Ditching the Lanyard

Mayday Asset Coach, Andrew Durman, explores how it feels to go from knowing something isn’t right with the system to ditching the lanyard and working in a genuine person centred way through the Personal Transitions Service.

 

Into the light

I count myself fortunate as I have recently been brought into the light as an Asset Coach for Mayday Trust in Northamptonshire. Prior to this I have spent the majority of my work alongside people experiencing homelessness as a project worker or similar non-descriptive job title in traditional hostels/supported accommodation units. This year I hit 10 years in this line of work which brought me to a crossroad which was unfortunately forcing me down a road I was not wanting to go and the only other way to avoid it was to change career completely. This brought me to feeling a sense of sadness as it was not a decision I wanted to make, but had to. The decision was that I wanted to continue my love for working alongside real people going through real difficulties and challenges within their lives, however the trouble was that I could no longer sustain working in the current system for supporting these individuals. Thankfully an opportunity came for me to join Mayday. Hence the fortunate position I now find myself in now.

Person centred, or just at the centre of the hoop you have to jump through?

In the months I have been a PTS Asset coach I have realised the reason for the feeling that something wasn’t right whilst working in the traditional hostel environment. These feeling was, that although those services believed they had right intentions to start with, something had got lost along the way. That something was the individual that the services had been created to support. For example, tag lines like ‘breaking the cycle of homelessness’ when in fact the service was part of that cycle of homelessness. Values like ‘person centred approach’, but only as long as you agreed to conform and be under the control of a service. You may have been at the centre, but the circle around you was not one that was personalised to the individual. It was in fact the centre of a hoop that you had to jump through in order to get a bed/room.

We are working with people so I never understood why, if that person is experiencing homelessness, we have a system with a specific ‘homeless way’ of working with that person. When that is the case you are not working with the person, you are in fact working with ‘the homeless’. If I go to the GP for support, I go in there with no labels and no other information other than I have something I need support with. That specific something is dealt with. I am a person and that is what I want help with at this time.

Working with individuals to break the cycle of homelessness yet seeing people return time and time again to the service did not seem right. Something was not working and the question would always be what is this individual going to do differently for this to be able to work, for us to allow that person to have access to the service (that does not sound empowering and person centred at all). This was the greatest contradiction and something I struggled with. It is so obvious, but sadly only if you can see it, and maybe you cannot see it because you are not looking! The question should be what can we do differently, in order to be able to support this individual ‘break the cycle of homelessness’?

The answer is to change the system!

I am very proud to be a part of Mayday Trust that are doing this right now. Where once I was meeting people in an office in a scheme, I am now meeting in coffee shops, pubs, pool clubs, games workshops, the park, the gym, anywhere other than the accommodation that are temporarily living in. Anywhere other than an office. There is no pressure to meet and no consequences to not meeting yet individuals choose to come. We are not having meaningless conversations for the sake of ‘key-working’ where the person is held at ransom as if they do not attend they are non-engaging and issued with warning letters threatening eviction.

We are having real conversations about life in the exact same way that I do with my wife and mates and if the outcome of that conversation is reassurance, hope, confidence, a clearer direction on where to go/what to do, happiness, self-belief, empowerment, freedom and control then that’s outcome achieved. How do you record that in the current system? Where is the room for that among details on substance misuse, offending, mental health, budgeting, healthy cooking etc?

Focus on the positives and the negatives disappear

The funny thing is the more those conversations on those subjects happen, the more information gets recorded. A shift in focus and having conversations like the ones I am currently having and you will find that less needs recording (because those issues are having less of an impact on that person’s life). A focus on the negative will always lead to the negatives. But focus on the positives and the negatives will disappear. Sounds simple and that is because it is. We are not just looking for a plaster to cover up the difficulty (to manage the difficulty) we are getting to the root of it which brings on longevity in life & happiness. It is the symptoms that the current system supports and not the root cause of the current situation someone is in. And it is very rare that the answer to the root cause comes from focusing on the symptoms.

