly, the AASW seems to have hung their hat on their micro credentialing program as their answer or response to many of these disparities. 

Never mind that there is no practical or tangible benefit beyond online “badges” for the misguided alliance with social media (with the sole exception of AMHSW which allows access to the Medicare scheme).

Never mind that despite the recognition of Accredited Mental Health Social Workers in the Medicare scheme, the approved fee schedule for their services is noticeably less than Psychologists — even when engaged in similar duties and managing similar risks.

Never mind that the public health systems only require applicants to be AASW eligible to apply for jobs (but never consider the credentialing system for promotions, advancement or other professional development).

Never mind that in practical terms it is often beyond the role of Social Workers to diagnose mental health conditions; yet the AASW credentialing requires demonstration of an applicants ability to do so — which is often above and beyond the credentialing expectations of some psychologists.

And never mind that the AASW seems to be moving toward the position that it will not endorse your skill set — unless you pay for the privilege of meeting their credentials criteria for each respective aspect of Social Work practice. (So for example, despite the fact that I have been providing clinical supervision for decades, in the near future the AASW may not recognise me as an approved supervisor if I do not hold their supervision credential — despite holding Fellow status).

Beyond the credentials issues, it has been more than 2 years now since the Social Work Registration law was passed in SA. Yet, the AASW has been largely silent in updating its membership in this regard? What’s the hold up? What is the status of implementing this law? 

To the best of my knowledge the 2019 National Conference in Adelaide, SA was the last live training event sponsored by the AASW. I think many agree that there is now an ongoing place for online training; however, with the COVID experience in our rear view mirror, the time has come to resume face-to-face training events to bolster the professional development of Social Workers. (The announcement of the International Conference to be held in Melbourne later this year is most welcoming).

And I see no evidence that any health union is doing anything to advocate for Social Workers to break through the glass ceiling and be recognised with similar stature to other professional disciplines.

CONCLUSION

The experiences discussed in this editorial are specific examples of things that I encounter routinely as a Clinical Social Worker in Australia. I have heard numerous war stories of clients who have had sub-par clinical experiences with psychologists. (And to be fair, I’ve also heard stories from clients about bad experiences with Social Workers too). So it is always curious to me when someone who is/was a psychologist decides to pursue a degree in Social Work. While they often recognise the broader clinical scope of a Social Worker’s approach to be more effective in many ways, they have yet to experience the glass ceiling that will prevent them from fully realising the benefits from the skills and knowledge we bring to the clinical experience.

At some level I understand (or at least accept) that other professions may view Social Work as a lesser profession. However, is puzzling to me that the national organisation for the Social Work profession (AASW) is silent on so many of these issues. With all the money they generate from the fees of this credentialing system, why don’t they hire lobbyist? Why have they been so reluctant and hesitant to support the resumption of live training events? Why are they silent on updating their members about the passage of legislation in SA? Why do they not advocate more and better for Clinical Social Workers providing the same clinical services in organisations that pay psychologist a hire wage for identical roles? Why do they not advocate for the use of their credentials program to be incorporated in professional advancement in the public health system? Why do they not advocate for Clinical Social Work roles in private hospitals? Why are they silent when organisations routinely thwart mandatory reporting laws?

As I explained to those interviewing me, what makes infinitely more sense to me is recognising all the various pathways one can become a clinician or psychotherapist; noting a minimum standard that all paths must adhere to rather than falsely and incorrectly pigeon-hole professional disciplines and creating obstacles that differentiate us. 

Alas, as I stated at the outset, I see little evidence — from any health union or the AASW itself that the glass ceiling for Social Workers in Australia will be broken anytime soon.

REFERENCES

1) Skidmore, M.  PROFESSIONAL RACISM (Nov 2019)