Improving services starts with people
From my experience, people don’t fit into neat and tidy boxes and we shouldn’t force them to, we also should avoid labelling them when they don’t.
So, it is unfortunate that, as a sector, we often seem to label people, even if it's unintentionally. Whether it’s ‘complex needs’ ‘high risk’, ‘homeless’ or ‘substance abuser’. And I get it. It can be helpful when we’re trying to allocate resources or point people to the right services. But what are the consequences and implications of us doing this, and does it help us to personalise and deliver appropriate services to every individual?
When people struggle, it is not uncommon for them to be labelled as ‘hard to reach’, when in reality a more constructive way of looking at it, would be to say that we haven’t yet figured out how to reach them. We are often asking them to jump through hoops that are way too small - services are far too hard to access. There is a lot to be said for meeting people where they’re at, treating people like people and asking them what they need.
When I was trying to get support, whenever I approached a new service, whether it was for homelessness, drugs and alcohol, or mental health, I was required to ‘tell my story’ over and over again, sometimes multiple times if the same member of staff wasn’t available, to someone I had just met. For me, as with many people who have experienced homelessness, we’re essentially being asked to relive our trauma, which is incredibly difficult.
In all of the places I stayed during the time I was classed as ‘homeless’, not once did I have a choice in where I was staying. Whether it was on sofas, emergency accommodation, a hostel, supported lodgings placements or a temporary flat - each accommodation type was the only one available at the time.
While I understand that there is only so much accommodation available, it is time for us to be asking the question of whether we are compounding people’s trauma, by not providing choice. In my experience, when I was forced into situations that were out of my control, as someone who had already experienced trauma, it led to me feeling chronically unsafe.
Should we be changing the way we work?
We should be focusing on the evidence of what works, and then creating person-led and psychologically informed services so that anyone accessing a service is in control throughout, and not having to jump through hoops that don’t add any value.
A recent systematic review by the Centre for Homelessness Impact found that involving people in decisions about their housing options and placement is considered essential to the success of any intervention. It also emphasised the importance of trauma informed approaches.
Housing first for example - the idea is that it puts the person first, and they receive support tailored to their individual needs. It has been successful in Finland and provides ordinary, settled housing as a first response to people who may require help with issues beyond housing, such as trauma or addiction.
When I was staying in a hostel in 2019, I was aware that I could be told I was moving on at any point with only a few days’ notice, with no choice in where I would be going. That created an additional level of fear and uncertainty, especially when I didn’t have a choice in where I was moving to.
A trauma informed and person-led approach would give people agency, and choice in where they are going to be living. This would also allow people to feel in control of their own lives, which if, like me they have experienced trauma, is vital for recovery.