stress in social services: mental wellbeing, constraints and job satisfaction

doi:10.1093/bjsw/bch088

RESEARCH NOTE

Stress in Social Services: Mental Well-being, Constraints and Job Satisfaction

Margaret Coffey, Lindsey Dugdill and Andy Tattersall

Margaret Coffey studied at Liverpool John Moores University before taking up a postdoctoral

research post in the Faculty of Science, researching stress in social services. Recently she has

been involved with Dr Lindsey Dugdill in a large health at work consultation in Sefton,

Merseyside, with over 200 organizations. Currently she is a lecturer in Health at Liverpool

Hope University College.

Lindsey Dugdill has worked in the field of occupational/workplace health research for over ten

years. Her work has been implemented within a wide range of organizations in the north west of

England. At a national level she worked as research advisor and trainer to the Health Education

Authority’s Health at Work in the NHS programme and also with the Department of Health

Workplace Task Force (1992). Internationally, the World Health Organisation has published

her work on workplace health evaluation (1999, 2001). Most recently, she has carried out a large

health at work consultation in Merseyside with over 200 organizations.

Andrew Tattersall studied at the University of Wales and the University of Oxford before taking

up a postdoctoral research post in the stress and workload team at the MRC/ESRC Social and

Applied Psychology Unit, University of Sheffield. Following nine years as a lecturer in

psychology at Cardiff University, he is now Director of the School of Psychology at Liverpool

John Moores University.

Correspondence to Margaret Coffey, Liverpool Hope University College, Room AEW 098,

Hope Park, Liverpool L16 9JD, UK. E-mail: [email protected]

Summary

The public sector is facing an impending shortage of staff, because young people no

longer want to work in it and nearly a third of its workforce is over 50 years of age. Staff

working within the public sector report that stress is the biggest single factor affecting

their decision to leave. This research note reports the findings of a recent study carried

out in two social service departments in the north-west of England. The primary aim of

the research was to explore work-related stress, using a ‘problem diagnosis tool’ to

understand the stressors experienced by social services staff, and to inform the

development of interventions aimed at reducing and/or eliminating them. This study

used in-depth interviewing to develop a questionnaire incorporating a variety of

Job No. 10263 MFK-Mendip Page: 735 of 746 Date: 25/6/04 Time: 10:30am Job ID: Social Work Op: mford

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British Journal of Social Work (2004) 34, 735–746

measures to assess potential stressors and mental well-being. The questionnaire

response rate was 33 per cent (n ¼ 1234) and the results demonstrated statistically

significant differences between staffing grades. Staff working with children and

families reported the highest levels of absenteeism, poorest well-being, and highest

level of organizational constraints. Job satisfaction was low compared with established

norms for various occupational groups. This grounded research baseline is a crucial step

to inform specifically designed and targeted interventions, which can be effectively

evaluated from this baseline position.

Keywords: stress, social services, well-being.

Introduction

The Audit Commission’s Report ‘Recruitment and Retention—a public

service workforce for the twenty-first century’ (2002, p. 2) stated that the

public sector is facing an ‘imminent staffing crisis’ because young people no

longer want to work in it and nearly a third of its workforce are over 50 years of

age. The situation is described as a potential ‘demographic time bomb’, with

further concerns about ‘skill shortages, both in terms of basic skill levels in the

workforce, and in the key leadership, management and technical skills that are

needed to deliver public service improvements’.

The latest Department of Health figures show that 9.4 per cent of posts

within social service departments (SSDs) were vacant in September 2001

(Employers Organisation, 2002). Although the overall level of vacancies fell in

most employee groups in the previous year, the vacancy rate increased by over

2 per cent amongst children’s residential manager and supervisor posts. The

biggest single factor in people’s decisions to leave was reported to be work-

related stress (Audit Commission, 2002).

There is reasonable consensus in the scientific literature on the psychosocial

and organizational hazards of work that stressful working conditions are

associated with poor mental and physical health (Cox et al., 2000a, 2000b;

Health and Safety Executive, 2000; European Commission, 1999). Stress-

related absence reportedly results in 187 million working days lost annually,

costing the country £12 billion each year (Confederation of British Industry

cited in Stuart, 2001). Whilst it is clear that there are variations in levels of

absence and associated costs to organizations across different occupational

groups, staff in the social services are reported to suffer higher levels of

sickness than staff in the private sector and other branches of local government

(Employers Organisation, 2000). Absences averaged 15 days sickness per

social service employee in 1998/99, with manual social care workers reported to

take nearly four weeks off. By region, northern UK authorities tend to have

the highest absence rates (Employers Organisation, 2003).

