Mackie, Paul Force-Emery

English

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Social Workers in RuralPlaces:A Study of  Practitionersin the Upper Peninsulaof  MichiganPresenterPaul Force-Emery Mackie, MSW, PhDAssociate Professor/BSSW Program DirectorDepartment of  Social WorkMinnesota State Universitypaul.mackie@mnsu.eduPresented atNational Association for Rural Mental Health38th Annual Conference. May 18, 2012.Anchorage, AlaskaIntroduction A little about me Currently BSSW Program Director and Associate Professor of Social Work at Minnesota State University Research – Rural mental health and social service labor force shortages, challenges of practitioners in rural areasThe Study The Upper Peninsula of Michigan is rural  (Ok, not “Alaska rural”) - How rural? REALLY rural... Land mass equivalent to RI, DE, CT, & NJ, combined (total pop of 4 states = 14.3 million) (794 persons per square mile) About 299,000 people live in the UP (16.5 persons per square mile) 3 of 15 UP counties are “frontier” (<7people per square mile) If the UP were its own state, it would be the only one in the union 100% rural A “perfect lab” for rural researchBackground: Poverty Social problems in UP are comparable to other places Overall UP poverty rate = 15.8%; MI rate = 16.1%; US rate = 14.3% Family UP poverty rate = 17%, MI rate = 16.4%; US rate = 15.3% Single-headed household poverty rate: UP = 46%; MI = 40.6%; US = 37.1%In addition:  Hilton & DeJong (2010).  Study of homelessness in the UP.  Several types of homelessness.  Many homeless families identified.Background:Mental health and social servicerural labor force issues  Mackie & Lips (2010).  Rural MN, 86% of rural social service providers wanted to hire BSW level social workers, but could only do so about half the time.  Hired from related disciplines.  Could not fill positions from this pool of applicants either. Mackie (2007).  Sowkers currently in rural practice sig more likely to have grown up in rural, completed rural field placement, been exposed to rural content in education. Mackie & Simpson (2007). UG sowk students in UP and MN.  Those from rural areas much more interested in working in rural vs those raised in urban locations. President’s New Freedom Commission on Mental Health (2003).  Serious lack of rural mental health practitioners across all fields of practice.  Forecast to continue in future. Carr & Kefalas (2009).  The rural “brain drain” and negative implications.The Study:SOWK in a very rural place Research questions1. What are demographic, gender, age differences among UP social workers?2. Why do UP social workers live and work here?3. What do UP social workers define as challenges and benefits of working in this region?4. What do UP social workers define as challenges and benefits of living in this region?The Study:  Data CollectionData collection Sample/Method Mailed pencil/paper survey:  UP social workers identified through NMU social work program(86) and MI NASW (139), total sample = 225.  Response rate = 87 (39%).  Questions: demographics, where grew up, educational background. Open-ended survey questions:  Reasons for living/working in UP, challenges to working in UP. Face-to-face interviews:  12 in-depth interviews (male = 5, female = 7, µ age = 40.75.  Identified using snowball method, key informants identified and referrals of others.  Interviews semi-structured, 1.5 – 2 hours/length.  Questions focused on general descriptions of living/working in UP, challenges of practice, joys of practice.The Study:  Data Analysis Quantitative analysis: SPSS (descriptive and univariate), group comparisons. Qualitative analysis: Open-ended questions analyzed using Pragmatic Analysis (Patton, 1988).  Allows to analyze questions without ability to re-connect with respondents. Face-to-Face interviews analyzed using Inductive Analysis (Patton, 1990).  Allows for the discovery of important categories and interrelationships without starting from an a priori perspective (not deductive).  Also allows for triangulation of other data sources (open-ended and quantitative findings).The Study:  Survey Results Quantitative Male age (µ = 50.66, SD = 11.76) similar to females (µ = 51. 58, SD 10.01).   MSW highest degree = 55 (68.8%) BSW highest degree = 12 (27%) Other (grand-parented as SOWKer) = 3 (4.2%) 2/3rds of sample grew up in rural area About 1/2 completed field placement in rural area 33% of BSWs & 38% of MSWs exposed to rural content during their education Ss reported that they are now (in the UP) on ave 300 miles from where they completed educationSurvey Results, con’t No sig diff between gender & degree levels and: Size of community where grew up Distance now living from where grew up Grew up in rural or non-rural area Undergrad-level coursework in rural concepts Undergrad-level rural or urban practicum location Grad-level coursework in rural concepts Grad-level rural or urban practicum location(see table 1, next slide)Table 1:  Subject and demographic characteristics  Characteristics     µ  (SD)  n   %  Range   Age         Male   50.66  (11.76) 34      Female   51.58  (10.01) 36 Highest degree earned      BSW       12   27.0      MSW       55   68.8      Other†       3   4.2 Distance to nearest urban     area (> 50,000) (in miles) 162.67  (85.20)    400 Population of county where     currently employed 34,453  (22,855)    72,000  Grew up in rural area? Yes    % No       %            Group  45     66.2  23     33.8     Educational background Yes % No %      don’t recall %    Undergraduate coursework included rural     specific content? 