Immigrant-Serving Social Service Providers' Work Stress and Mental Health during the COVID-19 Pandemic: A Mixed Methods Study

Background and Purpose

Latinx have the highest rate of COVID-19 infection of any race or ethnic group in the Maryland-Washington DC region. While social services often target society’s most vulnerable, little remains known about the experiences of those who work with Latinx during the pandemic. This is significant as the region experienced ~80% and 16% growth, respectively, in its Latinx population in the last two decades and its immigrant-serving infrastructure has struggled to meet the needs of this population even pre-pandemic. This mixed methods study explores the work conditions, work stress and mental health of social service providers in the Maryland-DC region.

Methods

Social service providers serving Latinx immigrants (N=100) were recruited using purposive sampling from May 2020 - October 2020. Questions related to demographic and organizational characteristics, work-related stress, psychological distress (Kessler-6), and qualitative open-ended questions were included. Multiple regression examined the association between COVID-19 related work stress, local policies related to language appropriate information about COVID-19, and social support on psychological distress. Guided by social ecological theory, the research group analyzed themes from the narrative responses.

Results

A majority of participants identified as Latinx (45%), female (85%), between the ages of 25 and 44 years. Almost all indicated their clients were undocumented (97%) from El Salvador, Honduras, and Guatemala.

The majority (66%) had limited English proficient (LEP) clients while 39% indicated their organization had some of the time or never enough direct service providers to meet LEP client needs. Thirty-two percent reported that their organization was only able to meet the needs of their clients to a small extent or not at all during the pandemic, while 60% indicated the needs of their Latinx immigrant clients had changed to a great extent. Just 9% of participants reported that the federal administration facilitated access to reliable and language appropriate information about COVID-19 and over half indicated that the federal administration heightened fear of seeking services. One in ten participants reported clinical levels of psychological distress.

Controlling for social support (β = -0.067, p = .43), the multiple regression results revealed that service providers who believed that COVID-19 impacted their work stress (β = .52, p<.001), and believed that local policies are not responsive to reliable and language appropriate information about COVID-19 for their Latinx clients (β =-.17, p <.048), reported higher levels of psychological distress, R² = .33, F (3,94) =15.47, p <.001. As one participant noted, “...federal and state policies create barriers to care and well-being...The past few years have been especially challenging and just when you think it can’t get any worse, they do...It is difficult to foster hope in our clients when we ourselves are overwhelmed, frustrated...”

Conclusion

Findings highlight the role of federal, state and local policies in immigrant-serving providers’ work stress and mental health. Further, they shed light on the conditions of scarcity endemic in immigrant-serving organizations in new immigrant settlement cities with implications for the exacerbation of health disparities in a public health crisis.