Ditch the lanyard

There are no labels attached in the places we meet, no judgement, or power imbalance, no lanyard. No one knows who we are, as far as they know we are just two humans having a conversation. The feelings that I get from this I find very hard to describe. So imagine the empowerment and feeling that the individual has. Not only does the system institutionalise the individuals it is there to support, but also the professionals working within it. The freedom and empowerment I feel now as a coach is powerful. I cannot imagine returning to work in a traditional supported accommodation service and will never do again. As the impact I can now have working with others is incomparable. That impact is that the power/control/choice is completely in the hands of the person. True empowerment, true person centred and not just a tag line in a mission statement or list of service values.

The most effective conversations I had whilst working in traditional services for homeless individuals was when bumping into someone in the corridor or around a pool table, not during ‘keywork’ meetings. Now all the meetings and conversations I have are effective and in ‘Places of Purpose’.

Not only that but I work for an organisation, with PTS partners and a team full of inspirational and like-minded people.

I feel very lucky and I am indeed empowered in the same way that finally the people I am working alongside are empowered.

I have locked myself out

“I’ve locked myself out!” What is an asset based, strength based approach in this situation? How can housing teams really start to deliver on promoting independence, leading to a ‘positive and sustained move on’? Mayday Chief Executive Pat McArdle discusses.

If only it was as simple as learning a new way of working, getting stuck into a new delivery model but as this very common example demonstrates, to get people out of homelessness demands a significant change in how we all think and act, individually, as teams, as organisations, and as commissioners. Strength based and personalised approaches require a complete change of mindset.

From Mayday’s Director of Operations:

I was involved in a discussion with a housing team who were setting up a new service and trying to solve the problem of people loosing their keys at night and what the answer was to avert this common problem.

 

The discussion very much focused on things like maybe having an ‘on call’ service but what if there was no one local to go out to the resident. The option of 24hr cover was not an option due to budget. The old service had a hostel nearby which held a ‘master’ key so they had a solution. It was expensive if the fire brigade had to be called! The point was made that many schemes do not offer a solution and the person usually finds somewhere else to go or waits until the staff arrive in the morning.

So the solution was either to ‘fix’ the problem or abandon responsibility. A very real illustration of how deficit approaches focus on trying to ‘fix’ problems without consideration of how this ‘fixing’ takes power, responsibility and control away from individuals and takes them further away from living independently.

The question, if you are working from a strength-based approach moves from, is “how will I, or we as an organisation, will we solve the problem?” to “how can we assist you in solving this issue for yourself, if it arises for you?” We need to retrain our mind to think:

Normalise the situation Our first thought needs to be how would I cope if I locked myself out. I might have a spare key somewhere, I might call out a locksmith ( so it might be good to give people numbers and costs as they move in) I might break a small window and block it up. I might stay with a friend. Ok so maybe none of these solutions will work with the person I am working with but normalising the situation removes us from the temptation of defaulting to our old, traditional, ‘fixing’ ways. It reminds us to treat people as people and not ‘clients’.

Personalise it People come up with really creative things to do, if they get locked out. All you have to do is ask them. It is an important discussion to have, before it happens. There was a man, who would pin his key to a chain inside his jacket when he was going out on a bender as it stopped the keys dropping out of his pocket; a woman, who had a spare under a plant pot as her hands were shaky and she couldn’t use the key safe outside;  a woman, who had organised a sleeping bag in his mums shed; and a man who could not find a way and had a volunteer who would come out to help once a week. Lots of ways that people found for themselves.

Empower not disempower By having a chat with someone when they move in, you are giving responsibility to them, not abandoning them in what could be a difficult and distressing situation. The person has time to think themselves about what they would do and they are also clear that this is THEIR responsibility because it would be when they live independently. So your ‘not helping’ is intentional and is about still supporting them.

