Summary
Mental health, wellbeing and retention are pressing concerns within children’s social care. This systematic review aims to summarise existing evidence on workforce interventions to improve mental health, wellbeing or retention of child and family social workers. Findings suggest a number of potentially promising interventions, particularly organisational level interventions. However, there is very little high quality or consistent evidence available, and more research is needed.
Objectives
The primary aim of this project was to review available evidence to understand the effects of workforce interventions on the mental health, wellbeing, and/or retention of child and family social workers.
In addition, this project aimed to review whether these interventions also had an impact on child and family outcomes, as well as their cost-effectiveness.
How We Went About It
Searches looked for comparative studies that evaluated the effect of workforce interventions on quantitative outcomes of wellbeing, mental health, and/or retention of child and family social workers.
Searches were carried out using twelve databases as well as websites, contacts with experts, and tracing citations from previously identified documents. Published or unpublished studies, reported in any language were included.
Key Findings
Fifteen studies (reported in 24 papers) were eligible for inclusion in the review. Of these, nine were carried out in the UK, four in the USA, one in Spain, and one in Australia.
Study quality
A review of the quality of included studies concluded that for most studies there were either serious or critical concerns over the ways in which they were carried out, or not enough information to be certain of their quality. This suggests that caution should be used when interpreting findings.
Individual-level interventions
Journaling of emotions and training in resilience skills (including mindfulness) produced mixed results for chronic burnout, compassion fatigue and other measures of psychological stress.
Organisational-level interventions
Promising results were found for strategies to enhance supervision and participatory organisational development (i.e. involving staff teams in decision-making and problem-solving for work-related issues).
Strengths-based service delivery models, and establishing social worker-led organisations independent of local authorities showed some evidence of positive effects but this was not consistent across all studies or all outcomes.
Providing enhanced supervision and professional support to newly qualified social workers, and training staff to lead mutual support groups, did not show benefits for the outcomes of interest.
Community-level interventions
A community-level intervention in which social services were co-located and integrated with other community services showed positive results for turnover and cost-savings. However due to methodological limitations of the study, the results should be viewed with caution.
Cost effectiveness and child and family outcomes
Only one of the included studies included a partial economic evaluation. This study indicated that the community-level intervention was potentially cost-saving.
No studies evaluated effects on child and family outcomes.
Implications
The review concludes that there is very little high quality evidence available with respect to the effectiveness of any of the interventions. In addition, different types of interventions each have a small evidence base and inconsistent outcomes. This makes it difficult to be confident when drawing conclusions about which interventions are effective.
There were tentative suggestions that interventions may be most effective when delivered at the organisational level. The most consistent findings were seen for strategies to enhance supervision and participatory organisational development (i.e. involving staff teams in decision-making and problem-solving). However, the quality of the evidence means that it is difficult to be confident in this finding.
Next Steps / What Next?
There is a need for more high-quality studies evaluating interventions at the individual, organisational and community level designed to support social worker mental health, well-being, and retention.