NASW Ohio has been contacted by numerous social workers employed by the Department of Veterans Affairs across the state, who have shared concerns about the current presidential administration’s return-to-office mandate. This mandate applies to nearly all VA staff, including social workers, many of whom have been effectively teleworking for years, particularly since the rise of telehealth following COVID-19. These teams, including outpatient mental health services, homelessness support and outreach, substance use, and suicide prevention, provide care to some of the highest-risk veteran populations.

Though local leadership at many facilities are doing their best to work with the executive order while also trying to protect clinicians and the veterans they serve, we are aware that many social workers are being forced to return to substandard circumstances - for example, open workstations, cubicles, or shared offices that do not allow for appropriate and ethical client privacy, some finding themselves in settings more akin to a public area than a private office setting.

We recognize the ethical dilemma that this poses for staff, balancing meeting the requirement to return to the office or risk termination, while also wanting to ensure continuity of care for clients and protecting their privacy in order to provide high-quality, evidence-based care. Some salient excerpts from our Code of Ethics, Standard 1.07 (emphasis added) include:

(e) Social workers should discuss with clients and other interested parties the nature of confidentiality and limitations of clients’ right to confidentiality… This discussion should occur as soon as possible in the social worker-client relationship and as needed throughout the course of the relationship.

(i) Social workers should not discuss confidential information, electronically or in person, in any setting unless privacy can be ensured. Social workers should not discuss confidential information in public or semi public areas such as hallways, waiting rooms, elevators, and restaurants.

(n) Social workers should develop and disclose policies and procedures for notifying clients of any breach of confidential information in a timely manner. Patient privacy is essential to building rapport and trust and creating a healing environment, which is necessary to provide high-quality, evidence-based care.

Patients have a right to privacy and to be informed about the nature of their care. NASW Ohio strongly opposes mandatory return to office orders when in-office accommodations do not meet the needs of quality care provision. We warn that the lack of privacy offered by shared workspaces will create ethical violations and erode the quality of care available to our veteran community.

For VA social work staff who are being put in this position, NASW Ohio recommends:

• Using appropriate channels to report privacy violations (possibilities include utilizing internal agency processes, or through the Office for Civil Rights, the VA Office of Inspector General, or The Joint Commission)
• Advocating to the extent possible for solutions to increase patient privacy
• Informing clients of the nature of your workspace as part of your discussions on confidentiality, including whether complete privacy (visual and/or auditory) may not be possible

Remember, collective action has power. We encourage staff to use the channels available to them to advocate and reach out with any further questions or concerns.