The European Commission’s (1999, p. 74) Framework Directive encourages

employers to try to ‘eliminate the stressor(s)’. However, preventative activities

are still comparatively rare, and ‘a review of the stress management literature



736 Research Note

reveals that most interventions are weak, targeting only the individual, and

very few are adequately designed or evaluated in scientific terms’ (Cox et al.,

2000b, p. 120; Springett and Dugdill, 1995). Moreover, few studies to date have

reported positive results, with frequent methodological limitations in the

research that has previously been published (Nytro et al., 2000). It has been

argued that this is leading to a growing feeling of discontent with the stress

management industry, which may offer solutions that can do more harm than

good, for example relaxation therapies, when in fact the problem is that staff

have been forced to take on too much work (Briner and Reynolds, 1999).

Earlier research has argued that there is a tendency to apply stress

management strategies without an initial ‘problem diagnosis’ stage and to focus

on single, rather than multiple intervention strategies (Cox et al., 2000b). This

is a form of damage limitation which generally addresses the consequences of

stress rather than its sources (European Foundation for the Improvement of

Living and Working Conditions, 1997).

This Research Note presents the findings of a recent large-scale study

carried out in two SSDs in the north west of England. These departments are

part of large borough councils, together serving the needs of over 600,000

people living within their boundaries. The primary aim of the research was to

develop and use a ‘problem diagnosis tool’ to explore sources of stress and

their impact on staff, in order to inform the development of targeted

interventions aimed at reducing stress. This study is unique, as it uses the

Organisational Constraints Scale (Spector and Jex, 1998) to assess organiza-

tional constraints within social services.

Respondents

The target population was the entire staff of two UK SSDs (SSD1: n ¼ 2,271,

SSD2: n ¼ 1,500). This population comprised 80 per cent female and 20 per

cent male staff working within two main staffing groups, salaried staff (higher

grades) and weekly paid staff (hourly rate of pay). The respondents were split

into two staffing grades because research has shown (see, for example,

Mullarkey et al., 1999; McLean, 1999) that these two grades experience

different pressures within the workplace. The SSDs comprise four main

divisions: Children’s Division; Adult Services Division; Directorate and

Support Services Division and Adult People with Special Needs Division.

Methods

Stress is difficult to measure because the process of interaction between a

person and their working environment is rarely static (Cox et al., 2000b).



Research Note 737

Therefore, a single method, such as a questionnaire, however ‘client centred’,

can never tap the whole of a respondent’s ‘world view’ or experiences (Shipley

and Orlans, 1988). To combat this, following the principles of ‘triangulation’,

multiple methods of measurement were used in this research (Cox et al., 2000b;

Ivancevich and Matteson, 1988).

Initially, following Goldenhar et al.’s (1998) conceptual model, background

information was gathered to clarify the scope of the project. The second stage

involved carrying out in-depth interviews with a sample of female staff (n ¼ 8)

to investigate issues that staff felt affected either their working lives or their

health. This information was then used to design a questionnaire as a ‘needs

assessment’ instrument (Dugdill, 1996).

Measures

Organizational Constraints Scale (OCS) (Spector and Jex, 1998)

The OCS was designed to identify situations that ‘prevent employees from

translating ability and effort into high levels of job performance’ (Spector and

Jex, 1998, p. 357). Each area is assessed with a single item, ranging from 1 (less

than once per month) to 5 (several times a day), and high scores represent high

levels of constraints. Coefficient alpha in this study was 0.88.

Job Satisfaction (JS) (Warr et al., 1979)

This scale measures overall job satisfaction, including extrinsic job satisfaction,

(features external to the work, for example the way the firm is managed, pay)

and intrinsic job satisfaction (people’s affective reactions to features integral to

the work itself, for example autonomy, variety), with higher scores represent-

ing greater levels of job satisfaction. In this study, internal reliability was good,

with coefficient alphas of 0.89 (overall), 0.75 (extrinsic) and 0.88 (intrinsic).

Mental well-being—General Health Questionnaire (GHQ-12) (Goldberg,1972)

The GHQ-12 is a twelve-item scale widely used in occupational settings to

measure psychological distress or mental health (Mullarkey et al., 1999). This

scale is used to identify ‘caseness’, that is whether or not an individual would be

classified as suffering from minor psychiatric disorder on the basis of

psychiatric assessment. The threshold for case classification in recent studies

has been equal to or greater than 4, with higher scores representing poorer

well-being (Mullarkey et al., 1999, Prior et al., 2002). Coefficient alpha in this

study, using the GHQ scoring method was 0.91.