Mayday’s Personal Transitions Service (PTS) is a strength-based and personalised approach. It requires recruiting people who aren’t afraid to challenge much of what they have learnt before and sometimes their own beliefs and thinking. It is always about balancing a duty of care with allowing someone to take their own risks and learn positively from their failures. This is why delivering strength based work is not for everyone.

Traditional deficit-based approaches try to solve too many problems for people and even when there is good forward thinking person-centred staff, organisational systems can have generic policies that disempower and restrict staff from personalising approaches. Ultimately, commissioners can have generic service specifications that require things like 24hr cover or set requirements that mean organisations can’t deliver personalised work.

So let’s all be reflective and honest with ourselves and while many say we deliver strength based or personalised work, let’s recognise that to really do this, we need to change the system. A system that at all levels is still focused on needs and risks.

As individuals, frontline staff and teams, let’s recognise that we all need to start to unlearn the ways of a deficit and risk-averse approach, challenge ourselves each day and truly embed strength based, empowering and personalised ways of working that might just let more people escape this broken system.

Zumba: Let’s get Loud!

Paddy Bates from Mayday Trust reflects on sector-specific Zumba and yoga sessions and asks friends in the sector to “demand for others only what we would demand for ourselves”

Yesterday an interesting advert landed in my inbox courtesy of a Google alert I have set up. It read: “Zumba and yoga teacher required to run sessions for Homeless Pathways”

Clicking on the link I read the following: “We are looking for volunteers to run either Zumba or yoga sessions at our hostel. Our clients are interested in learning these new skills and getting fit. Sessions can be run at a time that suits you either weekly, fortnightly or monthly.”

I was over the moon! – Here was an opportunity for me to do a good deed for the day. I switched to my internet browser and did a quick search for “yoga (my area)” and “Zumba (my area)”. There were so many results! I found, if you were inclined, you could Zumba and yoga twice a day, most days, in various venues within a walking distance from the centre of town. Most classes would cost less than half the price of a pack of cigarettes and there were classes at times to suit even the busiest of folk.

So there you go! I hope I have saved someone a bit of time.

I have the privilege of working at Mayday Trust. We support folks going through challenging life transitions, such as those experiencing homelessness. When one of our Asset Coaches is told by the individual that they would like to try Zumba or yoga, they do what I just did – they find a local yoga or Zumba class.

Why? Because that’s what I would do.

If I, Paddy, want to take up yoga or Zumba, I google local classes and I ask my fitter, healthier friends about opportunities to do this in my area. What I don’t do is hope someone sets up a private yoga session, in my house, specifically for Irish guys in their late thirties, who tend to comfort eat. That would be a bit weird and really unlikely to happen, right? But what if a kind, compassionate individual or group of individuals came along and considered that I might feel more comfortable doing the Zumba or yoga in my own house, with ‘my own kind’. Wouldn’t that be better for everyone? Well, no, folks are rarely grateful for segregation. We know this.

“OK”, I hear you say, “gone a bit too far there, and of course, no-one is going to set up a yoga class in your house for such a specific group of folks”. Unless I become homeless and end up in a hostel or shelter, that is. In that eventuality, then I will get my Zumba class in-house with folks who are all in the same boat as me.

Except… They are not all in the same boat; it’s not a house and they don’t all want a Zumba class on Tuesday at 1 pm, especially in their living room.

Our Mayday Asset Coaches reflect tirelessly on the wonderful unique natures of each individual they work with and offer an appropriately bespoke series of interventions to build on and develop what each individual is genuinely passionate about.

Let’s say that really is Zumba. Great! So, the Asset Coach will support the individual to get to a Zumba class in town. This might be as simple as suggesting they google local Zumba classes like I did. The individual might well be nervous about going to a Zumba class in the centre of town, full of strangers, for the first time. To be honest I would be too. So their Coach or a volunteer might go with them. Maybe we would use a bit of Personal Budget to get new gym clothes – I feel better if I look the part.

