Diagnoses of common mental disorders among social workers in Sweden: A register-based cohort study.

BACKGROUND: Little is known about common mental disorders (CMD) diagnoses among social workers, i.e., depression, anxiety, or stress-related disorders. This study aims to examine the risk of CMD among social workers in comparison to other workers and to further investigate differences between men and women and specific occupational titles. METHODS: This register-based cohort study consists of 3,034,304 persons, of which 26,610 were social workers (0.9 % of all workers), aged 30-64 years, living in Sweden in 2015. The risk of diagnosed CMDs was followed up until 2020. Cox regression models were used to calculate hazard ratios (HR) and 95 % confidence intervals (CI), adjusting for sex, birth country, education, and birth year. RESULTS: The participants were followed up by a total of 16,833,742.9 person-years, with an average follow-up of 5.5 years. Social workers, compared to other workers, were at a higher risk of CMD (HR 1.3, 95 % CI 1.2-1.4) after adjustment. The HR was equal, 1.3, for depression (95 % CI 1.2-1.5) and anxiety or stress-related disorder (95 % CI 1.2-1.4). The association between social work and CMD was stronger among men (HR 1.7, 95 % CI 1.6-1.9) compared to women (HR 1.2, 95 % CI 1.1-1.3). Further, men working as assistance analysts had the highest risk among the occupational categories (HR 2.2, 95 % CI 1.2-3.9). LIMITATIONS: CMD diagnoses only included cases treated in secondary care. CONCLUSIONS: Social workers, especially male social workers, had a higher risk of CMD. This deserves attention for future research and interventions aimed at improving the mental health of social workers.

Gaps and opportunities in addressing the needs of older adults in the Philippines and Vietnam: a qualitative exploration of health and social workers' experiences in urban care settings.

Background: Despite numerous government initiatives, concerns and disparities among older adults have continually been growing. Empirical studies focused on older adults in the Philippines and Vietnam appear minimal and mostly regarding perceptions of aging. An effective geriatric care strongly relies on functional service providers requiring their perspectives to be explored toward inclusive service delivery. Objective: To investigate the perceived gaps and opportunities in geriatric care service delivery among health and social care workers in selected urban areas in the Philippines and Vietnam. Methods: A qualitative case study approach drawn on social constructivism theory, examined working experiences, observed characteristics of older adults, geriatric services and needs, difficulties on service delivery, and recommended solutions. A total of 12 semi-structured interviews and 29 focus group discussions were conducted in the Philippines, with 174 health and social care workers, while in Vietnam, there were 23 semi-structured interviews and 29 focus group discussions with 124 participants. An inductive thematic analysis was employed. Results: Interview participants highlighted the increasing unmet needs such as accessibility, availability, and acceptability of geriatric care services. The implementation of interventions on the older population faced multiple challenges, including issues related to older adult conundrums and dilemmas in geriatric care providers and facilities. The participants from the two countries felt that strengthening implementation of collaboration toward an integrated geriatric care structure and expansion of training and capability in handling older adults can be potential in addressing the gaps at both individual and institutional levels. Additionally, a committed leadership was viewed to be the important step to effectively operationalize the strategy. Conclusion: Health and social workers emphasized that the needs of older adults are exacerbated by various challenges within a fragmented geriatric care system. To address this issue, an establishment of an integrated service delivery mechanism with dedicated leadership is needed. The findings from this study may help develop appropriate solutions for addressing the health and social care needs of older adults in similar settings across Southeast Asia. Further examination of the impact of these challenges and solutions on service delivery and the wellbeing of older adults is essential.

Who is behind the robot? The role of public social workers in implementing robotic eldercare program in South Korea.

A companion robot named Hyodol is a digital technology implemented for eldercare in South Korea. Drawing insights from semi-structured interviews with public social workers actively involved in the Hyodol care program, this study explores how social workers contribute to the success of the robotic care program. Throughout the phases of selecting potential users, introducing older adults to the robot, and maintaining the robotic program, the practical wisdom of social workers plays an important role. Despite the increased workload in case management and the emotional labor associated with navigating the care system, these pioneering social workers maintained high morale to adopt the robotic care system. By shedding light on the specific roles of social workers, this study contributes to a deeper understanding of the intricate dynamics that underlie successful robotic eldercare.

Difficult but achievable: medical social workers' experiences transiting older adults from hospital care to nursing home in Nigeria.