738 Research Note

Absenteeism

Absenteeism was measured using two self-report questions: have you been

away from work because of your own sickness or injury in the last six months?

and were any of your absences in the last six months caused either by injuries

sustained at work or by you being affected by your working conditions (if yes,

details were sought)?

Results

The overall response rate was 32.7 per cent (n ¼ 1,234), comprising 81 per cent

female staff (n ¼ 1,000), and 19 per cent male staff (n ¼ 228), (six staff did not

identify their gender); 357 of the respondents (29 per cent) were aged at least

50.

Qualitative and quantitative results from the surveys are reported below.

With respect to organizational constraints, job satisfaction, and mental well-

being, no statistically significant differences were found between the two

departments in this study (p 4 0.05), therefore the reported analyses are

based on the whole sample. Also, because of the small number of weekly paid

staff in Directorate and Support Services Division, differences between job

grades were carried out using Independent Samples t-tests and differences

between divisions were tested using one-way ANOVA. The qualitative data

were generated from open-questions in the questionnaire, which asked, ‘what

is the most difficult aspect of your job?’ and ‘what could be done to make that

difficulty less of a burden?’

Organizational constraints scale results

In respect of the OCS, there is a published norm of 21.30 (Spector, 1998), and

higher scores represent a greater the number of constraints, that is situations

that interfere with task performance. Table 1 indicates that the overall level of

reported organizational constraints was higher than the published norm for


Table 1 Mean levels of organizational constraints (Spector and Jex, 1998) by division and grade

Organizational Constraints Scale

Overall W/P S

Mean score No. Mean score No. Mean score

Total sample (n ¼ 1,019) 22.41 336 18.85 637 24.37

Children‘s Division (n ¼ 240) 24.67 31 23.00 194 25.07

Adult Older Division (n ¼ 313) 20.12 197 17.58 106 24.66

Directorate and Support Services (n ¼ 154) 22.81 5 15.40 141 23.38

W/P ¼ weekly paid staff, S ¼ salaried staff


Research Note 739

salaried staff, and significantly higher for salaried staff than weekly paid staff,

(t (961) ¼ 0.862, p 5 0.001). There was also a significant effect of Division (F

(3, 1138) ¼ 7.390, p 5 0.001). Post-hoc Tukey tests showed that reported

levels of constraints were significantly higher in Children’s Division than Adult

Older Division, who reported levels of constraints significantly lower than all

of the other Divisions (p 5 0.05). Overall, Children’s Division reported the

highest levels of constraints in both groups of staff, and Adult Older Division

staff reported the lowest mean level of constraints. In terms of the specific

constraints, interruption by other people was reported to affect 34.1 per cent of

staff several times per day, followed by conflicting job demands (13.5 per cent),

lack of equipment or supplies (8.2 per cent) and poor equipment or supplies

(7.6 per cent). Interruption, the most frequently reported constraint, has been

found to have a negative impact on the state of the person, in the sense that

‘the emotional feeling became less positive and well-being diminished’

(Ziljlstra et al., 1999, p. 183), causing an increase in ‘effort expenditure’.

Additional open-ended questions were responded to as follows:

What is the most difficult aspect of your job?

In response to this open question there were a substantial number of different

replies, which were grouped into themes. The largest number of responses

indicated that the most difficult aspect of the job was the lack of time and rigid

timescales in which to do the job properly.

Time factor—trying to juggle pending workload with urgent tasks and

feeling guilty and stressed for not giving pending workload the attention itneeds (Female—33, weekly paid, part-time—Adult Older Division).

This was followed by difficulties dealing with service users—issues around their

various needs, especially in terms of challenging behaviour, abusive/demanding

clients, dealing with life/death situations, taking people’s liberty away, etc.

Coping with the demands of so many families with complex needs. I worry

about missing something wrong with the child (as in child protection)(Female—57, salaried, full-time—Children’s Division).

Staff reported further pressures because of a lack of staff to cover the

workload:

Lack of trained staff, permanent anxiety regarding finding appropriate staffis a major area of concern—the work still has to be done and we have

responsibilities to fulfil, however the department doesn’t always appreciatethese difficulties (Female—50, salaried, full-time—Children’s Division).



740 Research Note

What could be done to make this difficulty less of a burden?

