University Professional and Technical Employees union members rally outside San Francisco General Hospital on Dec. 11 in response to the fatal stabbing of social worker Alberto Rangel. 

As a clinical social worker at San Francisco General Hospital, Julia Williams works closely with people whom many residents go out of their way to avoid. Her patients have severe mental illness, substance use disorders and difficult-to-manage behaviors. No other facility in the city will accept them. 

Williams, 30, is passionate about improving conditions for these patients. So much so that she returned to work just a few months after giving birth to her first child. 

Then a patient sexually assaulted her. 

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Williams was the patient’s primary social worker and had been painstakingly building trust. But one day last June, Williams said, the patient suddenly engaged in “impulsive sexual behavior” at the hospital’s inpatient psychiatric unit. Internal emails I reviewed corroborated the assault.  

The incident was “extremely traumatic,” Williams told me. But she only took one day off to cope. She’d already used her paid days off to extend her maternity leave, and even though she was eventually diagnosed with post-traumatic stress disorder, she felt guilty about taking more time. It would just put more pressure on her colleagues, many of whom were already juggling huge caseloads amid persistent vacancies. 

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Beyond that, Williams told me, being assaulted seemed to be part of the job description. 

“There’s this culture in inpatient psychiatry that assaults happen so often … that we’re kind of expected to bounce back quickly.” 

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A new survey of behavioral health social workers — who, like Williams, are employed by UCSF and work at community clinics, hospitals and other facilities operated by the San Francisco Department of Public Health — makes clear that she’s far from alone in her experience. 

The survey........

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