Assessing Suicidal Ideation in Frontline Child Welfare Workers

Background and Purpose: Child welfare workers are vulnerable to mental distress due to burnout and traumatic stress. Suicidal ideation has not been investigated among child welfare workers; however, research suggests that workers in protective service fields such as emergency responders are at increased risk for completing suicide because exposure to trauma and violence may decrease fear of death. The purpose of this study is to understand the risk of suicidal ideation in a sample of frontline child welfare workers, and to explore factors that may contribute to worker mental/emotional distress.  

Methods: The Florida Study of Professionals for Safe Families (FSPSF) is a five-year longitudinal survey of newly hired child welfare case managers and protective investigators (n=1,501). The fourth wave of the survey (18-months post-hire) examined the mental health status of workers and included the PHQ-9, a screening tool for depressive symptoms. One 4-point Likert scaled item asked whether, in the past two weeks, participants have had “thoughts that you would be better off dead, or of hurting yourself.” Participants who screened positively for suicidal ideation were contacted by telephone by clinically-trained members of the research team and offered mental health resources. The results of the telephone calls were documented, and thematic analysis of this documentation was used to explore possible contributing stressors and resources for coping.

Results: A total of 65 child welfare workers screened positively for suicidal ideation (10% of participants still in child welfare at wave four), and ­­­37 participants responded to the follow up telephone calls. While some participants denied any current suicidal ideation, many acknowledged passive thoughts of suicide. Thematic analysis of respondents revealed that workers attributed ideation primarily to work-related stressors. Themes emerged related to workplace stress such as: high caseload, organizational pressures, and high turnover of co-workers.  Participants expressed concern with both the “volume” and “intensity” of caseloads, and described feelings of “pressure” and being “overwhelmed” with work expectations. Many participants were actively engaged in supportive mental health services such as counseling and medication management, but some participants reported that these supportive services were not enough to offset the stress associated the job. Several participants noted that leaving their child welfare position may be the best option for maintaining mental health and well-being.  

Conclusions and Implications: Due to the nature of their work, child welfare workers may have increased vulnerability to mental distress and accompanying suicidal ideation. Many of the workers in this sample were actively engaged in supportive services such as mental health counseling, but for some this did not appear to offset distress related to job conditions. Results of this study may be used to inform future research into the mental health of child welfare workers and to explore ways to mitigate the negative consequences of the strain of the job (i.e. debriefing during supervision sessions, encouragement for use of self-care strategies, etc.). This topic should be considered in discussions related to training and continuing education of child welfare workers, and organizational policies and practices related to workers’ mental health and well-being.