December 7, 2020
Social workers provide numerous services to those in need, identifying and addressing challenges in health, home life, employment and finances. This year, COVID-19 has impacted all of those areas.
For many people, the virus has led to temporary or permanent job loss and, as a result, decreased access to health insurance, health care, food and medications. Social isolation, financial woes and fear about the future are leaving some people anxious and depressed.
Dr. Robert McKinney, director of the Office of Case Management and Social Services at University Medical Center, is a licensed clinical social worker. He said social workers, like many health and behavioral health professionals, are concerned about the impact of COVID-19 on the people to whom they provide services, their families and others in the community.
McKinney, also an assistant professor at The University of Alabama College of Community Health Sciences, sat down recently with Dr. Tom Weida, chief medical officer of UMC, to talk about how social workers are helping patients during the COVID-19 pandemic. CCHS operates UMC.
TW: What is a social worker?
RM: One of the great things about the profession of social work is that you could have 20 or 30 social workers in one room and none of them do exactly the same job. It’s a broad field. In the health care profession, we assist patients who are having issues related to access to health care, so people who don’t have health insurance, people who don’t have transportation. We help people who are having issues at home, so family dynamic issues related to children, parents or other family members. We help people in the University Medical Center setting. We help people who are unable to afford prescriptions by connecting them with medication assistance programs. We also, and me, as a licensed clinical social worker, provide clinical mental health therapy for patients, too.
TW: How does one become a social worker?
RM: In order to be a social worker in the state of Alabama, you must have a degree in social work from an accredited institution and you must have a license in social work.
TW: How do you get the license?
RM: You have to take a test, a significantly challenging test. It’s about four hours long. And then you renew (your license) every couple of years.
TW: Where are all the different places that social workers work?
RM: In hospitals, in doctors’ offices, in jails and prisons, sometimes in police departments, in clinical inpatient mental health settings and in schools. Social workers can work in a lot of different places.
TW: You mentioned that you do counseling. How did you get into that area as a social worker?
RM: Step No. 1 is training. Just having the license doesn’t mean you are able to do counseling. Built into our code of ethics is that we don’t practice outside of our training, that we don’t do things that we don’t think we’re qualified to do. Once you have had training, and are licensed to do clinical mental health work, then you can pursue that as your career or part of your career.
TW: What sort of things do you see with your counseling?
RM: My work, primarily, is with adults who are experiencing symptoms of anxiety and/or depression. Other social workers work primarily with children, and others work primarily with the geriatric population. Some people who are licensed clinical social workers might work in family dynamic situations and do group therapy. Some people might do substance abuse. There are lots of ways you can take that career path.
TW: Is there a role for social workers in COVID-19?
RM: There are lots of opportunities for social workers in COVID. If you are a member of the community and you’ve been told, for whatever reason, that you need to isolate or quarantine, that’s going to bring with it some significant challenges. The idea of having to stay in your home, or maybe in a room of your home or part of your home, for 10 to 14 days, potentially longer depending on what the exposure looks like, can be challenging. Sometimes people who are in that situation might not be able to get access to food, might be unable to get access to medications. So, there are opportunities for social workers there. Further, people who are experiencing some sort of loss or stress – they might have lost a job, might have lost a family member, might have lost friends, might have lost a combination of these things due to the pandemic – they might be dealing with stress and we as therapists can help with that, too.
TW: Have you had to change how you do social work as a result of COVID-19?
RM: At University Medical Center, our department has always used (University of Alabama) social work student interns. In March, when all of the students at the University (were dismissed for the semester), that fell to us in our department. So, we saw, in addition to picking up that, there was an increased need for services that, frankly, none of us was prepared for, none of us in the United States was prepared for. I think we’ve weathered the storm. We’re still in it but I think we’re doing quite well.
TW: Has how you deliver social work services changed?
RM: It’s changed dramatically. I like to say about social workers as professionals that one of our best skills is our ability to make and sustain relationships with our clients. For my career, that has involved sitting in a room with someone and having a conversation. (Because of COVID) We don’t do that so much anymore. Our conversations and our face-to-face interactions with our clients, patients at University Medical Center, are not the sort of stereotypical medical 10-to-15-minute interactions. Ours might last an hour or might last 90 minutes. And because of the safe distancing requirements that the pandemic has brought, that’s really challenging for us. So, we do most of our interactions with patients over the phone. I, as a slightly older person, didn’t think that this was going to go very well. But I will say that my interactions with patients over the phone have all gone well. The patients with whom we’re working have adapted pretty well to getting their health care and their social services needs met through telehealth delivery.
In addition, we work with other providers in the community who might provide things like assistance with food, assistance with clothing and things like that. We don’t provide those things at University Medical Center, but we connect patients with people who do. And a lot of that is sometimes done face-to-face but now everything is done over the phone. It’s a very different landscape. I think we have acclimated to it reasonably well, and some of it will continue beyond the pandemic I’m sure, for efficiency’s sake.TW: You mentioned that COVID-19 has affected the patients and the community. In what specific ways?
RM: Patients who have either lost their jobs or their spouses have lost their jobs, (there are) changes the way their health insurance looks. We’ve seen patients who, because of that, have an increased need for medication assistance. Patients who have, for various reasons, relied on community resources for assistance with food or assistance with clothing have been faced with the challenge of not being able to get those items in a face-to-face format. But I think by and large we’ve been able to meet (patient) expectations. And then clinically, I have worked with several patients who are experiencing significant stress related to the pandemic.
TW: Have these needs been overwhelming for patients?
RM: It depends. Some patients are remarkably resilient and have sort of responded to the stress of the pandemic reasonably well, very well. Others have not. Maybe their situations were different, or their backgrounds and histories are a little bit different. I think that we (UMC’s Office of Case Management and Social Services) have acclimated to the stresses of the increased patient needs, too.
