VA History Tidbit: Evolution of Social Work in VA’s history – Irene Grant, first Director of Social Work (Veterans Bureau) – National Social Work Month

Social work has been an important cornerstone of veterans’ health care since the American Civil War.

During the Civil War, there was no American Red Cross in existence, so numerous volunteer organizations like the U.S. Sanitary Commission, U.S. Christian Commission, churches, and various state and local groups raised money for supplies, held soldier’s hands, combed their hair, wrote letters for them, and provided countless vital services  and moral support to benefit military medical staff, active-duty and discharged soldiers 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 (NHDVS), which was the origins of today’s Veterans Health Administration (VHA). Clara Barton, a nurse with the U.S. Sanitary Commission, founded the American Red Cross after the war in 1881.

From 1866 until World War I, all forms of social work were practiced every day at the National Homes, although it wasn’t called that at the time. No formal “social work” training, discipline, or program existed at the time. 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. National Home officers, matrons, or veterans assigned as hospital workers performed much of that social work. Initially National Home patients with psychological issues were housed and treated in special wards within the home’s hospitals, but after August 7, 1882, all “insane” veterans were sent to the Government Insane Asylum, later known as St. Elizabeth’s, in the District of Columbia.

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A paradigm shift in the approach to veterans’ medical care took place during World War I.  The Bureau of War Risk Insurance and Public Health Service (VA predecessors) were charged with providing medical care for World War I veterans. The National Homes, which took care of veterans from all earlier wars, were opened up to World War I veterans until the new bureaus could build their facilities. The War Risk Bureau and Public Health Service consulted with the American College of Surgeons on development of the government’s largest hospital construction program in history, at the time. Beginning in 1918, psychiatric hospitals became a new and distinct type of veterans medical facility. Specialized, professional medical and psychiatric social workers were needed for this new formalized element of veterans’ health care. Smith College in Northampton, Massachusetts, was a leading institution in training social workers at that time and others soon followed.

Beginning in 1919, the “[American] Red Cross was asked to organize social services for treating mental diseases [in veterans hospitals] like those in civilian hospitals. By 1920, 42 [Veterans Bureau] hospitals had such services and 15 of these psychiatric social work departments were headed by graduates of the first training class at the Smith College School. Psychiatric social workers were solidly entrenched and Red Cross scholarships made some of this training possible. Their control was demonstrated in 1927, when the Veterans Bureau 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).” The Red Cross provided social services in veterans’ hospitals for roughly 7 years.


On June 16, 1926, Veterans Bureau Administrator General Frank T. Hines authorized the first Social Work department and hiring of professional social workers began. On September 1, 1926, the Veterans Bureau formally 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.


Screen Shot 2015-03-12 at 7.44.13 PM Irene Grant (photo, left) was the first Director of Social Work under the Veterans Bureau. Fresh out of college, she entered social work 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. When the Veterans Bureau authorized its own social work department in 1926, Irene Grant was hired as the Veterans Bureau’s first Director of Social Work. She remained through the bureau’s transition into the Veterans Administration serving in that capacity for 20 years (1926-1946). 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.”

 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. A VA annual report stated that “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 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 raising the standards for psychiatric social work and social work in general. Today, VA is one of the largest employers of social work graduates in the world. Their work remains crucial to veterans and their families.



Alice Beal Baker Hyde, a Red Cross social worker for the Veterans Bureau in 1922:


Photos: top –  Dr. Houston in a clinic with students for Smith College School of Social Work, 1919, courtesy of Smith College, Sophia Smith Collection; bottom –  Irene S. Grant, 1918, courtesy of Mount Holyoke College.


Historian, U.S. Department of Veterans Affairs


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