A substantial number of different responses were received to this question, of

which the largest number by far indicated that the way to ease their difficulties

was to employ more staff, especially trained, permanent, competent staff and

to replace staff who leave as quickly as possible:

More staff/workload to be lessened so that things can be done in the time

allotted that are of importance to the service user’s needs (Female—28,weekly paid, part-time—Adult People with Special Needs Division).

This was followed by more support and understanding of working conditions

and the nature of the job—recognition and appreciation of hard work:

Provide more support. Managers cannot support staff when they are underimmense pressure re. sickness absence/best value etc. (Male—31, weekly

paid, part-time—Adult Older Division).

Staff also wanted more training, both internal and external, including

management training, especially before new procedures were implemented:


Table 2 Job satisfaction (Warr, Cook and Wall, 1979) by division and grade

Job Satisfaction Score

Overall Intrinsic Extrinsic

Client group Total W/P S Total W/P S Total W/P S

n 1,096 376 652 1,149 396 682 1,143 396 675

Total sample 4.19 4.08 4.24 4.22 4.14 4.27 4.16 4.07 4.20

Children‘s Division 4.24 4.28 4.24 4.33 4.42 4.33 4.14 4.21 4.14

Adult Older Division 4.10 4.13 4.04 4.11 4.15 4.05 4.11 4.14 4.04

Directorate and Support Services 4.32 4.62 4.28 4.34 4.51 4.33 4.31 4.72 4.25

Adult People with Special Needs 4.17 3.89 4.33 4.20 4.00 4.30 4.17 3.85 4.33


Table 3 Mean levels of mental well-being (Goldberg, 1972) by division and grade

GHQ—12 Score (GHQ Scoring Method)

Overall W/P S

Client groups n Mean n Mean n Mean

Total sample 1,159 3.18 405 2.39 689 3.62

Children‘s Division 1,264 3.90 34 3.68 209 3.92

Adult Older Division 1,369 2.54 241 2.18 116 3.10

Directorate and Support Services 1,170 3.46 10 2.50 151 3.70

Adult People with Special Needs Division 1,339 3.20 114 2.40 203 3.59



Research Note 741

I feel that I have too much responsibility and I am asked to undertake tasksthat I have had little or no training in, causing me to feel stressed

(Female—27, salaried, full-time—Children’s Division).

Job satisfaction results

Extrinsic job satisfaction refers to features external to the work, for example

the way the firm is managed and pay, whereas intrinsic job satisfaction

concerns people’s affective reactions to features integral to the work itself, for

example autonomy, variety. Higher scores represent greater levels of job

satisfaction. Previous research in local authorities (n ¼ 4,442) reported an

overall mean job satisfaction level of 4.35 (Mullarkey et al., 1999), whilst the

workforce studies of staff in social service departments in England reported an

overall mean job satisfaction level of 4.65 (McLean, 1999). Table 2 indicates

that in this study the mean level of overall job satisfaction, 4.19, was

considerably lower than previous research had indicated. Staff reported that

the main areas they were very/extremely dissatisfied with, were; the way the

organization is managed; chance of promotion; rate of pay; industrial relations

and recognition for good work.

Using an Independent Samples t-test, salaried staff reported significantly

higher levels of overall job satisfaction than weekly paid staff (t (1,026) ¼11.52, p 5 0.05). One-way ANOVAs revealed no significant differences

between Divisions (Intrinsic JS, F (3, 1127) ¼ 2.37, p 4 0.05, Extrinsic JS,

F (3, 1123) ¼ 1.52, p 4 0.05, Overall JS, F (3, 1076) ¼ 1.93, p 4 0.05).

Interestingly, staff in the Children’s Division did not report lower levels of

satisfaction to those in other divisions, despite reporting higher levels of

constraints.

GHQ-12 results

For comparative reasons, following the Health Survey for England 2000 (Prior

et al., 2002) a score of 4 or more was used as a cut-off point in this study. Higher

GHQ-12 scores represent poorer well-being.


Table 4 GHQ ’Cases‘ by division and grade

GHQ ‘Cases’ with Scores of 4 or over

Children’s

Division

Adult

Older

Divison

Directorate

and

Support

Services

Adult People

with Special

Needs

Division

W/P S W/P S W/P S W/P S Total

Total 14 87 63 41 2 65 37 83 1,392

No. 34 209 241 116 10 151 114 203 1,078

Percentage 41 42 26 35 20 43 32 41 1, 36



742 Research Note

Table 3 shows that salaried staff reported significantly higher GHQ-12

scores than weekly paid staff (t (1089) ¼ 24.71, p 5 0.001). A one-way

ANOVA indicated a significant difference between the Divisions (F (3, 1138)

¼ 7.39, p 5 0.001). Post-hoc Tukey tests showed there was a significant

difference between Children’s Division and Adult Older Division, and Adult

Older Division and Directorate. Staff in Adult Older Division had the lowest

GHQ-12 scores throughout the Department (2.54), whilst staff in Children’s

Division had the highest (3.90).

