Managerialism: A workforce health hazard in human service settings.

BACKGROUND: This study assesses the relationship between managerialism and health among human service workers. METHODS: A total of 2154 New York City human service workers participated in an electronic survey that included validated measures of a system of work organization (the Organizational Commitment to Managerialism scale [OCTM]) and a work stressor (the Effort Reward Imbalance scale [ERI]), and single items about physical, mental, and behavioral health. Controlling for demographic variables, logistic regression models were used to predict health outcomes assess the potential role of ERI as a mediator. RESULTS: Managerialism was associated with increased risk of high blood pressure, neck and back pain, gastrointestinal difficulties, sleeping disorders, anxiety, and depression. Mediation analyses suggested that the effects of managerialism on health were partially explained by ERI. CONCLUSIONS: Managerialism in human service agencies significantly increased the risk of adverse physical and mental health. Increased levels of a work stressor helped to explain part of this association.

On the Front Lines: The Impact of Managerialism on the New York City Addiction Treatment Workforce.

Since the mid-1970s, neoliberal policies have relied on privatization and other tactics to down-size the state, transforming human service organizations in the process. The impact of this approach, also known as managerialism, has not been examined in addiction treatment, where the opioid epidemic has intensified the need for services. Using qualitative semi-structured interviews, we explore how managerialism has affected the workforce, service delivery, and the quality of care in New York City addiction treatment programs. Front-line and managerial staff identified threats to working conditions, including high caseloads and productivity demands; threats to service quality including standardization of practice, loss of professional discretion and serving only those most likely to succeed; and threats to worker well-being marked by stress, burn-out, and low morale. The contradictions between the goals of managerialism and addiction treatment threaten the ability to meet the needs of people struggling with addiction.

The Perils of Privatization: Bringing the Business Model into Human Services.

During the last three decades in both the United States and Europe, neoliberal policies, especially privatization, have restructured services in ways that dramatically affect the capacity of human services workers and agencies to serve all clients. Privatization means not only transforming public programs such as Social Security, but also managerialism-the incorporation of business principles, methods, and goals into public and nonprofit human services organizations. Few researchers have looked at the impact of market-based managerialism (focused on productivity, accountability, efficiency, and standardization) on social work's mission and the effectiveness of human services workers and organizations. Using an anonymous survey of 3,000 New York City human services workers, authors examined the impact of managerialist practices including performance measures, quantifiable short-term outcomes, and routinized practices on frontline workers and service provision. A troubling trend emerged. Workers in agencies with a high commitment to managerialism found it considerably more difficult to adhere to social work's mission and fundamental values. This conflict between the "logic of the market" and the "logic of social work" subsided dramatically in agencies with a low commitment to managerialism, indicating that even in today's competitive environment, agencies can protect the social work mission.

Double jeopardy: the impact of neoliberalism on care workers in the United States and South Africa.

Many researchers have explored how neoliberal restructuring of the workplace has reduced the standard of living and increased workplace stress among private sector employees. However, few have focused on how neoliberal restructuring of public policy has had similar effects on the public sector workforce. Using original case study research, the authors examine how two iconic pieces of neoliberal policy--the 1996 welfare reform bill in the United States and the GEAR macroeconomic policy in South Africa--affected public/nonprofit human service workers in New York City, United States, and public sector nurses in KwaZulu-Natal, South Africa. The authors argue that in both situations, despite national differences, these policies created a "double jeopardy," in which patients/clients and care workers are adversely affected by neoliberal public policy. This "double jeopardy" creates significant hardship, but also the opportunity for new social movements.

The largely untold story of welfare reform and the human services.

Welfare reform has placed the lives of clients, the jobs of social workers, and the mission of agencies in jeopardy. Based on interviews with senior staff at 107 nonprofit human services agencies, this article documents the largely untold story of how nonprofit agencies' workers responded to the impact of welfare reform on their clients, their jobs, and the delivery of services. Workers reported less time for social services because of welfare-related regulations, penalties, work mandates, crises, and paper work. They also reported more service dilemmas including less control of the job, more ethical conflicts, less efficacy, and increased burn-out. Even so, workers felt that they were making a difference, and agencies indicated increased advocacy. Relying heavily on the voice of social workers, the article illuminates the experiences and feelings of agency staff as they try to do their best for clients in difficult times.