It’s hard work being a human services worker in today’s healthcare environment. It’s the opposite of most things these days where the younger generation has it easier and we older folks can talk about how hard we had it (like walking to school in the snow, uphill, both ways).
Being a behavioral healthcare worker in today’s world has many of the same challenges of the behavioral health worker of the 1960s, 1980s and so on, but a few newer additions that make it hard to try the “you have it so easy” talk.
In honor of Mental Health Awareness Month, let’s talk a few minutes to focus on the world of the dedicated professionals who do this work every day, often every night and weekends, all over the country.
(disclaimer: this is not a comparison or “who has it worse” type post. Living with mental illness and/or an addictive disorder can be challenging and heart-wrenching, and those who work with and support those living with behavioral health challenges struggle as well. This is a world full of struggles, challenges and thankfully, victories as well. We get to experience both cloudy days filled with rain and despair, and bright sunny days of hope and a shining future. Today we focus on the worker.)
We do walk uphill both ways in the snow
Let’s look at not a comprehensive but pretty darn solid list of challenges and struggles (some are not new but worth reviewing and reminding us all):
- Low pay – especially in behavioral health or when serving the underserved, organizations still piece together budgets and depend on grants and other funding sources that aren’t as stable year over year. Staff aren’t paid what they are worth (teachers know what we’re talking about here) and organizations struggle with salaries (most expensive budget item). It’s not for lack of trying, but being forced to close one’s doors isn’t the way to pay staff more.
- Compassion fatigue/burnout/emotionally draining work – especially when working in child welfare, with the high cost/complex population with multiple chronic conditions, and working in a more “trauma-informed” methodology. Professionals in the helping profession can experience and hear things day after day that are challenging, painful and difficult.
- Workload – caseloads get higher, we have to do more than we used to, staff numbers go down but work stays constant. The message is often to “do more with less”. See “low pay” item above; when we talk about budget challenges, this is impacted as well.
- Scope of practice – professionals are responsible for more than ever; this field isn’t specialty-focused anymore and refer or outsource. The shift to integrated care and whole health management means you have to know much more in terms of assessment and screening, interventions, best practices and coordination of care with other providers.
- Technology – we have seen an increasing use of technology in every-day tasks. This extends beyond EHRs, as we start using health apps, telemedicine and other risk management tools to help us better monitor client status, provide services, and predict crises or health challenges. While these tools are exciting, helpful and often elevate the quality of care provided, it’s a bit intimidating and scary at times to adopt new methods of doing your job.
- Well-informed patient/client – most people do research online before coming in for an appointment, often bringing others with them to advocate, ask questions and help. Today’s healthcare consumer knows more about medications, treatment options and best practices. Often they and/or family members are demanding of specific types of interventions.
I’m sure there are many more challenges, as I said, this is not comprehensive or even new, but worth looking over and seeing how we feel we are doing now vs. in the past. And more importantly, how do we improve for the future.
Who is in the driver’s seat?
Let’s talk about the last one, the well-informed person being served by your organization.
In the past the model was healthcare professional as expert, you knew everything about conditions, treatments and the “best” course of action. Using my favorite driver/passenger analogy, that meant you were driver, navigator, tour guide, everything. You were the expert, you know what should happen next, where your patient needed to be and you guided them there. we would conduct an assessment, create a treatment plan and then work with the patient on compliance.
In today’s healthcare world, we have shifted to person-centered and the well-informed consumer of services is the driver. You as the professional are the passenger; helping guide the way, supporting, looking at the map and evaluating options, consequences, thinking things through. You don’t have to know everything or decide everything.
You and the person you serve are a team, collaborating, communicating, researching and determining what is next. In the end, you walk out of their home or they walk out of your office and you are not the one living with the choices, implementing changes or managing the symptoms, the person you serve is. We would much rather follow-through on a plan if we believe in it, helped create it and personally benefit from it.
Next time someone walks into your office with a smart phone, a health app and a slew of questions from the research they did, relax, take a deep breath and dive in together as a team. This isn’t a situation where you have to prove yourself as the professional with the degree who knows more. This isn’t a competition or some intelligence test, this is a collaborative working relationship to better manage health, to prevent crises and living a happier, healthier life.
Driver vs. passenger, don’t forget that you are the passenger, always.
What is the capital of Madagascar? I don’t know.
Two bits of advice came to me earlier in my career from two brilliant women: my mother and my first social work practicum supervisor from day one of grad school.
My mother used to say it’s more important to know how to find out the answer to something than to know it from memory. Like the capital of Madagascar. I don’t know it, but I sure know how to find out.
My social work supervisor said a social workers best friend is the yellow pages.
timeout: for those of you who don’t know what the yellow pages are, it’s a thing that might still be delivered to your doorstep 1-2 times a year and you unwrap the plastic, toss the book in the recycling bin and toss the wrapper in the trash. Seriously though, it’s a book that has business listings and information. Back before we had the internet, this was the primary source of information on businesses; where you looked up phone numbers, info about a business, address, everything you needed to find help or resources or anything.
The point is that you don’t have to know everything to be smart, skilled and brilliant at your job. You need to know how to go off and figure it out, how to get help, how to work with someone else and find out. Work with someone else…wait a minute, didn’t we just talk about you and the person you serve as a team in this together? Your teammate is the driver and you’re the passenger, a very knowledgeable, kind, helpful and patient passenger helping this journey be as smooth and successful as possible.
As an added bonus, when you say “I don’t know, let’s go figure it out together” with someone you are supporting, you are role modeling and teaching them skills to do this on their own next time there is a question or crisis. You are teaching self-sufficiency, better self-care skills and you are instilling confidence and hope. An expert in a shiny white lab coat who knows everything and answers every questions perfectly doesn’t teach me all those intangibles like working on it together as a team. Opening those yellow pages, making some calls and figuring it out. That’s powerful, not something that makes me feel dumb as a professional.
Today’s human service workers have a difficult job at times, but it’s also one of the most rewarding jobs you’ll ever have. Truly making a difference every day, even if you don’t see it and even if it’s just one person or one moment. The challenges with pay, workload and burnout aren’t new. But look at this well-informed person you are helping, the technological advances and tools available to us and this community of providers who are really starting to communicate and coordinate in meaningful ways.
We’ve come a long way and the sunny days seem to be more abundant than the cloudy ones, for all of us.
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