Changes we must make for people experiencing multiple disadvantage

As I interviewed people it came up time and time again in many forms and guises, that, regardless of how we choose to dress it up, when you strip everything away it all adds up to the same thing—humanity—and being listened to, heard and valued.

Groundswell researcher

For the last two years, we’ve been leading the research and learning partnership for Fulfilling Lives Lambeth, Southwark and Lewisham (FLLSL), one strand of the national Fulfilling Lives programme funded by the National Lottery Community Fund, alongside Groundswell and the Centre for Regional Economic and Social Research at Sheffield Hallam University (CRESR), to understand the current system of support in Lambeth, Southwark, and Lewisham, explore how it could change, and share what we learnt across the system.

People experiencing multiple disadvantage have been at the heart of our research, with Groundswell leading on peer research to understand their experiences and ideas. Our research has also connected to the wider evidence base, with CRESR leading on a literature review of models of support for people experiencing multiple disadvantage.

Here are five key issues we found, along with five changes that services, funders and commissioners can make to help more people live more fulfilling lives. You can read more in our full report and let us know what you think by emailing Margery.Infield@thinkNPC.org

Issue 1: Services can be difficult to access and navigate.

A lack of accessible information, rigid eligibility criteria, and inconvenient appointments can make it tough to access support. Siloed services and high caseloads can prevent practitioners from helping people navigate the system.

They’ve got a book and if you don’t fit into it they don’t see this.

Person accessing support

Change: Improve access and transitions by working across service boundaries and recognising interconnected needs.

By working together, you can recognise and respond to multiple needs. You can better understand each person’s context and how their needs are connected. This will allow you to form stronger relationships with people accessing services and offer more tailored support.

Issue 2: Services can retraumatise people and fail to meet their specific needs.

Asking people to constantly re-tell their story as they move between services can be re-traumatising. If you’re not using trauma-, gender- and culture-informed approaches you may not be equipped to support the needs of specific groups, such as women or people from minoritised communities.

You might feel worse from engaging with services. You’re not going to get better because of the way you get treated. But you have to engage with the system to get better and get support.

Person accessing support

Change: Meet people’s specific needs by taking a trauma-, gender- and culture-informed approach.

We must recognise people’s specific experiences and the intersections of their identity to be most effective. Trauma-informed approaches can be empowering as they help people feel in control of their experience when accessing services. Gender- and culture-informed approaches ensure services are tailored to the specific needs of different groups of people.

Issue 3: Services and commissioning are not always informed by people’s lived experience.

A focus on ‘hard’ outcomes rarely reflects the reality of people’s lives. People experiencing multiple disadvantage tend not to follow a linear path to ‘overcome’ a particular issue such as substance use. It’s important to leave room for the reality of relapse and non-linear recovery journeys.

If you fail to meet their requirements, then it can affect your relationship with them and the support you receive.

Person accessing support

Change: Commission and deliver person-centred and person-led services.

Listen to people, give them choices, and support them to make their own decisions. This can have a bigger impact as your service will better match the realities of people’s lives and their goals.

Issue 4: Practitioners are not always well equipped to support people accessing support.

Practitioners often face pressure to ‘do more with less’ and services themselves may not be able to provide adequate training to practitioners. They are therefore likely to have limited capacity and resources, which makes it difficult to provide tailored services.

[Practitioners] can become hardened to get on with their work and protect themselves.

Person accessing support

Change: Invest in practitioners and organisational capacity.

Invest in training and staff support—particularly in trauma-, gender- and culture-informed approaches—to help practitioners provide longer-term, higher-quality, person-centred services.

Issue 5: Short-term funding flows and siloed policy decisions can lead to ineffective services.

Short-term commissioning cycles can destabilise services, as they cannot guarantee that they will always be there for the people they support. Funding different needs separately also leads to people receiving inconsistent and fragmented support.

Nobody is looking at how all the different areas of need or services fit together. Services are commissioned separately.

Person working in the system

Change: Take a longer-term view with funding and policy.

Investing in longer-term change gives services the best chance of creating sustained impact in communities and people’s lives. Funders and policymakers should look to create more joined-up, person-centred support, for example, by looking at joint commissioning models and creating space for conversations between policymakers and people with lived experience.

We hope this research will help services, funders and commissioners to support more people to lead more fulfilling lives. Read more in our full report and let us know what you think by emailing Margery.Infield@thinkNPC.org