What happens when the Coach, or volunteer, walk into that community hall with that individual for the first time? Not much really. It’s just two new members walking into Zumba. Not “Homeless Dave” and “Keyworker Lisa” but simply Dave and Lisa. – “Hi. Nice to meet you. Let’s get to dancing and exercising.”

Can you see the difference? Can you feel it? The folks we work with certainly do. The freedom, the lack of label, the lack of bothering, the being part of rather than kept apart from. Our experience has shown that in a few weeks, Dave won’t need or want Lisa to go to Zumba. He has made his own new friends now. His networks of positive relations, his confidence and his internal and external assets have expanded in ways that never would have happened had he stayed in his hostel and taken part in Zumba once a month with his bunk-mate.

We see this time and time again, don’t we? An individual works their way through the “homeless pathway” until they reach that pot of gold at the end – their own place. However, so many times, where do we see them the very next day? Right back on that wall outside the hostel. Why? It’s clear and proven – without that “parallel pathway” of positive new experiences, new networks and relationships, you are left with a man or woman alone in a room. I’d be back on that wall in a flash – it’s where my friends are, where I feel comfortable. Dare I say it, where I belong.

It is not always so simple. Obviously. But I urge you. I plead with you. You the compassionate, hard-working, kind friends of this sector. Let’s give it a try. Let’s chat, reflect, consider and demand for others only what we would demand for ourselves. Homelessness is transitional. We believe this. We know this. Let’s make it as brief a transition as possible.

Evaluating the Personal Transitions Service

WeiHsi Hu, the Director of Logical Thinking discusses their research looking into the effectiveness and impact of the Mayday Trust’s Proof of Concept for Personal Transitions Service.

Logical Thinking is a consultancy supporting charities to undertake research and evaluation to better understand the needs of their communities and the impact of their work.

We have worked with Mayday Trust from the very beginning in designing the theory of change and the evaluation framework. We work closely with Mayday’s in house analyst to evaluate both quantitative and qualitative data. On our end, our focus were mainly on the qualitative data interviewing people they work with, stakeholders, and reviewing case notes of 113 individuals.

Our evaluation examined prioritised outcomes in 5 phases of the Theory of Change, particularly:

  • Individual’s initial engagement and relationships with Mayday
  • The degree to which there is trust and understanding between the individual and their coach
  • Individual’s own learning and understanding of their assets and strengths
  • Individual’s own development of their assets
  • Individuals’ utilisation/application of their assets to achieve the hard outcomes

You can read our evaluation in full detail in the report – but for now I would like to share some highlights from this research.

Evidence base & Key messages

The Proof of Concept had set out to deliver the new Model to a minimum of 220 people, consisting of various cohorts of people including those from the existing homelessness pathway, young people from the young people’s pathway, probation referrals and care leavers. Referrals have mostly been received from the homelessness pathway, which amounted to a total of 113, as opposed to the initial 220 target.

Due to the limited numbers, the volunteers were not engaged as part of the Model so the full extent of the approach has not been tested. With the limitation of numbers and quantitative data collection, we are unable to establish quantitative evidence on the outcomes of asset development. Additionally, we have not been able to model an effective staff:people ratio as originally designed—that a Coach could work with between 35 and 50 people at a time.

However, the data (interviews and full review of the case notes) we collected evidence that what Mayday is doing is new and that people are welcoming and engaging with it.

In terms of engagement, we have found that:

Seeing PTS as new approach makes better engagement

People living or working with Mayday talked about wanting to try something different.

People who knew about the Mayday programme felt that the programme offered a real alternative to the current homeless pathway in Oxford, and the fact that it was different was enticing to people to engage. It shows how much people desired an alternative approach in the pathway.

The feedback from people who took part in the Mayday programme commented on their ability to have ample time and space to have conversations with their coaches. They felt they were in control of their support, when and how they would like to progress.

It was particularly interesting how individuals often talked about having the space to explore their assets and had the choice to withdraw and rethink and not being thrusted upon when they were working with Mayday.

