They save lives under fire — but who will save the social workers? | Miriam Reis
Social workers continue to save lives even during air raid sirens, but they pay a heavy mental price. Rates of secondary trauma and burnout are skyrocketing, and the collapse of the system could endanger patients and Israel's social resilience.
This is another routine day in the life of a social worker working under fire. Last night, a patient called my personal phone and said in a trembling voice that she did not feel safe at home and asked me to help her leave immediately. I have been fearing for her safety for some time, and I have been holding many conversations and meetings with her, far more than my time allows.
She needs a sensitive and warm gaze, someone who will be there for her step by step, until her understanding matures and she is able to see the reality of her life as it is. To see, and to survive what she sees and understands, without falling apart. More than she is afraid of being hurt at home, she is afraid of breaking down mentally from the intensity of the pain, the shame, the disappointment in herself, which could overwhelm her when she admits the truth: this relationship is dangerous.
Her readiness to leave the house and the dangerous relationship comes completely by chance when the whole country is under fire. I am working from home, five children with me, sirens rising and falling, and the waves of anxiety as well. My children have already been exposed for several years of emergency to a variety of stories from work that take place from home, and this time I go out into the empty street to manage the transfer of that woman to a safe place — a shelter for women.
Around me are interceptions, loud noises, planes taking off and landing. I am tense inside, I am tense outside, but focused on the goal: there is a life to save here. I am not alone in the mission, I have a manager, there is supervision, there is police, there is a shelter. We all together need to ignore the general emergency situation for a moment to continue managing the routine emergencies that are part of the daily life of our work.
In routine times, over 50% of social workers working with populations in trauma report symptoms of secondary trauma: a stress response resulting directly from indirect exposure to trauma within the framework of a therapeutic relationship with victims. The symptoms overlap with post-traumatic stress disorder (PTSD) and include intrusive thoughts, nightmares, hyperarousal, emotional apathy, and avoidance. About 15.2% of workers meet the full criteria for PTSD as a result of indirect exposure to trauma in their work, which is considered one of the reasons why professionals leave the field.
A joint study by the University of Haifa and Hunter College found that 83.6% of therapy and mental health professionals in the country suffer from symptoms of secondary trauma, and 44.7% experience average burnout. The highest levels of anxiety and secondary trauma were found among social workers treating bereaved families and families of hostages. Another study by the University of Haifa and Bar-Ilan University found that 18% of therapists developed symptoms of PTSD due to indirect exposure to war content.
The looming collapse of the social work system in Israel — due to mass departures, long sick leaves, and loss of work capacity of skilled personnel — will lead to a risk to human life and a risk to the social resilience of the State of Israel. Social workers are at the forefront of the response for people in distress: children at risk and the helpless, domestic violence, mental health, suicidality. Investing in the resilience of social workers is not a privilege, but a vital strategic interest for the State of Israel.
The author is a member of the executive committee of the National Union of Social Workers.
