This study reaffirms the findings of the smaller initial study and adds two important new findings. First, in this state system, while social workers believe that they should be performing more therapy, they appear to be committed to humane care. The chronicity of patient illness did not appear to discourage them from this commitment. Second, the problem in providing good patient care is that the state hospital has different expectations than those of the social workers. Emphasis on administrative tasks, oversupervision, focus on short-term patient care, were issues cited as hindrances to professional development. Social workers interviewed believe that these factors, among others, cause their colleagues to become frustrated and leave either for jobs that they feel will allow them more autonomy and professional discretion, or for private practice. In short, frustration with the bureaucracy appears to be responsible for the high turnover, and not the intent of social workers to use the state psychiatric hospital as a stepping stone to higher opportunities; nor is high turnover due to lack of support from longterm employees of the system. © 1993 Human Sciences Press, Inc.
