Social Work at VA

Social services and social work have been important cornerstones of veterans health care since the American Civil War. During the Civil War, there was no American Red Cross in existence, so organizations such as the U.S. Sanitary Commission, U.S. Christian Commission, and various state and local groups raised money and supplied volunteers for vital services, supplies, and moral support to benefit military medical staff and veterans alike. The U.S. Sanitary Commission’s social research and advocacy ultimately led to the founding of a national soldiers and sailors asylum, later known as the National Home for Disabled Volunteer Soldiers, which was the origins of today’s VHA.

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Various types of social work were practiced every day at the National Homes, although no formal “social work” program existed and no professional social workers were employed there. The work included providing educational, recreational, occupational, and religious activities for veterans, as well as helping them to work out relationships with one another, their families, National Home management, and the local community.

A paradigm shift occurred during World War I when the Bureau of War Risk Insurance and Public Health Service (VA predecessors) were charged with providing medical care for a new generation of veterans—those who served in World War I.  The War Risk Bureau and Public Health Service consulted with the American Board of Surgeons on development of the government’s largest hospital construction program, at the time, and beginning in 1918, psychiatric hospitals were included as a new type of veterans medical facility.  Specialized, professional medical and psychiatric social workers were needed for this new formalized element of health care.  In the beginning, the American Red Cross provided those services in veterans’ hospitals and did so for roughly 7 years:

“In 1919 the Red Cross was asked to organize social services for treating mental diseases like those in civilian hospitals. By 1920, 42 hospitals had such services and 15 of these psychiatric social work department were headed by graduates of the first training class at the Smith College School. Psychiatric social workers were solidly entrenched and Red Cross scholarships had made some of this training possible. Their control was demonstrated in 1927, when the Veterans Bureau (1921) took over the operation of social services from the Red Cross. Before the transfer, the bureau established a social work section as part of its medical service, which drew up Civil Service requirements and job functions for the psychiatric social workers throughout the veterans hospital system. Psychiatric social workers shaped these bureau standards through the organized efforts of the Psychiatric Section of the American Association of Hospital Social Workers, later the American Association for Psychiatric Social Work (1926).”

On June 16, 1926, Veterans Bureau Administrator, Frank T. Hines, authorized the establishment of a Social Work department and the hiring of professional social workers as employees began.  On September 1, 1926, the Veterans Bureau took over social work in its neuropsychiatric hospitals and 2-3 general hospitals with the goal of doing so at all of its hospitals by July 1, 1927.

Irene Grant was the first Director of Social Work under the Veterans Bureau.  She began as a social worker with the Red Cross Social Service during World War I, rising to the rank of Chief (Red Cross) at the Veterans Bureau hospital in Minneapolis.  After being hired as the Veterans Bureau’s first Director, she remained through the bureau’s transition into the Veterans Administration, and served from 1926 until 1946.  More research is needed on Ms. Grant, but she published several articles and reported on VA’s social work activities in professional journals such as the Social Work Year Book.  In July 1945, under Administrator Hines, Civil Service classifications for nurses, dietitians, social workers, and librarians changed from subprofessional to professional with requirements for a professional psychiatric social worker including “completion of a four-year college course, and one year of school of social work training with six hours of psychiatric courses, and three hundred hours of field work.”

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After VA established its Department of Medicine and Surgery in 1946, which implemented robust medical research and medical school affiliation programs, the number of social workers mushroomed:  “The VA social service staff has increased from 550 in July 1946 to 1,026 in June 1947. The quality of the VA social service program was considered of such a standard that 27 accredited schools of social work placed 105 students with the Veterans Administrations for field placement in connection with their graduate training. Among the many services rendered veterans and their families are the following: Physicians are furnished social information pertaining to patients’ disorders; patients are assisted with personal and family problems which interfere with recovery, and are helped to effect [sic] their post-discharge adjustment; veterans who are ineligible for VA medical care are assisted in securing medical care in non-VA agencies; and neuropsychiatric patients and their families are prepared for the patient’s return home on a trial visit prior to ultimate discharge from the hospital.” By the 1950s, social workers were essential members of the professional medical team and were key contributors to many medical research projects.

VA and its ancestors significantly expanded the role of medical social work in the U.S. and influenced the raising of standards for psychiatric social work.  Today, VA is one of the largest employers of social work graduates in the world.

Links:

http://www.socialworkers.org/profession/centennial/milestones_3.htm

Alice Beal Baker Hyde, a Red Cross social worker for the Veterans Bureau in 1922: http://asteria.fivecolleges.edu/findaids/sophiasmith/mnsss387_bioghist.html

Photo: Red Cross social worker, n.d., University of California

info from the Historian, Veterans Health Administration, U.S. Department of Veterans Affairs

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