Every year, beginning on Mother’s Day, National Women’s Health Week encourages women of all ages to prioritize their health. Social workers play a valuable role in making alcohol screening, brief intervention, and referral to treatment (SBIRT) part of routine practice for all clients, including women. Females ages 12 and older are the fastest-growing group of alcohol users in the U.S., and drinking impacts women’s health at every stage of life.

Women of Reproductive Age

About half of pregnancies in the U.S. are unplanned, and most women will not know they are pregnant for up to four to six weeks. Any alcohol use during pregnancy can lead to harmful health outcomes, including miscarriage, stillbirth, premature delivery, and sudden infant death syndrome (SIDS). Alcohol-exposed pregnancy can also lead to  fetal alcohol spectrum disorders (FASDs), a range of lifelong disabilities that can include mental health conditions, learning disabilities, and physical manifestations such as heart defects.

Older Women

In older women, alcohol use can worsen menopause symptoms.  Moderate to heavy drinking can intensify and increase the frequency of hot flashes and night sweats, as alcohol often causes body temperature to rise. Sleep issues, another common symptom of menopause, can also become more of a problem with alcohol use, which interferes with sleep quality. In addition, alcohol affects elderly women due to age-related changes in metabolism and body composition, increasing the risk of falls, medication interactions, and cognitive problems, even at lower levels of drinking.

Women of All Ages

Regardless of age, women experience alcohol-related problems sooner and at lower amounts of drinking than men. On average, women weigh less and have less water in their bodies, resulting in a higher blood alcohol concentration in a woman who drinks the same amount of alcohol as a man of the same weight. As a result, women face higher risks for alcohol-related brain damage, liver damage, and heart disease than men. Research has also shown a strong link between alcohol use and breast cancer in women, with one drink a day raising breast cancer risk by 10 percent compared to women who do not drink.

Universal Screening for Prevention Practice

Social workers can take a leading role in women’s health—and help prevent FASDs—by implementing universal alcohol SBIRT. More than 40 years of research shows alcohol screening and brief intervention works to reduce risky alcohol use. Alcohol SBIRT involves using an evidence-based set of screening questions to identify clients’ drinking patterns, followed by a short conversation with those who are drinking too much, as well as referral to treatment when appropriate.

 Learn More

Practice Perspectives: Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Risky Alcohol and Other Substance Use (NASW)

Video Series: Lived Experiences with Fetal Alcohol Spectrum Disorders (CDC)

Alcohol and Pregnancy (CDC)

Drink Size Badge Card  (HBRT in partnership with NASW Foundation, Oak Ridge Associated Universities and CDC)

SBIRT Pocket Card (HBRT in partnership with NASW Foundation, Oak Ridge Associated Universities and CDC)

The Healthcare Professional’s Core Resource on Alcohol (NIAAA, CEs available)

FASD National Partner Network: Ready-to-Use Materials

Alcohol and Cancer Risk: The U.S. Surgeon General’s Advisory

This initiative, Engaging Social Workers in Preventing Alcohol- and Other Substance-Exposed Pregnancies, is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services as part of a financial assistance award totaling $1,222,292 with 100 percent funded by CDC/HHS. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS, or the U.S. Government.

May is Mental Health Awareness Month, a time dedicated to highlighting the importance of mental wellness. Social workers, counselors, therapists, and other mental health professionals lead that charge every single day.

But did you know recognition month has deep roots? Mental Health Awareness Month began in 1949, founded by Mental Health America, then known as the National Association for Mental Health. It was Clifford Whittingham Beers who built the organization after experiencing firsthand the mistreatment of those living with mental illness. His mission: to raise awareness, educate the public, and reduce the stigma surrounding mental illness. That mission is still alive today, and social workers are at its heart.

You Are a Hero

Before anything else, I want to say something that does not get said enough – social workers are heroes!

Not in a ceremonial way. In real life, every single day, we walk into impossible situations. You carry the weight of families in crisis, children at risk, systems that fail people, and communities in pain. You write the reports, attend the court hearings, make the home visits, and absorb the trauma of others, often without adequate support, supervision, or recognition.

You do this because you care. And that matters more than most people will ever know.