Overall, 36 per cent of the respondents in this study would be considered as

‘cases’, or as suffering from mental distress, using the GHQ scoring method.

These results compare unfavourably to the workforce studies that reported

that 21 per cent of staff overall scored two or more using the GHQ-12

(McLean, 1999). In this study, the highest proportion of those scoring four or

more was found amongst salaried staff, with weekly paid staff generally

reporting lower levels of caseness. These grade differences in mental distress

are similar to those found in the workforce studies, where managers and field

social work staff reported GHQ-12 levels of 3.57 and 3.24, respectively,

compared with home-care and residential workers who reported levels of 1.71

and 2.67, respectively. The highest levels of mental distress were reported in

Children’s Division, where 42 per cent of salaried staff and 41 per cent of

weekly paid staff would be considered ‘cases’. Similarly, a study of social

workers carried out by Bennett et al. (1993, p. 41) reported ‘that those

employed in childcare services had significantly higher stress outcomes, greater

perceived stress from a variety of sources, and were less able to distance

themselves from these stresses than other groups’.

Table 5 indicates that more salaried staff reported being absent from work in

the previous 6 months due to illness than weekly paid staff, (w ¼ 8.21, p 50.01). Children’s Division reported the highest levels of sickness absence from


Table 5 Absenteeism by division and grade[Q]

One or more bout of

absence from work (in

previous 6 months) due

to illness

Absences from work

(in the previous 6

months) due to work-

related

injuries

Client groups Total W/P S Total W/P S

Total sample % 49 43 52 17 17 17

n 1,220 434 711 790 275 457

Children‘s Division % 54 54 52 17 10 17

n 263 35 207 180 29 134

Adult Older Division % 42 42 41 15 16 15

n 389 252 123 248 162 75

Directorate and Support Services % 52 27 53 18 25 19

n 180 11 159 113 4 102

Adult People with Special Needs % 52 43 37 20 24 18

n 370 130 215 235 74 141



Research Note 743

work amongst the divisions, which may be a reflection of the high levels of

caseness reported in this division. Absences due to work-related injuries were

much less prevalent, with the highest levels (52 per cent) reported by Adult

People with Special Needs Division. Stress-related absence accounted for the

biggest cause of work-related absenteeism, followed by infections caught at

work and back problems. Overall, 50 (4.3 per cent) staff reported being off

work due to stress-related illness, of whom 34 (4.9 per cent) were salaried and

16 (3.95 per cent) were weekly paid.

Correlations were carried out between the main outcome measures, of

organizational constraints, job satisfaction and GHQ-12. Also included were

the demographic variables of age, number of hours worked per week and

length of time working in the organization. GHQ-12 scores were found to be

positively correlated to the level of organizational constraints reported (r ¼0.42, p 5 0.001), number of hours worked each week (r ¼ 0.188, p 5 0.001)

and length of time working in the organization (r ¼ 0.08, p 5 0.05), and

negatively correlated to reported levels of intrinsic job satisfaction (r ¼ 0.393,

p 5 0.001), extrinsic job satisfaction (r ¼ 0.429, p5 0.001) and overall job

satisfaction (r ¼ 0.442, p 5 0.001).

Conclusion

The main findings from this unique large-scale study reveal that: mental well-

being (GHQ-12) is poorer than previous studies have indicated; job

satisfaction is considerably lower than previously reported; and organizational

constraints, which have not previously been reported in social service

departments, are higher than the published norm in other sectors. Salaried

staff reported more stressors than weekly paid staff, and the worst affected

division appears to be Children and Families Division, suggesting that the

situation in social services is worse than previously thought.

References

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(2000a)Organisational Interventions for Work Stress: A Risk Management Approach,Nottingham, HSE Books.



744 Research Note

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Research Note 745

Warr, P. B., Cook, J. and Wall, T. D. (1979) ‘Scales for the measurement of some workattitudes and aspects of psychological well-being’, Journal of Occupational

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mental work: Effects of interrupted activities’, Journal of Occupational and

Organizational Psychology, 72, pp. 163–85.



746 Research Note

stress in social services: mental wellbeing, constraints and job satisfaction

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