Very few literatures have focused on transition of older adults from hospitals to nursing homes in African region. As a first step, this study explored the experience of medical social worker when transiting older adult from the hospital to nursing home in southwestern region of Nigeria. A descriptive qualitative approach collected through a semi-structured interview among 16 medical social workers showed that there is limited availability of nursing home facilities in Nigeria. Additionally, bureaucratic and administrative hurdles often added to the complexities of facilitating seamless transitions into nursing care homes. Cultural beliefs and family dynamics exert a substantial influence on the decision-making process, making the task of medical social workers even more intricate. There is a need for a greater support from policymakers and healthcare authorities to address the challenges facing Nigerian medical social workers. Hence, to better understand and address these experiences, the healthcare system can better equip medical social workers to navigate the transitions effectively and ensure the well-being of older adults during this crucial phase of their lives is adequately supported.

COVID-19: Experiences of Social Workers Supporting Older Adults With Dementia in Nigeria.

Amidst the COVID-19 pandemic, numerous public health protocols were instituted by government agencies to safeguard individuals with dementia, their family caregivers, and formal care providers. While these preventive measures were implemented with good intentions, they inadvertently imposed significant challenges on medical social workers in Nigeria. This paper explored the experiences of medical social workers caring for people with dementia during the COVID-19 pandemic in Nigeria. Twenty-six medical social workers from 6 government hospitals in Southwestern Nigeria participated in an in-depth interview. The research reveals 3 pivotal aspects: Firstly, the escalating demands within the work environment, where medical social workers grapple with the intricate task of conveying sensitive information about dementia diagnosis and COVID-19 prevention protocol, managing expectations regarding dementia diagnoses, and navigating resource constraints for individuals with dementia during the pandemic. Secondly, discernible impacts on the work climate and interprofessional relationships shed light on the challenges these professionals face in collaborating with other healthcare providers. Lastly, the reverberations on social workers' personal lives underscore the pandemic's toll on their well-being. Thus, the findings underscore the need for proactive measures to equip medical social workers to face the distinctive challenges in dementia care during future pandemics. Recognizing the potential resurgence of global health crises, the research highlights the need for strategic preparedness to mitigate the impact of future pandemics on the well-being of individuals with dementia and the professionals dedicated to their care.

Courtesy Stigma and HIV Professionals: A Brief Review of Implications for Psychosocial and Professional Well-Being.

The impact of HIV-related stigma on social workers, clinicians, counselors, and advocates working in organizations serving people living with HIV (PLWH), is rarely considered. Professionals experience "courtesy stigma" when working with or on behalf of PLWH, regardless of their personal HIV status. PubMed, Medline, and PsycInfo databases, along with a review of relevant reference lists and referrals, identified 13 studies addressing this phenomenon. Although limited, this brief review suggests that members of the HIV workforce do indeed face challenges that compromise their personal and professional well-being as a result of courtesy stigma. Addressing stigma among professionals is necessary to support the health of those working in the field, and to avoid undermining the efforts of this important workforce. More research is needed to understand the perceptions and experiences of courtesy stigma and how this stigma may adversely impact the psychological well-being, social functioning, and professional practice of HIV professionals.

Anti-Asian Hate's Impact on Asian American Social Workers: Implications for Professional Training and Education.

This article explores the impact of recent incidents of anti-Asian hate and violence against Asian American social workers, clients, and communities. Asian Americans represent a small but growing proportion of the U.S. population. Yet, Asians are underrepresented in the social work profession-approximately 3.6 percent of the social work workforce and 2.1 percent of licensed social workers are Asian, and data on underrepresented racial and ethnic groups in the workforce continue to omit details on Asian people. Recent social and political framing of the COVID-19 pandemic as attributable to Asian people has fueled racist rhetoric and incidents of hate and bias crimes against Asian people. Through exploratory research to understand the experiences of Asian American social workers in the proliferation of anti-Asian hate, authors identified that more should be done to support and meet the needs of Asian American social workers, clients, and communities by improving social work education and training, by addressing the social work workforce and agency practices, and by expanding upon advocacy and community building.

Exploring Social Work Practitioners' Perspectives on the Contributors to Burnout since the COVID-19 Pandemic.