Breaking the Silence: My Story

I know this world personally. A graduate of Catholic University of America, I was honored with the Patricia Roberts Harris Fellowship for my community service work before beginning my career in child welfare in Washington, D.C. In 1991, fresh out of graduate school, I began my career as a frontline child welfare social worker in D.C., a city then known as the murder capital of the nation. The crack cocaine epidemic was devastating Black and brown children and families across our city. Home visits took me into neighborhoods that felt like battlegrounds, with gunfire, isolated violence hotspots, and families in desperate crisis.

I was a young man trying to manage all of this while also building a life. I had just married my high school sweetheart, welcomed our first child, and bought our first home, a family home in serious disrepair. Money was scarce. Stress was high. It was, as I now understand clinically, a perfect storm.

The allostatic load, the cumulative burden of chronic stress on the mind and body, exceeded what I could bear. And when that happens, normal anxiety can escalate into something far more serious. I developed generalized anxiety, social anxiety, panic attacks, agoraphobia, and clinical depression. I worked in a fog of mental illness that I told no one about. The stigma was real. I was committed to the children and families I served, but the weight of it all was nearly crushing.

In 1992, a colleague recruited me to join a specialized unit called Families Together, a program designed to work intensively with families for one month to keep children safely at home rather than removing them. Three years later, in 1995, Washington Post journalist Katherine Boo selected me to cover and was embedded with me in the field for seven months as I did my work. She witnessed my dedication to children and families up close, all while I was privately coping with mental illness, never letting it show. The story was nominated for a Pulitzer Prize.

All these years later, I remember the numbness, the dissociation, the fear, the avoidance, the shame. Still, I also remember the strength, the resilience, the courage, and the determination to educate myself and learn new tools that eventually rescued me from mental illness. Just a few years before retiring, I was honored as Maryland Social Worker of the Year, the state’s highest professional recognition.

That award meant everything, not just as a professional milestone but also as a reminder of how far the journey had come since those early days in the D.C. battleground. In 2024, I had the honor of returning to my alma mater, George Washington University, where I earned my undergraduate degree, to deliver a TEDx Talk sharing my personal experience with mental illness, recovery, and the work that grew from it.

The Reality Social Workers Face Today

My story from 1991 is not just history. Research tells us it is still happening right now, to social workers in the United States and around the world. According to available data (source at bottom of this article):

• 55 percent of social workers have experienced burnout that has led to anxiety and depression.
• 66 percent report feeling emotionally drained more than once a week.
• Nearly 47 percent report a direct decline in their mental health linked to work stress.
• 50 percent say they lack adequate supervision or mentoring.
• Social workers experience anxiety at rates significantly higher than the general population.

These are not statistics about weak people. These are statistics about heroes carrying too much for too long without the right tools.

Self-Care Is a Start, But It Is Not Enough

In fact, the National Association of Social Workers (NASW) Code of Ethics, updated in 2021, makes it clear:

“Professional self-care is paramount for competent and ethical social work practice. Professional demands, challenging workplace climates, and exposure to trauma warrant that social workers maintain personal and professional health, safety, and integrity.”

Self-care is not optional. It is an ethical obligation.

Many social workers are already practicing self-care. Therapy, supervision, exercise, and time with family. That is admirable and important. But self-care largely happens after the stress hits, after the difficult home visit, after the court hearing, after the crisis call.

What about in the moment? When anxiety rises in the middle of a session, or before a difficult conversation, or during a home visit in a neighborhood that reminds you of everything you carry?

That is the gap. And that is what led me to develop the Webster Calm Response Method.

Another Tool for Your Toolkit

The Webster Calm Response Method is built on a simple four-step framework: Label, Down Regulate, Allow, and Continue.

Label: Recognize the moment anxiety begins to escalate

Down Regulate: Downregulate the fear-based response that keeps the cycle going

Allow: Let uncomfortable feelings be present without fighting them

Continue: Move forward with your life while anxiety is present, weakening its hold over time

I did not learn this method in graduate school. I built it from bibliotherapy, clinical training, and my own lived experience fighting my way back from mental illness. I created it because I needed it, and because I knew others needed it too.

To the Social Worker Struggling in Silence

If you are a social worker struggling to cope with stress, anxiety, and depression, I recognize how hard it is. Very hard. Coming to work every day under a cloud of despair and anxiety, but showing up anyway and doing your best. What you are doing under the heavy burden of it all is worthy of deep respect. And you are worthy of being vulnerable enough to get help.

