How people get into difficulty
The Relational Worker
We all face challenges in life.
Relationship problems. Money problems. A dip in our mental health. Drinking or eating too much. The outer-reaches of dependency. Mostly we deal with life’s vicissitudes with our close ones, neighbours and colleagues. Occasionally we might seek professional help, a doctor, a therapist or an accountant. Sometimes the professionals impose help, a police officer or a social worker. This is rare though.
But sometimes challenges accumulate. What happens then?
Sitting on the Outside, looking in
Severe and multiple disadvantage. Multiple and complex needs. Multi-problem. Poly-victimisation. High support needs. Dual diagnosis. Multiple disabilities. Adverse life experiences.
What do you think when you hear these labels?
If you are a policy maker, you will focus on system responses. On matching needs with services, on eligibility and access to help, on relationships between support providers, on quality of care and user engagement. And, of course, on showing that all of this makes a difference for the person who gets help.
If you are a scientist, the focus changes. You will count the risks and examine their effect on health and development. System responses will not matter as much. You might ask, ‘How many people with significant needs are in an area?’. ‘Which interventions reduce risk and produce better outcomes?’
Different lenses. Different wants. Different definitions. Each leading to different results.
If you are the one in difficulty, these labels may feel cold. Impersonal. Emotionless. Clinical. A few years ago, I asked a young person about the words ‘facing severe and multiple disadvantage’. She said,
I don’t care what you call me, as long as you treat me right.
This is the heart of the matter. Treating people right demands deep understanding. How do people facing difficulties get in and then get out of difficulty? There is so much written about this. I tried to make a contribution by seeing the disadvantage through the lens of those living it. It reveals something different. Something that social policy and epidemiology miss.