18     33.3   29     53.7      7                13.0 Completed practicum in    rural area?       28     52.8   25     47.2      0               Graduate Coursework that included      rural concepts?   18     38.3      28     59.6           1             2.1  Completed practicum in      rural area?        25     54.3          21     45.7      0                     Distance (in miles) µ  (SD)  n   Range   Distance currently      from where earned      undergraduate degree 239.02  (219.41) 51   750 Distance currently      from where earned      graduate degree 321.86  (244.78) 43   1200 ______________________________________________________________________________ † = BS/BA, MS/MA, Doctorate Survey Results, con’t Differences were identified based on age (older/younger workers, separated at medium of 41.5 y/o) on two variables: Distance now living from where grew up Younger workers (µ = 1.15, SD = .376) live closer to where they grew up compared to older workers; (µ = 1.49, SD = .505), t = -2.25, p = < .05 Grew up in rural or non-rural area Younger workers more likely to have grown up in a rural area (µ = 1.00, SD = .000) compared to older workers (µ = 1.42, SD = .497), t = 2.99, p = .01 Interpretation:  Younger workers more likely regionally affiliated (grew up in or near UP).  Older workers more likely grew up farther away and less likely to have grown up in rural area.Older workers may represent a group who have gravitated to UP for lifestyle, professional, or family reasons.  Perhaps older workers may be self-selecting working here, whereas younger workers are here because this is where they are from and are still earlier in their careers.(See table 2, next slide)Table 2:  Gender and age differences between UP social workers        Male (N = 33)         Female (N = 35) Gender      µ          (SD)          µ          (SD)    t   Size of community where      grew up    3.85 (2.54)  4.69 (2.82)       1.285 (NS) Now live within reasonable      distance from where grew up 1.52 (.508)  1.32 (.482)      -1.436 (NS) Consider where you grew      up as rural    1.39 (.496)  1.29 (.458)        -.935 (NS) Undergraduate coursework      included rural specific content 1.70 (.542)  1.89 (.751)         1.039 (NS)  Undergraduate practicum      completed in rural area  1.58 (.504)  1.52 (.643)         -.367 (NS) Graduate coursework      included rural specific content 1.61 (.499)  1.67 (.565)         .372 (NS) Graduate practicum completed      in rural area   1.50 (.512)  1.42 (.504)        -.556 (NS) ______________________________________________________________________________  Age        Younger (N = 13)      Older (N = 53)             µ     (SD)            µ      (SD)         t   Size of community where      grew up       4.77   (1.48)  4.23 (2.93)  .645 (NS) Now live within reasonable      distance from where grew up    1.15   (.376)  1.49 (.505)  -2.252* Consider where you grew      up as rural       1.00   (.000)  1.42 (.497)  -2.991**  Undergraduate coursework            included rural specific content    2.00  (.667)  1.76 (.656)   1.029 (NS) Undergraduate practicum            completed in rural area     1.30   (.483)  1.61 (.586)  -1.544 (NS)  Graduate coursework             included rural specific content    1.86  (.690)  1.59     (.498)   1.232 (NS) Graduate practicum completed      in rural area      1.29   (.488)  1.49     (.506)    -.974 (NS) ______________________________________________________________________________ *p < .05, **p < .01 NS = Not Significant Open-Ended Questions:  FindingsWhy do social workers live and practice here? Category One:  Rural lifestyle. Theme 1: Prefer living in rural place Sub-theme:  Wilderness, outdoor recreation Theme 2: Grew up in rural culture Sub-theme: Safe/comfortable place to live Category Two: Family ties and connectedness. Theme 1: Family lives in the area Sub-theme: Spouse &/or family lives here Theme 2:  Good place to raise a family. Safe/healthy place for children Category Three:  Employment. Theme 1:  Enjoy working in rural areas Professional autonomy and freedom Theme 2:  UP is where the job was located Sub-theme 1: Couldn’t find work elsewhere Sub-theme 2: MSW degree in demand in UPOpen-Ended Questions, con’tWhat are the challenges of practicing here? Category One: Transportation/Geographic space. Theme 1: Consumer transportation Sub-theme: lack of public/affordable transportation Theme 2: Provider transportation Sub-theme: low reimbursement, distance Category Two:  General lack of resources. Theme 1: Lack of financial resources Sub-theme 1: Getting/keeping agency funding Sub-theme 2: State funding not distributed equally Theme 2: Lack of services for consumers Sub-theme : Lack of psychologist, psychiatrists, specialistsOpen-Ended Questions, con’tChallenges, continuedCategory Three: Professional challenges. Theme 1: Dual relationships Sub-theme: Practitioner known/lack of privacy Theme 2: Continuing education & training Sub-theme: Lack of training opportunities, available trainings too far awayCategory four: Economics. Theme 1: Consumer unemployment & povertyFace-to-Face Interview QuestionsWhat are the challenges of practicing here? Category One:  Direct professional challenges Theme 1: Lack of professional training opportunities Sub-theme 1: Lack of cultural knowledge among providers