In my 30 years  working in the D.C. government, I witnessed colleagues die by suicide, including the very supervisor who hand-picked me to help others. Untreated stress, anxiety, and depression can escalate into what the late suicidologist Edwin Shneidman called psychache, an unbearable psychological pain that people react to rather than respond to. That is why getting help is not optional. It is urgent.

If you or a colleague is in crisis, please call or text 988 (Suicide and Crisis Lifeline) anytime, day or night.

Do not suffer in silence.

Here is something the science tells us that I want you to hold onto: the brain is malleable. It changes with the environment and with the right support. The anxiety pathways that have been worn deep by years of chronic stress can be rewired. New responses can be learned. Recovery is not just possible, it is biological. You are not broken. You are adaptable.

Today, mental illness is more accepted. The stigma is not what it was 30 years ago. There are many new treatments that are highly effective. Help is available, and seeking it is not weakness. It is the bravest thing a helper can do.

You showed up for everyone else. Now show up for yourself.

Darryl Webster, LICSW, is a Licensed Independent Clinical Social Worker with over 35 years of experience, founder of the Webster Anxiety and Stress Education Center, LLC, and creator of the Webster Calm Response Method. He is the author of I Thought I was Going Crazy: Overcoming Stress, Anxiety, and Depression. He has been featured on the Oprah Winfrey Show, CBS’s Week of Wishes, USA Today, and the Washington Post. He is a recipient of the Maryland Social Worker of the Year award and the Distinguished Government Award. Since retiring from government service, he has maintained a thriving private practice. Learn more at websteranxietystress.com.

Disclaimer: The National Association of Social Workers invites members to share their expertise and experiences through Member Voices. This blog was prepared by Daryl Webster in his personal capacity and does not necessarily reflect the view of the National Association of Social Workers.

The Trump administration’s Department of Justice (DOJ) on April 21 announced  the indictment of the Southern Poverty Law Center (SPLC). This is an unfortunate but not surprising turn of events.

Not surprising because of the Trump administration’s well-known pattern of hostility to historical civil rights laws and protections. That the administration has now decided to weaponize the DOJ to charge a venerable civil rights organization such as SPLC with violations of the law have been anticipated within concerned communities. For example, recently  FBI Director Kash Patel ended all ties between the bureau and the SPLC, accusing the group of being a “partisan smear machine.”

SPLC has fought for civil rights protections for people of color, immigrants, LGBTQ+ people, women, workers, people with disabilities, and Arab, Muslim, and South Asian communities for 55 years. SPLC has also been one of the nation’s  leaders in identifying, tracking and exposing some of the nation’s most violent white supremist hate groups.

An organization with such a rich history of combatting injustices should be venerated and not targeted by a government agency bent on using its powers to undermine more than a century of civil rights gains. This administration views the struggle for civil rights as a threat to its power. Moreover, in order to quinch its thirst for absolute power, the administration is compelled to dismantle mechanisms of civil rights protections.

For that reason, it is important that we stand with and support The Southern Poverty Law Center until the legal travails are complete — with full confidence that SPLC will be vindicated.

Get Involved

By Ashlee Fox JD, MSW
Deputy General Counsel
National Association of Social Workers

What was This Case About? 

Ashlee Fox, JD, MSW

Kaley Chiles is a Colorado-licensed mental health counselor who practices talk therapy only. Some of her minor clients came to her hoping to change their sexual orientation or gender identity, and she was willing to work toward those goals.

Colorado’s Minor Conversion Therapy Law, passed in 2019, prohibited licensed professionals from practicing conversion therapy with minors. It defined conversion therapy broadly to include any attempt — including through speech — to change a minor’s sexual orientation, gender identity, or gender expression.

Chiles challenged the law as applied to her talk therapy, arguing it violated her First Amendment right to free speech. She asked courts to block the law’s enforcement while the case proceeded. Both the trial court and the Tenth Circuit Court of Appeals denied her request, reasoning that the law mainly regulated professional conduct, not speech. Chiles appealed to the Supreme Court.

NASW’s Role

In August 2025, NASW and its Colorado Chapter joined the American Psychological Association, the American Psychiatric Association, and 11 other health organizations to file an amicus brief urging the Supreme Court to uphold Colorado’s law.