Burnout has a historic and disproportionate impact on social workers and is one important contributor to the ongoing health and behavioral health workforce crisis in the United States. Little is known, however, about social workers' experiences of burnout and their perceptions of factors that contribute to burnout since the COVID-19 pandemic. This study sought to explore this by answering the following research questions: (a) To what extent are social workers in South Carolina experiencing burnout? and (b) What do South Carolina social workers view as the top reasons for burnout in their professional role? Seventy social work practitioners and leaders from South Carolina completed an online survey during Fall 2022 that included the Copenhagen Burnout Inventory and an open-ended question focused on identifying their perceptions of the top three reasons for burnout in the profession. Findings suggest that social workers in this study are experiencing moderate levels of burnout since the COVID-19 pandemic and report primarily organizational (83 percent) contributors to burnout. They also identified individual (36 percent), systemic (29 percent), and interpersonal (27 percent) contributors to burnout. Implications are discussed related to policy and practice responses to prevent and address burnout among social workers.

Applying a Novel Approach to Understanding Social Worker Job Retention during the Pandemic.

The job demands-resources (JD-R) theory explicates factors that facilitated social worker burnout prepandemic. Authors believe the JD-R theory can illustrate how certain factors facilitated social worker job retention in the novel context of the pandemic because a sizable group of social workers resisted burnout-related turnover. Disseminating these factors can benefit the profession. Qualitative cross-sectional data were elicited from a semistructured interview about experiences of U.S. Department of Veterans Affairs (VA) outpatient social workers (N = 13) who provided care during the pandemic. Authors conducted content analysis and coded the text into six themes of factors that facilitated retention: (1) commitment to serving veteran population, (2) job flexibility, (3) supportive colleagues, (4) leadership support, (5) maintaining normal routines, and (6) trusting in scientific/evidence-based practices. Application of the JD-R theory illustrated how social workers utilized specific resources that balanced job demands during the pandemic and facilitated job retention. Future work should apply the JD-R theory among larger samples of VA social workers, as well as non-VA social workers, in the context of the pandemic, for comparative purposes. Authors conclude with policy implications related to the impact of permanently allowing telework options and job flexibility options among social workers.

Social work practice in perinatal palliative care: an overview.

Social workers in Perinatal Palliative Care (PPC) play an essential role in caring for birthing people carrying a baby with a life-limiting condition and their families. Perinatal palliative care is consistent with social work values concerning fostering quality of life and promoting social justice and access to care. Social workers play a multidimensional role in providing a holistic approach to caring for the birthing person, baby, and family. Although social workers may be part of an interdisciplinary care team, their role is not defined solely by the goals of the greater team, nor has it been discussed in depth in the perinatal palliative care literature. The purpose of this paper is to describe the knowledge, values, and skills essential to the role of the social worker in a hospital-based perinatal palliative care team. A case study will be used to illustrate the relevant practices, and implications are outlined.

Factors Associated with Israeli Social Workers' Intention to Stay in the Profession.

The phenomenon of social workers leaving the profession occurs frequently, underscoring the importance of understanding factors contributing to the intention to stay (ITS) in the profession. Based on the job demands-resources theory (JD-R), this study examined selected social worker workplace "demands" (i.e., their organizational sector of employment and level of work-family conflict) and "resources" (i.e., levels of meaning, locus of control, and salary satisfaction at work). Online survey data were obtained from 407 Israeli social workers. The findings showed that higher levels of meaning and salary satisfaction at work, greater professional seniority, and lower levels of work-family conflict were associated with greater ITS in the profession. Data were gathered during the COVID-19 pandemic, enabling examination of variables contributing to the ITS during times of crisis. These findings confirm that meaning at work is the main factor that motivates social worker ITS in the profession. Salary satisfaction was also found to be an essential factor, highlighting the recent escalation in social worker demands for fair compensation in Israel. Greater work-family balance also contributed to ITS. These findings should be considered by governmental decision makers and welfare service providers wishing to preserve this essential workforce, not just in Israel but also in other countries.

A Lack of Workplace Resources for Social Workers in Schools.

Social workers support youth in schools, but there is a lack of research that explores the supports that are offered to these helpers. Research suggests workplace coping resources for social workers in other environments that may help buffer the effects of stress; however, there is a significant lack of research on the availability of these resources. The purpose of this study was to determine common available resources to social workers in schools. A total of 100 public school social workers were surveyed using the Workplace Resource Questionnaire for School Social Workers (designed for this study). The study's findings indicate a significant lack of workplace resources for school social workers; only 27 percent of participants reported regularly available resources outside their schools, and 18 percent and fewer reported resources regularly available in their schools. There was a range in how significant participants felt each resource would support their coping, but many participants felt the resources would support their coping at least minimally. Participants suggested training topics and other resources they felt would help their coping with stress while in the workplace.