Voluntary engagement is key

In the early stages of the programme, stakeholders’ views highlighted the potential challenge of voluntary engagement and that Mayday seemed to have difficulties engaging people when support was voluntary. The assumption goes ‘if support is mandatory, people will have to and therefore will engage’.

Interestingly, we found statistically significant quantitative evidence for the contrary to this assumption: When coaching became a mandatory part of the accommodation service, the active engagement dropped significantly.

This highlights the crucial role of voluntary engagement – and how the theory of change got this right. Clearly, when individuals have an active choice and control over their engagement with their coaches, they are more likely to trust their coaches and participate meaningfully. Conversely, when coaching is made mandatory, individuals feel far less in control of their progress and see coaching as yet another ‘box to tick’ to move out of homelessness, and therefore engage less enthusiastically, or not at all.

Persistent and positive approach brings people back in

Coaches’ persistence and ever-present presence was the single utmost factor in re-establishing engagement. In many occasions, coaches found innovative ways to reach out to people.

Having positive conversations about things people are interested in, their hobbies, their passions were a big part of re-engagement. For example, one person started to engage, because they wanted to pursue their interest for music.

As a result of this persistent and positive approach, people felt the coaching offer was sincere and people felt they were valued as individuals – not just as clients.

It is important to emphasise how the two previous findings tie together. It is a fine balance between voluntary engagement &/vs. outreaching to keep people engaged. When we talk about voluntary engagement, it is not just leaving clients be and letting them fall through the crack when people don’t engage. The Mayday approach let people have a say if and when they want to engage, but at the same time, coaches persistently reach out to let the clients know that people should get in touch when they are ready. As a result, people felt the sincerity and became more genuinely engaged as time goes by.

Relationships and Trust

People felt coaches were non-judgmental and always accessible for them. The coaches’ behaviours was a prominent factor in building trust and forging good relationships.

People who work or live with Mayday said they had a good relationship with their coaches, they trusted them and felt free to talk to them about anything The conversations were not just their typical ‘needs’. From fixing a bike to their football team, from keeping fit to their relationship with their children.

Self-reliance and independence

People felt comfortable asking for help and indeed they did for various reasons. But as they progressed, people started to seek less help, and not because they were not engaged, or they thought they could not be helped, but because they developed new skills and networks to overcome problems.

Coaches were very successful at promoting independence. We found that coaches consistently enforced a sense of ownership, by handing over the responsibility to people.

Coaches should be commended in their initiative to take on a supportive role providing information and advice as requested, and empowering people to take self-action to make things happen.

Asset utilisation and hard outcomes

The next stage of research will look into the relationship between asset utilisation and hard outcomes more closely. For our discussion on Mayday’s Theory of Change and how asset utilisation and hard outcomes relate, please download our presentation below.

Download the full Logical Thinking Report on the Theory of Change

 

Delivering System Change on The Ground

At the launch of Mayday’s Personal Transitions Service and our report Homelessness System Under Deconstruction, Sarah Hughes describes her experiences of bringing about systems change through delivering Personal Transitions Service.

Nearly 3 years ago, I came to work in the Oxford Adult Homeless Pathway, straight from university, with little knowledge of what homelessness means and carrying with me all the perceptions and ideas that society had given me on how we define a ‘homeless person’. This included all the ‘problems’ associated with homelessness and all the assumptions about how more and better services could provide a fix. Working as a coach at Mayday, I had to unlearn everything I was told by society and the sector. I couldn’t have done this without the people I have worked with over the course of the Proof of Concept. I feel privileged to have worked with such a diverse, interesting, funny and passionate set of people who have taught me so much. But all too often this same set of fantastic people who have enriched my life, are reduced to a set of problems and labels.

Let’s put ourselves in their shoes for a minute. Answer these questions in your head and think about how you would feel about saying your answers out loud. How would you feel about the person who is asking you? Someone you may have never met before, a stranger who does not know you… Do you use drugs? Do you drink? Do you have mental health issues? If you are a woman, are you pregnant? Have you been to prison? These questions are very personal and are based on pre-conceived ideas about the people that we meet.