Sub-theme 2: Lack of Veteran service knowledge Theme 2: Geography/location and distance among/between providers & clients Sub-theme 1: Dual relationships/personal relationships Sub-theme 2: Lack of peer support/professional connectednessFace-to-Face Interview Questions, con’tChallenges, (con’t) Category Two:  Lack of client resources Theme 1: Lack of child welfare services Sub-theme 1: family/youth homelessness, lack of affordable housing, poverty among children Theme 2: Lack of client resources Lack of specialists (psychologist, psychiatrists, child therapists) Theme 3: General lack of resources Overall lack of resources (unspecified) Theme 4: Homelessness General homelessness, lack of resources for housingFace-to-Face Interview Questions, con’tWhat are the professional benefits  of practicing here? Category One: Professional joys Theme 1: Helping families/children Sub-theme 1: Creating healthy and safe environment for families/children Sub-theme 2: Helping families/children overcome problems of: Poverty, homelessness, abuse, neglect, addictions Theme 2: Ability to help people in need (general) Sub-theme 1: Ability to see results of my work & have a lasting impact Sub-theme 2: Ability to help people I know and care about; Yoopers helping YoopersFace-to-Face Interview Questions, con’tWhat are the personal benefits of practicing here?Category One:  Personal joys Theme 1: Strong sense of community Sub-theme 1: Community pride and values A sense of belonging Great place to raise a family Theme 2: Relationship with peers Sub-theme 2: Providers work well together Collegial relationships with peers, friendships in the workplaceFace-to-Face Interview Questions, con’tOverall, how do you describe working here?Category One: Positives Theme 1: Positive sense of community Sub-theme 1: Friendly people – accepting Sub-theme 2: A unique place & culture “Outdoorsy” Enjoy/appreciate Yooper culture & lifestyle Theme 2: Safe and secure place Sub-theme 1: Safer than urban areas Sub-theme 2: great place to raise a family Theme 3: Professional respectFace-to-Face Interview Questions, con’t Overall, how do you describe working here? Category Two:  Negatives Theme 1: “It’s a little too small sometimes…” Sub-theme 1: Limits to living here Lack of opportunities for youth Lack of cultural diversity Lack of job mobility Theme 2: “Podunk” & “Yooperish” Sub-theme 1: Podunk. “It’s really rural here!” Sub-theme 2: Yooperish.  Yooper culture is: Too accepting of poverty Too accepting of substance abuse Too accepting of social problemsDiscussionThis study sought to identify unique qualities, attitudes, and perceptions of social workers in an extremely rural region of the US.In the UP, it’s clear that poverty, homelessness, lack of services (especially for families/children), professional isolation, distance, lack of continuing education/training are all serious challenges for providers.Additionally, personal challenges include geographic isolation, lack of diversity, and other issues associated with lack of opportunity.Discussion con’tBut there are joys…It is also clear that providers are here because they want to be here – for many reasons: Professional freedom and autonomy The natural environment To raise their families To be close to their familiesThe positives appear to outweigh the negatives…Study LimitationsFindings from this study must be approached with certain caution: Survey response rate (39%) lower than expected 12 Interviews do not represent the populationBut we did learn much about this population, and many new questions were generated: Ss shared their concerns about the state of families/children in the region, but we have not yet heard from those families. Homelessness emerged as a serious concern.  Aside from the Hilton & DeJong (2010) study, little is empirically known.Summing Up  There are many joys and challenges to working in social services in the UP. Challenges:  Lack of resources, distance, isolation, continuing education. Joys:  Cooperation between agencies/workers.  Ability to help people in need.  Yoopers helping Yoopers.One unique challenge that emerged was that of cultural sensitivity.  Some workers not understanding “Yooper culture” and making poor decisions based on what they “think” and what they “know” – especially among child welfare workers.Summing Up But the challenges and joys of working in UP doesn’t tell whole story – people working here appear to do so based on a quality of life they feel they cannot find elsewhere. Close to family Appreciation of Yooper culture Natural resources Safe/healthy place to raise family Being a “Yooper”- personal identityWorkers are here because they want to be here.Recommendations Policy suggestions: Workers feel that the State often ignores regional needs and fails to allocate resources at equal rates as downstate Need to reevaluate how allocations are determined/distributed. Education suggestions: Strengthen educational responses at regional level. Increase continuing education opportunities, especially for those with state-mandated needs. Focus on those more likely to stay in UP.  Thank you.

Social Workers in Rural Places: A Study of Practitioners in the Upper Peninsula of Michigan

https://cornerstone.lib.mnsu.edu/cgi/viewcontent.cgi?article=1020&context=sowk_fac_pubs

Social Workers in Rural Places: A Study of Practitioners in the Upper Peninsula of Michigan

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