'So being here is. . . I feel like I'm being a social worker again, at the hospice': Using interpretative phenomenological analysis to explore social workers' experiences of hospice work.

BACKGROUND: Social workers have a significant role in hospices working with clients who are facing death but there is limited detailed understanding of the emotional impact of this work on social workers. Research has highlighted that those involved in hospice work find the work both a struggle (e.g. because of heightened emotions) and rewarding (noting that end-of-life care can feel like a privilege). AIM: To explore UK hospice social workers' emotional experiences of work and how this influences their practice. DESIGN: Semi-structured interviews were conducted with hospice social workers. Interviews were transcribed and transcripts were analysed using Interpretative Phenomenological Analysis. SETTING/PARTICIPANTS: Eight social workers from different hospices in the UK. RESULTS: Five overlapping superordinate themes emerged: making a difference to clients and families ('the difference made'), the emotional impact of working in hospices ('dealing with people's emotions, and death, and dying, it's serious stuff'), the relational context of this type of work ('awareness of affinity to connect'), the ways in which coping is facilitated in hospices ('seen it coming') and a foundation theme, connection and disconnection to values ('(dis)connection to values'). CONCLUSIONS: The results offer an exploration of social workers' experiences of their work in hospices; how adept they were at coping and how they prepared for and made sense of the often emotionally-laden experiences encountered. Their experience of the rewards and meaning derived from their work offers important findings for clinical practice. Further research is suggested to explore a multitude of healthcare professionals' perspectives across country settings using Interpretative Phenomenological Analysis.

A collaborative practice pilot between child welfare and child health care providers: Lessons in implementation and evaluation of cross-sector interventions.

BACKGROUND: Improved collaboration between child welfare and health care offers the possibility of improved child well-being after child welfare involvement. OBJECTIVE: To pilot a collaborative practice model between CPS caseworkers and pediatric primary care providers (PCPs). PARTICIPANTS AND SETTING: Infants remaining at home following child welfare involvement in 2 regions of a Western state were randomly assigned to collaborative vs. standard practice between 11/2017 and 03/2019. METHODS: CPS caseworkers were trained and randomized into standard vs collaborative practice model developed to promote information sharing between caseworkers and PCPs. A mixed-methods evaluation integrated administrative and qualitative data from child welfare, caregivers, caseworkers and PCPs. Outcomes evaluated included practice implementation; caregiver, caseworker, and PCP satisfaction with collaborative practice; and preliminary descriptions of practice impact. RESULTS: There were 423 eligible cases randomized to either collaborative or standard practice. Uptake of all elements of the collaborative practice by caseworkers was limited. There were no significant differences in parental satisfaction with caseworkers, parental communication with PCPs regarding social risks or CPS involvement or repeat CPS investigations within 6 months of case closure identified between practice arms. Qualitative themes regarding facilitators of and barriers to implementation were explored from both PCP and CPS caseworker perspectives. CONCLUSIONS: Limited uptake challenges our ability to identify potential benefits of a collaborative practice for infant health or welfare outcomes. CPS caseworkers and pediatric PCPs report barriers to implementation as well as potential benefits for children and families with a more successful collaborative practice model.

Knowledge, Accessibility and Utilization of the National Health Insurance Scheme (NHIS) Among Registered Employees of Federal Government Institutions in Ebonyi State: Lessons for Medical Social Workers.

Like most low-and-middle-income countries, Nigeria has been finding it difficult to meet the basic needs of her populace including their health needs. Nigerians are dying of preventable diseases because of poverty and the lack of a functional healthcare system. As a result, the Nigerian government introduced the National Health Insurance Scheme (NHIS) to cater to the health needs of its population. This study assessed the knowledge, accessibility and utilization of the NHIS among registered employees of federal government institutions in Ebonyi state. The study used Focus Group Discussions (FGDs) and in-depth interviews (IDIs) to collect data from 43 participants. The collected data was analyzed using thematic analysis. Findings revealed that most of the participants have accessed and utilized the scheme and saw it as a good healthcare system. They also reported a lack of most of the prescribed drugs and inadequate personnel at the NHIS clinics which is impacting the effectiveness of the scheme. The paper recommends that NHIS should create more awareness about the scheme, and cover more dependents, drugs, tests, and treatment bills to make it more effective in healthcare delivery.

