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During my assessed and supported year in employment (ASYE), I was struck by how consistently ‘improving emotional resilience’ came up as a personal development goal.

Social work is known for being a demanding profession, requiring a great deal of emotional intelligence. The potential for vicarious trauma from supporting adults in extreme distress was something I was prepared for during the specialist mental health social work training scheme I undertook.

What I felt ill-prepared for was the unspoken need to balance the needs of the adults I support with those of the under-resourced organisation that employs me, which have frequently clashed.

Feeling conflicted

I found myself conflicted by the dual responsibility to deliver care and support tailored to each person’s circumstances, whilst managing a continually growing waiting list that was becoming unmanageable.

This tension has been particularly acute in my work with adults experiencing hoarding and self-neglect. This has provided some of the most enjoyable and rewarding experiences of my first year in practice – but also significant anxiety.

Research is clear that gradual, long-term, creative relationship-building is vital to securing sustainable outcomes for this group of adults, who frequently struggle to engage with services or reject support (Barnett, 2018).

Deficits in self-neglect practice

Such research also notes that this approach is still insufficiently practised; what you get instead are short-term, risk-averse and often traumatising interventions, such as ‘blitz cleans’.

Insufficient use of mental capacity legislation, including applications to the Court of Protection, is one of the most commonly noted practice deficits in self-neglect cases (Local Government Association, 2020).

Consequently, adults who may lack capacity to make decisions regarding their hoarding or self-neglect and who are at significant risk of harm have been erroneously discharged from services due to ‘non-engagement’ (Preston-Shoot & Braye, 2017).

In my experience, this stems from a stark inability for current statutory services to provide the long-term, time and resource-intensive work that is needed for many adults experiencing these difficulties.

Facing resistance from management

This can be seen at the statutory mental health service I work for, where waiting times reach up to 15 months.

When attempting to complete assertive outreach work with an adult who had experienced longstanding self-neglect and was both very averse to support and at high risk of harm, I experienced resistance from management.

This involved conversations about how the time taken working with this adult could have been spent supporting many more service users who “wanted to engage”.

Second-guessing yourself

Consequently, when making a lengthy application to the Court of Protection for another adult who lacked capacity to maintain her home safely due to hoarding, I found myself repeatedly second-guessing the need for such a time-intensive intervention.

I started to wonder whether I was erroneously prioritising individual interventions over offering support to the greatest number of people possible.

I doubt I am alone in feeling pressure to close cases early because of my caseload.

A recipe for burnout

What resulted throughout my ASYE year was an undercurrent of anxiety, low confidence in my own decisions and poor satisfaction with the work I was achieving – a perfect recipe for burnout.

Guidance from supervisors when I reflected on this anxiety was that I was internalising a service level pressure that was above my responsibility to manage: hence, the consistent drive to improve my resilience.

Yet, such a focus on individual resilience has been criticised as a neoliberal transference of responsibility from organisations to social workers (Garrett, 2015).

In other words, the burden often falls on practitioners to respond to circumstances in need of wider system change, rather than on organisations to make these changes.

I struggle to understand how social workers can communicate this state of affairs to those they support. When ending work with at-risk adults early, how do we ensure that is not perceived as them not struggling ‘enough’ for services to support them?

‘Good enough’ social work

How do we make clear the impact of limited resources on the extent of support we offer, without transferring the overwhelm we feel as a service and thereby eroding a sense of safety within public services?

Donald Winnicott (1953) spoke about ‘good enough’ parenting as a sustainable alternative to striving to provide a perfect, and impossible, experience of childhood. Pursuing ‘good enough’ social work – practising in the best means possible within the constraints of resources available – offers a coping strategy for practitioners.

But this only goes so far.

What is desperately needed is systemic change, backed up by the increased resources for statutory services that so many have demanded, over so many years, to no avail.

What I fear will continue to happen without this is that more practitioners will burn out and ‘vote with their feet’, exacerbating staff shortages and deepening the crisis in our services.