The brief argued that talk therapy is not just conversation, it is a medical treatment subject to decades of professional training, licensing requirements, and evidence-based standards. Treating talk therapy as speech protected by the First Amendment neglects the education and training needed for it to be safely and effectively conducted. Additionally, mental health institutions, such as NASW, have directly opposed conversion therapy because of its ineffective and harmful outcomes. 

What Did the Supreme Court Decide?

On March 31, 2026, in an 8–1 decision, the Supreme Court reversed the rulings of the lower courts and sided with Chiles. Writing for the majority, Justice Gorsuch held that Colorado’s law amounts to viewpoint discrimination. Here’s the core of the Supreme Court ruling:

• The Colorado law allowed a counselor to say, “I can help you explore your identity and accept your sexual orientation,” but prohibited that same counselor from saying “I can help you change your sexual orientation.” The Court decided that choosing which message is legally permitted is taking sides based on viewpoint.
• The Court found that calling therapy a “treatment” or “clinical modality” doesn’t strip it of the First Amendment protection.
• The Court concluded that licensed professionals do not have fewer free speech rights than anyone else. The Court expressly rejected the idea that “professional speech” can be regulated more freely.
• Colorado could not show that its law fit within any recognized historical tradition that would justify regulating this kind of speech at a lower standard.

The Court granted the preliminary injunction Chiles requested and sent the case back to lower courts. Colorado must now prove its law survives “strict scrutiny,” the highest and hardest legal standard to meet.

Justice Jackson’s Dissent

Justice Jackson was the sole dissenter, and her argument reflects the position NASW and allied health organizations advanced. Her dissent deserves careful attention because it articulates why this ruling is so troubling for the mental health profession.

Justice Jackson argued that the majority fundamentally misread the legal landscape by treating talk therapy like ordinary conversation. Her core point: when a licensed healthcare professional speaks to a patient as part of delivering medical care, that speech has always been subject to state regulation, and for good reason.

In her view, the key question was not simply whether Chiles’s words constitute “speech,” but whether Colorado was targeting that speech because of its message or restricting it incidentally as part of regulating a harmful medical treatment. She argued it was clearly the latter, and that the majority’s approach creates a dangerous and unworkable rule. Justice Jackson argued:

• States have always regulated medical professionals, including what they can and cannot do with patients.
• Talk therapy is a medical treatment. The fact that it is delivered through words rather than a scalpel or a prescription pad does not make it something different. As Justice Jackson put it, “treatments administered through words versus treatments administered through acts are not meaningfully different” when it comes to a state’s power to regulate harmful care.
• The majority’s ruling effectively creates a “free speech” loophole in healthcare regulation.

Under the majority’s logic, any harmful therapy delivered solely through talk could potentially be afforded First Amendment protection, making it much harder for states to protect patients from unscrupulous or incompetent providers.

NASW’s Commitment Going Forward

NASW is deeply disappointed by this decision. The Court’s ruling undermines decades of work by the mental health community to protect LGBTQIA+ youth from a practice that is not only ineffective, but demonstrably harmful. We stand firmly with Justice Jackson’s dissent and believe the majority got this wrong.

A court ruling does not change the science, and it does not change NASW’s values. NASW remains unequivocally opposed to conversion therapy in any form and will continue to:

• Advocate for LGBTQIA+ youth and the legal protections they deserve.
• Support state and federal legislative efforts to protect minors from harmful practices.
• Uphold evidence-based, affirming standards of care in social work practice.
• Challenge any effort to normalize or legitimize conversion therapy within professional settings.

Every person deserves care that is affirming, evidence-based, and rooted in dignity. Social workers remain on the front lines of this work, and NASW will continue to provide guidance and advocacy as this legal landscape evolves.

Ashlee Fox, JD, MSW, is Deputy General Counsel for the National Association of Social Workers.

April is Alcohol Awareness Month, an opportunity for social workers to get the facts on alcohol’s health effects. As the nation’s largest mental and behavioral health workforce, providing services in a wide range of practice settings, social workers are essential resources for evidence-based information about client alcohol use.

Here are three key facts to share with clients in conversations about their drinking:

The less you drink, the better it is for your health.

According to the Centers for Disease Control and Prevention (CDC), moderate drinking is:

• one drink or less in a day for women who aren’t pregnant, and
• two drinks or less a day for men.