Pharmacist-social worker interprofessional relations and education in mental health: a scoping review.

Background: One in eight patients is affected by a mental health condition, and interprofessional mental health teams collaborate to improve patient care. While pharmacists and social workers are recognized as mental health team members, there is a lack of literature describing interprofessional relations and education between these professions, especially as it pertains to mental health. The purpose of this review was to identify and characterize reports describing pharmacist-social worker interprofessional relations and education within mental health. Methodology: To address this knowledge gap, this scoping review was conducted to collect and characterize reports published between January 1, 1960 and August 18, 2023 describing pharmacist-social worker interprofessional relations and education within the field of mental health. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines were followed. Ovid MEDLINE, CINAHL, and Social Work Abstracts were searched using keywords "pharmacy student," "pharmacist," "social work student," "social worker," and "social work." Reports were included if they were published in English and interprofessional relations or education occurred directly between (student) pharmacists and social workers. Results: Three hundred twenty records were identified and three records were included: one cross sectional study, one qualitative educational project, and one case report. Each record suggested positive patient and/or educational outcomes developing from pharmacist-social worker interprofessional relations and education. In clinical practice, pharmacist-social work teams identified mental health risk factors, reduced 30-day readmissions, and improved post-discharge telehealth care. In the classroom, a social worker improved pharmacy students' confidence assessing patient suicidal ideations. Conclusions: This scoping review identified needs and areas for future research: pharmacist interprofessional education with Master of Social Work and Doctor of Social Work degree students, transitional care and mental health outcome measure reporting using evidence-based outcomes, and development of scholarly teaching projects utilizing higher-level educational frameworks beyond learner reactions.

Professional relationships during crisis interventions: A scoping review.

INTRODUCTION: A crisis can be described as subjective experience that threatens and overwhelms a person's ability to handle a specific situation. In dealing with crises some people are looking for support from professionals. The "professional relationship" between people experiencing a crisis and professionals plays an important role in the successful management of a crisis which has been widely researched in many contexts. However, regarding outpatient services (e. g. crisis resolution home treatment teams), yet empirical evidence remains limited. OBJECTIVE: We aim to explore descriptions of supportive professional relationships during outpatient crisis interventions in empirical literature. Accordingly, a scoping review was conducted to identify types of evidence, map the key concepts, and point out research gaps. METHODS: MEDLINE, PsycINFO, CINAHL and Social Science Citation Index were searched for studies reporting empirical data on the professional relationship between people experiencing a crisis (18+) and professionals (e. g. social workers, psychiatrists) during a crisis intervention, defined as a short-term, face-to-face, low threshold, time-limited, outpatient, and voluntary intervention to cope with crises. Studies were excluded if they were published before 2007, in languages other than English and German, and if they couldn't be accessed. Included studies were summarized, compared, and synthesized using qualitative content analyses. RESULTS: 3.741 records were identified, of which 8 met the eligibility criteria. Only one study directly focused on the relationship; the others addressed varied aspects. Two studies explored the perspectives of service users, five focused on those of the professionals and one study examined both. The empirical literature was categorized into three main themes: strategies used to develop a supportive professional relationship, factors influencing the relationship and the nature of these relationships. DISCUSSION: The results reveal a gap in understanding the nature of supportive professional relationships from the service users' perspective, as well as how professionals construct these relationships.

Nurse and Social Worker Palliative Telecare Team and Quality of Life in Patients With COPD, Heart Failure, or Interstitial Lung Disease: The ADAPT Randomized Clinical Trial.