The truth is – the Personal Transitions Service is nothing, if not deconstructing the assumptions about what makes, keeps and solves homelessness. This would not happen without the input of people experiencing homelessness or the coaches who are bringing about change through their actions, values and behaviours. And trust me, being in the system, and going against it is no easy task.

Coaches aim to connect with people at a personal level. When individuals are referred to Mayday, they come with a ‘needs’ profile – but this tells us nothing about who they are, what their preferences are, and what they would like to do with their lives. There is a big discrepancy between the needs profile, and the people we work with every day. Unless there are grave safety issues, we prefer not to see their needs assessment and start by building a relationship with the person through a conversation about their strengths.
Saying we do not always agree with needs and risk assessments and saying people’s strengths, skills and aspirations need to be recognised requires much bravery. When we said we see ‘strengths’, we were deemed to be too fluffy! But truly listening to people and building strong relationships at a human level is so fundamental. Without it people do not have a voice in the system.

People are suspicious when they start working with Mayday. They are not sure what to expect and base their judgements on previous experiences of working with services. Coaches put a lot of work into winning people around, proving to them we are a worthy service. When I was coaching, I worked with an individual, Jim, who for the first 3 months didn’t turn up to any meetings. Then I found a hook through setting Jim up with guitar lessons and from this we got to know each other and spent a lot of time discussing books, politics, music and history- all things I was more than happy to talk about! Once Jim got to know me, and what Mayday is about, he turned up every week and did not miss a meeting. Sometime later, Jim reflected with me and said that he didn’t like me at first and that is why he did not come but that he now greatly regretted wasting time and wished he had worked with a coach regularly from day one.

The Personal Transitions Service is about finding what people are passionate about, and building on their passions to find purpose and surround them with new friends and community outside of the homelessness system.
We have been received with much scepticism – ‘Mayday is all carrots, and not enough sticks’. Well, to me, what others called ‘the carrot’ is about being human, and not a system. The carrot is about thinking outside the box, and working with an individual to open up opportunities which use the rich set of skills, abilities and strengths of the people we work with so that they can move on to where they want to be.

For example we worked with Bob, who was doing street art and this was getting him into trouble. But instead of seeking to stop this behaviour, punish him or use the ‘stick’ we turned it into a carrot. The coach worked with Bob to explore his love of art and graffiti. They went on a street art tour in Shoreditch and the coach also brokered an opportunity for Bob to do some art on a wall in a local café in Oxford. This focused him on the future and on the back of this he is looking to do a course and get into work.

But Asset Coaches not only build the critical initial relationship with the individuals, they also work autonomously and creatively with the individual to ensure that the power remains with them. The focus is on each individual continually building evidence of their ability to achieve for themselves.

Often people in services end up having things done for them or situations ‘fixed’. Someone going into rent arrears? Let’s make some calls to sort it out. Someone started using again? Let’s refer them to a drug worker. Whilst well intentioned, this interventionist approach takes agency away from people.

We have of course duty of care – but we also need to give people room to fall safely. We learn by falling and the falls must not be prevented- but people need a non-judgemental network of support around them to facilitate them getting back up and to encourage them to carry on. Standing back is one of the most crucial but difficult things a coach has to do.

When I was coaching I worked with Ray who was going through a difficult time. He did not have contact with his daughter who he was very close to and he was drinking heavily to cope with the situation. We had looked at several options he was interested in, including going to meditation, film courses and martial arts. But he was not coping well with not being able to see his daughter and his engagement dropped and his drinking escalated. I stayed in touch, let him know I was there but we slowed things down.

A few months down the line he thanked me for giving him space. He said it would have been detrimental to push him at that time and he was glad that whilst he knew I was there to talk to, I was not forcing him to make decisions he was not ready for. Sometimes coaching is just about knowing when to give someone safe space; which is hard because you have to know that things could go wrong. When he started engaging again, he reduced drinking, got in touch with his daughter and started applying for a degree. This was the right time for him. He made the decision.