Women face unique risks from alcohol, including alcohol-exposed pregnancy.

Alcohol guidelines differ for men and women because after drinking the same amount, women tend to have higher blood alcohol levels, and the immediate effects of alcohol usually happen faster and last longer in women than in men.

In addition, compared to men, women who drink have a higher risk of developing alcohol-related liver diseases, heart damage, and a faster decrease in mental functioning.

In women of reproductive age, drinking increases the risk of alcohol-exposed pregnancy (AEP), a leading preventable cause of fetal alcohol spectrum disorders (FASDs), a group of diagnosable medical conditions with lifelong effects. People with FASDs can have problems with mental health, learning, and behavior, as well as physical issues such as heart defects and visual impairments.

It’s important to share with clients that there is no known safe amount of alcohol to consume, no safe time to drink, and no safe type of alcohol to consume during pregnancy.  All types of alcohol can be harmful to a developing baby, including wine, beer, and liquor.

Alcohol screening, brief intervention, and referral to treatment (SBIRT) is a highly effective, evidence-based approach to identifying and addressing risky alcohol use.

SBIRT is a comprehensive, research-backed approach to early intervention for substance use disorders that is used in healthcare and other practice settings nationwide. The U.S. Preventive Services Task Force recommends alcohol SBI for all adults, including pregnant women. Using a validated screening tool can take as little as one minute, followed by a brief conversation with those who are drinking too much, and referral to treatment if appropriate.

Learn More

Practice Perspectives: Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Risky Alcohol and Other Substance Use (NASW)
Video Series: Lived Experiences with Fetal Alcohol Spectrum Disorders (CDC)
Alcohol and Pregnancy (CDC)
Drink Size Badge Card  (HBRT in partnership with NASW Foundation, Oak Ridge Associated Universities and CDC)
SBIRT Pocket Card (HBRT in partnership with NASW Foundation, Oak Ridge Associated Universities and CDC)
The Healthcare Professional’s Core Resource on Alcohol (NIAAA, CEs available)
FASD National Partner Network: Ready-to-Use Materials

Alcohol and Cancer Risk: The U.S. Surgeon General’s Advisory

This initiative, Engaging Social Workers in Preventing Alcohol- and Other Substance-Exposed Pregnancies, is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services as part of a financial assistance award totaling $1,222,292 with 100 percent funded by CDC/HHS. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS, or the U.S. Government.

Travel social work has been gaining popularity in recent years.

A travel social worker operates in much the same way as a travel nurse – social workers assume short-term contracts, typically around 13 weeks in duration, in order to help solve an organization’s staffing crisis. Social workers are employed by a staffing agency, and work directly with a recruiter to locate assignments and arrange interviews for roles of interest. The agency also can assist travel social workers in getting to and from assignments, securing housing, a rental car, and even booking flights during the contractual period.

Agencies like Allied Travel Careers, AMN Healthcare, and TotalMed Staffing handle travel social work contracts, and most travel social workers collaborate with recruiters from multiple agencies to find the next opportunity that is the best fit for their interests. The Military Family Life Counseling program provides free, confidential counseling to service members and their families, and is an opportunity that travel social workers can get involved in through agencies like Magellan Federal, Leidos, and Zeiders Enterprises.

Most travel social work assignments take place in medical settings, such as outpatient clinics, mental health hospitals, acute care hospitals, long-term care hospitals, skilled nursing facilities, and home health agencies. While less common, placements may also be available in non-medical settings, like schools, jails and prisons, and government entities. Contracts in non-medical settings may last longer—for example, a placement in a school setting may last the duration of the school year.

Social work students interested in pursuing travel social work in the future should consider specializing in medical social work, school social work, or a related field. At least two years of experience is required before pursuing a travel contract, and most positions require a license. While regular full-time employees might enjoy up to six weeks of training in a new role, a traveler may only get one or two days to orient themselves before being expected to fully step into their responsibilities. Understanding insurance, medical terminology, and other specific skills related to the assignment is crucial to success. There are times that travel social workers are let go if they are unable to work independently from the start.

While some social workers are experienced in working PRN (as needed) roles, most often in hospital settings, travel social work allows for professionals to assume local contracts, less than 50 miles away from your home address, or travel contracts, more than 50 miles away from home. “Travel social work took PRN work and made it broader so you can travel across the country, not just hopping from hospital to hospital in your area,” explained Makeesa Johnson, DSW, an experienced travel social worker.

