Depression in North Carolina Social Workers: Implications for Practice and Research.

This article explores depression in social workers, examines the potential negative professional consequences--that is, impairment--and investigates the personal and occupational variables associated with depression. One thousand active NASW members were anonymously surveyed as a part of the study "Work and Well-Being: A Study of North Carolina Social Workers," which explored a variety of health, work, and personal variables. The study found that 19% of the sample scored above the threshold on the Center for Epidemiologic Studies-Depression Scale measuring depressive symptoms, 16% had seriously considered suicide at some time in their lives, 20% were currently taking medication for depression, and 60% self-evaluated as depressed either currently or at some time in the past. Both occupational and personal variables were related to depressive symptoms. Key words: depression; impairment; social workers ********** Although social workers provide more mental health services than professionals in any other discipline (Center for Mental Health Services, 1999) little is known about their own mental health. Research about social workers is largely limited to studies about burnout, and a thorough review of the literature found very little information about depression among social workers. Yet, depression could be an important issue for social workers, not only because depression is found in high numbers in the general population, but also because it has been found to be even higher in caregiving professionals (Deutsch, 1985). One study of helping professionals reported a 57% lifetime rate of depression (Deutsch), and another from the United Kingdom found rates of depression to be higher in social workers than in the other helping professionals studied (Bennett, Evans, & Tattersall, 1993). Other disciplines have examined depression and other mental health concerns among their memberships, although the findings are limited and no recent studies have been conducted. Past estimates suggest that physicians suffer at least as many emotional problems, have a higher rate of suicide, and have a higher incidence of affective disorders than those of a comparable socioeconomic status (Doyle & Cline, 1983). Among studies of medical students, estimates for psychiatric illness ranged from 15% to 46% (Doyle & Cline). The field of psychology has reported that emotional distress exists in its ranks as well. Self-reports of depression and burnout were as high as 32%, and proxy reports for depression and burnout were as high as 63% (Wood, Klein, Cross, Lammers, & Elliott, 1985). Studies of depression among nurses are largely unpublished dissertations or studies of nurses outside the United States, and they typically report widely varying prevalence rates while exploring depression in relation to stress, burnout, and occupational risk factors (Baba, Galperin, & Lituchy, 1998; Lam, Ross, Cass, Quine, & Lazarus, 1999; Maurier & Northcott, 2000). Although depression can have serious personal consequences for any individual, depression in caregiving professionals may diminish the quality of their practice, creating negative consequences for their clients. Impairment, the negative professional consequence of any kind of distress, is not well defined or researched. The lack of comprehensive population-based studies makes it difficult to ascertain the prevalence of impairment (Flaherty & Richman, 1993). One study that addressed impairment reported that 62% of psychologists in the survey sample admitted working when too distressed to be effective, even though 85% of them believed it was unethical to practice when this distressed (Pope, Tabachnick, & Keith-Spiegel, 1987). Two models that explain impairment in helping professionals have emerged from the literature--burnout and compassion fatigue. With their origins in empirical generalization, each model was developing into an explanatory theory with very different notions of causality. …