John Willard was casually chatting with a colleague last August on a Castro sidewalk when it happened: a brutal and unprovoked blow to the side of his head. Everything went black, he heard yelling, and he braced himself against his bike to stay on his feet.
“I’m 190 pounds. I played hockey, I played football — I’ve been knocked out. And this was a very big punch,” said Willard, 45.
Whereas many would flee or respond with violence, Willard, a social worker, tried to talk to his assailant and de-escalate the situation. Even in his staggered state, he could recognize signs of psychosis in the person who’d punched him.
Willard called police to get help for his attacker, but an officer said nothing could be done unless he pressed charges. He didn’t, and that was the end of it.
It could have happened to anybody. But Willard is a “campus” social worker employed by UC San Francisco. He and his colleagues spend more time with those in the throes of crisis than pretty much any other professionals in San Francisco.
Rather than working in UCSF hospitals, campus social workers are assigned to behavioral service centers like Citywide and the Trauma Recovery Center, where they serve unhoused and uninsured clients with substance use disorders and mental illness. Serving these clients requires Willard to walk the city and meet them where they live — often on the streets or in single-room occupancy hotels.
Willard’s job is to take referrals from the Department of Public Health and link clients to shelters, navigation centers, services, and the city’s coordinated entry program. But he ends up spending much of his time doing on-the-ground therapy in the streets. The experience of being assaulted or threatened is a well-understood part of the job.
“I have colleagues who have been attacked, held at knifepoint, sexually harassed,” he said.
A spokesperson for the Union of Professional and Technical Employees, which represents campus clinical social workers, said only half stay in the role beyond two years and eight months, the time it takes for them to get their license. UCSF did not respond to a request to confirm this figure.
The UCSF social workers who leave typically take higher-paying jobs in hospitals or with the Department of Public Health, move into private practice, or depart the field altogether, according to social workers interviewed by The Standard.
UCSF’s starting salary for campus social workers with master’s degrees and provisional licenses is about $93,000, and many work more than 40 hours per week without overtime pay, the workers said. But social workers at UCSF hospitals, even those with identical qualifications and licensure, can have starting salaries of more than $120,000.
That two-tier pay system is one of the reasons UCSF social workers voted (opens in new tab) Friday to authorize a strike. UPTE has been bargaining with the university for more than a year; the contract for healthcare professionals, including social workers, expired last September. The campus social workers are looking for their pay to be leveled with their hospital peers.
UC spokesperson Heather Hansen said UPTE has refused to bargain in good faith and has not responded to the university’s last, best, and final offer.
“We remain disappointed that UPTE continues to rely on strike actions rather than engaging at the bargaining table,” she said.
Social workers say that if the pay system continues, turnover will increase, leaving scores of clients living on the streets or in SROs without services. UC social worker Brenna Alexander said a drastic decline in campus social workers, who currently number around 200, is a “nightmare thought.”
“The communities that we serve fall deeper into poverty,” Alexander said. “There are hundreds or thousands more people outside on the street. Their deaths skyrocket.”
Her colleague Juliette Suarez works in the Trauma Recovery Center (opens in new tab), a UCSF service provider, and frequently treats survivors of sexual assault and domestic violence. She believes attrition from the ranks would increase rates of domestic violence, as well as the burden on the police and medical workers who would pick up the slack.
“You don’t get a lot of people who are naturally attracted to this work,” Suarez said.
She has taken on credit card debt to cover San Francisco’s high costs, on top of student loans. Social workers have asked UC for better pay for years, she said, with no results.
“Everybody is going to have to reconsider,” she said.
District 9 Supervisor Jackie Fielder introduced a resolution (opens in new tab) last month to support UPTE and urge UCSF to end the two-tiered pay system, citing high turnover rates. Eight other supervisors have signed on as cosponsors.
The city last October passed a resolution urging UCSF to fix pay and promotion gaps among its clinical social workers. But a year later, nothing has changed.
Fielder went on a walk downtown with social workers last month and heard their grievances.
“I’m here to support their campaign for a fair contract,” she said. “They are the backbone of recovery in San Francisco, and it’s important that we take care of them.”
Willard, who works on a “stabilization team” of about 15 clinicians, lost hearing in his left ear for months after being punched on the street. He said he’s one of many social workers who have been diagnosed with post-traumatic stress disorder after experiences on the job.
“It’s almost a rite of passage,” Willard said of the PTSD diagnosis, adding that he thinks about quitting “almost daily.”
Despite safety concerns, exhaustion, and anxiety, Alexander still finds her work rewarding. Sometimes she connects with people who haven’t seen a provider in 20 years, she said.
Rodrigo Avila is a former UCSF campus social worker who made the jump to the hospital side last year. He felt it was his only path to a higher wage, more training, and a potential management position. But he’s now less able to pursue the population-specific work with the elderly and Latinos that compelled him to pursue social work in the first place.
“I didn’t want to switch roles,” he said. “And I don’t think it’s right that colleagues who’ve been here for years make less than I do.”