Read the full story in the NASW Social Work Advocates magazine

As the understanding of human impact on the environment has grown, so too has the understanding of the environment’s impact on humans. Everything about the climate—from the day-to-day conditions of the air, water and soil to the frequency of extreme weather events—has short and long-term effects on individuals’ and communities’ physical and mental health.

It is no surprise then that many professionals—not just conservationists and ecologists—have begun to focus more on the intersection of humanity and the environment, and how it correlates to their work. Social work is no exception.

Ecosocial work is an aspect of social work that both clinical and macro social workers are a part of. “I think it is theory and practice,” says Amy Krings, PhD, MSW, associate professor at the College of Social Work at The Ohio State University and network co-lead for the Grand Challenges for Social Work’s “Create Social Responses to a Changing Environment.”

“To me, the easiest way to explain it is that social workers are working, and their work engages with environmental issues and topics. So probably for most social workers, they don’t think of themselves as an ecosocial worker, but if you pause and think about if and how environmental topics touch the communities and clients we work with, you start realizing, OK, my work does involve ecosocial work. So for instance, you might work with clients or communities that have been hit by a natural disaster of extreme flooding or extreme heat—all these issues that have impact on people’s health and well-being,” she says.

“The other way to think about it is more of a specialization where people are more intentionally seeing themselves as working on environmental topics,” she says. “In that case, that could range from anything from doing more policy work to community organizing or working to promote healthy food access and independence.”

Whether a social worker is focusing directly on the environment or recognizing the ways in which it is impacting their clients, the work is challenging and ongoing, as environmental injustices and concerns become increasingly evident. The rising global temperatures, for example, have led to more heat waves, floods, droughts and wildfires. These events in turn require more resources, research and support—directly within the communities and from the governments and systems surrounding them.

Unfortunately, it appears that support, at least from the federal government, may be hard won if not nonexistent in the coming years, as the Trump administration has either taken or proposed numerous actions that weaken environmental safeguards.

For social workers to continue working with an eco-lens, they must take the time to understand the progress as well as the challenges that existed before the second Trump administration, and the ways in which the administration may further exacerbate the already present and persistent issues.

Read the full article in the NASW Social Work Advocates magazine

In May 2023, social isolation and loneliness were declared an epidemic. The declaration, made in a report from the U.S. surgeon general at the time, Dr. Vivek M

It would be logical to attribute the findings in the report to the COVID-19 pandemic, which officially began in the U.S. in March 2020, prompting stay-at-home orders across the country. With millions of Americans working remotely, attending school virtually and limiting nonessential movement outside the house, it’s little wonder that the country collectively would have been experiencing cabin fever by 2023.

But the data in the 2023 report actually came from a study published in 2010.

The fact is, Americans were socially isolated and lonely long before COVID; the pandemic simply made people more physically isolated. But physical isolation is just one part of the equation. And here’s something else to consider: Not all physically isolated people are lonely; some are happy in their isolation. Likewise, not all lonely people are physically isolated.

As Murthy warned, there are serious personal health effects of loneliness and unwanted isolation. There also are harmful societal effects, including devastating violence. The turbulence of the past few years and deep polarization of the country has further exacerbated the problem — but it is not intractable.

Policymakers, individuals, community organizations, schools and social workers all have an important part to play in reducing harm to the people experiencing loneliness and isolation. And experts agree that loneliness and isolation are societal problems that cannot be ignored.

Loneliness Can’t Be Cured With More Social Media Clicks

Anyone who has ever felt lonely in the middle of a crowded party understands that loneliness isn’t necessarily connected to the number of people in your life. Similarly, if it were possible to see every person on the planet who was physically alone, you couldn’t tell how many of them were lonely.

“Social isolation is a form of being alone; you can count the number of social contacts you have. Being lonely is completely subjective. It’s how you feel about the world around you and your relationship to it from a social perspective,” says Jeremy Nobel, MD, MPH, a longtime faculty member of Harvard Medical School, the Harvard T.H. Chan School of Public Health, where he teaches a highly sought-after course on loneliness.