Importance: Many patients with chronic obstructive pulmonary disease (COPD), heart failure (HF), and interstitial lung disease (ILD) endure poor quality of life despite conventional therapy. Palliative care approaches may benefit this population prior to end of life. Objective: Determine the effect of a nurse and social worker palliative telecare team on quality of life in outpatients with COPD, HF, or ILD compared with usual care. Design, Setting, and Participants: Single-blind, 2-group, multisite randomized clinical trial with accrual between October 27, 2016, and April 2, 2020, in 2 Veterans Administration health care systems (Colorado and Washington), and including community-based outpatient clinics. Outpatients with COPD, HF, or ILD at high risk of hospitalization or death who reported poor quality of life participated. Intervention: The intervention involved 6 phone calls with a nurse to help with symptom management and 6 phone calls with a social worker to provide psychosocial care. The nurse and social worker met weekly with a study primary care and palliative care physician and as needed, a pulmonologist, and cardiologist. Usual care included an educational handout developed for the study that outlined self-care for COPD, ILD, or HF. Patients in both groups received care at the discretion of their clinicians, which could include care from nurses and social workers, and specialists in cardiology, pulmonology, palliative care, and mental health. Main Outcomes and Measures: The primary outcome was difference in change in quality of life from baseline to 6 months between the intervention and usual care groups (FACT-G score range, 0-100, with higher scores indicating better quality of life, clinically meaningful change ≥4 points). Secondary quality-of-life outcomes at 6 months included disease-specific health status (Clinical COPD Questionnaire; Kansas City Cardiomyopathy Questionnaire-12), depression (Patient Health Questionnaire-8) and anxiety (Generalized Anxiety Disorder-7) symptoms. Results: Among 306 randomized patients (mean [SD] age, 68.9 [7.7] years; 276 male [90.2%], 30 female [9.8%]; 245 White [80.1%]), 177 (57.8%) had COPD, 67 (21.9%) HF, 49 (16%) both COPD and HF, and 13 (4.2%) ILD. Baseline FACT-G scores were similar (intervention, 52.9; usual care, 52.7). FACT-G completion was 76% (intervention, 117 of 154; usual care, 116 of 152) at 6 months for both groups. Mean (SD) length of intervention was 115.1 (33.4) days and included a mean of 10.4 (3.3) intervention calls per patient. In the intervention group, 112 of 154 (73%) patients received the intervention as randomized. At 6 months, mean FACT-G score improved 6.0 points in the intervention group and 1.4 points in the usual care group (difference, 4.6 points [95% CI, 1.8-7.4]; P = .001; standardized mean difference, 0.41). The intervention also improved COPD health status (standardized mean difference, 0.44; P = .04), HF health status (standardized mean difference, 0.41; P = .01), depression (standardized mean difference, -0.50; P < .001), and anxiety (standardized mean difference, -0.51; P < .001) at 6 months. Conclusions and Relevance: For adults with COPD, HF, or ILD who were at high risk of death and had poor quality of life, a nurse and social worker palliative telecare team produced clinically meaningful improvements in quality of life at 6 months compared with usual care. Trial Registration: ClinicalTrials.gov Identifier: NCT02713347.

Training Master of Social Work Students in Brief Intervention for Unhealthy Alcohol Use: Results of a Validated Adherence Assessment.

BACKGROUND: Many social workers receive limited training in working with clients engaged in unhealthy substance use. As a result, national organizations and agencies such as the Council on Social Work Education and individual social work programs are beginning to address this need by incorporating training into higher education social work programs. The purpose of this study was to examine Master of Social Work (MSW) students' adherence to a brief intervention protocol for unhealthy alcohol use. METHODS: A total of 91 MSW students consented to the assessment of their digital, audio-recorded class assignment by independent raters. RESULTS: Although 90% of MSW student participants were found to be overall adherent to the protocol, gaps in training quality were also identified. CONCLUSIONS: Lessons learned for addressing the gaps are discussed, along with future directions for teaching and learning in social work related to substance use.

Examining the role of child welfare worker characteristics and the substantiation decision.

BACKGROUND: The role of child welfare workers is twofold, to promote the safety of children and youth and to address their wellbeing. This provincially legislated mandate requires child welfare workers to make decisions across the child welfare service continuum. After a report of child maltreatment is investigated, workers are required to assess the veracity of the allegation through the substantiation decision and to determine whether the child has been victimized, which may impact on families' future involvement with services. Little is known whether or how individual worker characteristics impact the substantiation decision. OBJECTIVE AND METHODS: This study estimated the degree of variation across caseworker characteristics in the substantiation decision through secondary data analysis of the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS, 2018). We explored how the substantiation decision varied across clinical and caseworker characteristics, using both simple and multilevel logistic regression models. RESULTS: Findings suggest that primarily clinical characteristics predicted the substantiation decision, however, worker years of child welfare experience also predicted substantiation, such that more experienced workers were significantly more likely to substantiate than less experienced workers (est = 0.02, SE = 0.01, p < .10). The Intraclass Correlation Coefficient (35 %) suggests differences among child welfare workers' substantiation decision, they are however, characteristics not measured in this study. CONCLUSIONS: Further research to assess the differential nature of child welfare worker characteristics and their role in decision-making is required.