Predictors of Mental Health Outcomes Among Public Sector Social Workers in the Occupied Palestinian Territories

Background: Burnout, physical exhaustion, and secondary traumatic stress are common phenomena among social workers and human service professionals, especially for those working in conflict-ridden settings or emerging nations with fragile governance, such as the Occupied Palestinian Territories (OPT). Few studies have focused on mental health needs of Palestinian social workers who carry out duties under an arduous set of vocational, organizational, and environmental hazards, including Israeli military occupation. Despite severe obstacles to conducting research in OPT (e.g., personal safety, sporadic violence, distrust of researchers), the current study was conducted with two primary aims: a) to assess levels of three mental health outcomes (i.e., psychological distress, anxiety, somatic problems) and b) to examine workplace risk and protective factors for those outcomes among public sector social workers in the West Bank.

Methods: Data were collected through anonymous, paper-based surveys administered in-person to social workers at twelve local offices of the Ministry of Social Development in West Bank towns, such as Ramallah, Jericho, Salfit, Nablus, and Hebron. The 100-item survey consisted of adapted versions of standardized measures and was translated from English into Modern Standard Arabic by an international team of educators that used standard translation protocol to ensure accuracy. Measures for dependent variables were Kessler Psychological Distress Scale (K-10), Generalized Anxiety Scale (GAD-7), and Somatic Symptoms Scale (SSS-8). Independent variables included: years of employment, job stress, exposure to violence, job satisfaction, and job security. The final sample consisted of 207 (of 256 eligible) social workers, a high response rate (80.9%). Participants’ age ranged from 25 to 57 years; most were female (72.0%), married (76.2%), and held bachelor’s degrees (85.2%). Though missing data were generally low (< 4%), multiple imputation was used to create ten datasets, pooled for analyses. After univariate and bivariate analyses, ordinary least squares regressions was used to examine workplace predictors of outcomes.

Results: For the first aim, a high percentage of participants met clinical thresholds for two outcomes: distress (34.7%) and anxiety (19.3%). An exceptionally high percentage met criteria for somatic problems (70.9%). Relatedly, one in five workers reported poor or average physical health (20.2%). To address the second aim, multivariate models explained between 24-28% of the variance in outcomes. Job stress, exposure to violence, and job satisfaction emerged as significant predictors in two of three models; physical health had a protective effect in all models.

Conclusions and Implications: Based on our literature review, this study appears to be the first systematic attempt to measure levels of mental health problems in this population. Findings suggest that Palestinian social workers experience alarming levels of anxiety and distress, and extraordinarily high levels of somatic problems. Until a broader political solution to the Israeli-Palestinian conflict materializes, MOSA can utilize workplace levers (i.e., reduce stress and violence exposure, increase job satisfaction) to strengthen mental and physical health of social workers. Future research should examine practical mechanisms for accomplishing those goals, thereby promoting social change for frontline workers charged with caring for the most vulnerable, marginalized families in OPT.