“That makes loneliness harder to measure, harder to get people to talk about or understand, harder for social workers or anybody else on the front lines to recognize. Social isolation is easier. You can just ask people, ‘How many other people do you see in a typical day or week?’ and they’ll tell you. But if you ask them if they’re lonely, they often feel embarrassed and ashamed. So, they minimize it,” says Nobel, who also is the author of “Project UnLonely: Healing Our Crisis of Disconnection.” However, according to Noble, we are making progress as a society in that regard, and younger people are more willing to talk about their loneliness. “Sometimes I compare the stigma around loneliness and talking about it to where depression was 25 years ago,” he said.

Antoinette Shine, LCSW, who works with families and individuals in NYC, is seeing a similar pattern. “For some, loneliness is an entirely new experience, and for others it’s not new but is manifesting in new ways.” She also notes that over the past five years, “more men are coming in — not because they are necessarily more lonely, but because seeking help has become more normalized.”

Read the full story in the NASW Social Work Advocates magazine. 

Sachie German Koufalis, LMSW, MPH, CCM, is a Behavioral Health HEDIS Manager at Healthfirst.

I didn’t set out to become a social worker. I fell into it, shaped by growing up in New York City and navigating public systems from an early age. I attended public schools, experienced housing instability, and spent periods without health insurance, so I understand what it means to rely on systems that are meant to help, but do not always show up when you need them.

Now, after spending the last 10 years working in managed care, I see this work at a population level through rates, measures, and outcomes. Still, I try to hold onto what brought me here in the first place: remembering that behind every number is a person, a family, a story. That is why this year’s Social Work Month theme, Uplift. Defend. Transform., resonates so deeply with me. It reflects the responsibility we have to center people, protect their dignity, and improve the systems they depend on.

In my work in behavioral health quality, I focus on working with and educating providers to ensure people receive appropriate care throughout their interactions with the health system. This includes supporting providers in completing timely follow-up care after hospitalizations or emergency department visits related to mental health or substance use, as well as promoting appropriate screening and early identification, such as depression screenings, before more acute needs arise. Much of this work happens behind the scenes, but it plays a critical role in helping people stay connected to care and avoid falling through the cracks. Behind every quality measure is a person trying to manage a chronic condition, access mental health support, or seek help for substance use.

Improving how care is delivered helps close gaps in care and ensures people receive services when they need them. This work is especially critical for the Medicaid population, one of the largest payers of behavioral health and substance use treatment in the country.

As social workers, it is our responsibility not only to defend access to essential services, but also to improve the systems themselves so that care is coordinated, effective, and responsive to people’s needs.

March is social work month and we’re celebrating more than 810,000 social workers practicing in schools, hospitals, corporate settings, foster care, policy, and many other environments.

Defending access to care does not always mean protesting or speaking publicly. Often, it looks like meeting with providers, discussing the needs of members, and identifying care gaps or risks in the system that could prevent people from receiving care.

At its core, this work is about defending the dignity of those who rely on these systems and ensuring they are treated with respect and compassion, even when the systems themselves can feel impersonal or difficult to navigate.

Social work is not only about responding to immediate needs; it is also about transformation. It is about improving the systems people must navigate, which can often feel confusing and disempowering.

That perspective shapes how we approach our work every day. Even without being policymakers, those of us working in quality improvement have opportunities to make a difference at the system level.

By identifying patterns and opportunities for improvement, we can help make services more accessible, better coordinated, and centered on the real needs of the people they are meant to serve.

Across the United States, more than 810,000 social workers practice in schools, hospitals, corporate settings, foster care, policy, and many other environments, and this month, we celebrate them.

I want to take a moment to thank every social worker who chose this challenging and often unrecognized field. Our work does not always come with the visibility or acknowledgment it deserves, but it matters deeply.

Being a social worker gives us the tools, language, and purpose to create real change; to uplift the people we serve, stand up for their dignity, and reshape the systems they rely on.

During Social Work Month, I encourage social workers to celebrate loudly, take pride in the work we do, and remember that your work truly matters. Whether on the front lines or behind the scenes, we continue to uplift, defend, and transform!

Sachie German Koufalis, LMSW, MPH, CCM, is a Behavioral Health HEDIS Manager at Healthfirst. With over 15 years of case management experience, her expertise spans utilization management, foster care, clinical programs, care management, and clinical quality.