Working by the schedule of the people we work with is in constant contrast to the systems we work within. The focus on deficits and ‘fixing’ people’s issues when they are not ready, ends up acting as a barrier for them moving forward. When they do not achieve what is set out for them, they then cannot access options that they would like to explore. There is emerging evidence to suggest that some of the people termed ‘complex needs’ did not require some of the high-cost interventions given to them. For example, drug rehabilitation and long periods in hostels or supported accommodation, before being able to move into the community and successfully sustain their own accommodation. But there is a need for the people we work with to prove themselves in certain areas, areas which they may not be ready to address yet, and do not define their ability to live their life the way they want to. Does someone need to have addressed all their ‘issues’ before we can deem them ‘move on ready’? Could we all class ourselves as ‘move on ready’? I know I have credit card debts, I order too many pizzas and I drink too much sometimes. If I became homeless tomorrow, would these things that I can manage in my own home today, become barriers to my independence tomorrow?

A needs based system says “We will believe you when you achieve it, when you complete the tasks given to you”. We say “we believe in you, you will achieve”. A major disruption has been in how we see people, and how they achieve their outcomes.

When I was working as a coach I was told by others that Mayday coaches just do the ‘fun’, ‘soft’ stuff whilst other services do the ‘real’, ‘hard’ work. I believe our work is extremely real and if you work in a strength based way, you are choosing to take the more difficult path. You are also choosing to go against the norm. Being an Asset Coach is about being in the system, but against it at the same time. It isn’t for everyone, and it takes personal strength and resilience to carry on doing, carry on challenging.

But I take strength from knowing that it works. My gut first told me this would work, then I heard it from the people I worked with and then I saw it in the data; people’s asset scores were improving, they were adding more and more of the good stuff to their lives; the good stuff which would eventually make no room for the bad stuff.

The real systems-changers are the people who access services and the coaches – every decision they make, every action they take, chips away at the system. But we are able to do this, because we operate in a micro-system called Mayday that gives us the freedom to break the rules, challenge assumptions and change practice.

Deconstructing a Broken System

At the launch of Mayday’s Personal Transitions Service and our report Homelessness System Under Deconstruction, Pat McArdle describes why the sector requires a paradigm shift to transform how we tackle homelessness.

I would like to begin by sincerely thanking The Lord Mayor for choosing Mayday as one of her charities of the year. Having the privilege of working with The Lord Mayor this year, will enable us to maintain a focus and raise the profile of an issue that many of us feel very passionate about – homelessness.

There are few social issues, though often misunderstood, that I feel so strongly about, seeing people trying to survive, and not just from a night on the street, hunger or poverty or a decent roof over their head but trying to maintain their dignity, overcome rejection, isolation, loneliness, seeking a place to belong, to escape pain, emotional or physical, to find somewhere where you can feel a sense of purpose or self-respect. Watching people trying to survive is hard, with some even judging those very survival strategies apportioning responsibility to the individual, pathologising or labeling but homelessness is a state, a state from which it is hard to climb out of, no matter how strong, how resilient, ultimately over time it takes its toll, it wears people down.

No one was born to be homelessness – Charles Darwin once said:

“If the misery of our poor is caused not by laws of nature, but by our institutions, great is our sin”.

So over the last 3 years, I have begun to think how I, over the last 30 years, maybe have not listened enough, reflected enough, educated myself enough to understand the role that I was playing in building and colluding with a system that in essence has dis-empowered, not empowered people to get through their tough transition, overcome whatever demons they are facing, or barriers they are climbing.

When did it happen that we became so system led not human led, when did ticking the boxes become more important than doing what’s right for that person.

This is why our report is called: “Homelessness System under Deconstruction.”

In the summer of 2014, I stood with a safeguarding officer watching a vulnerable man get into a taxi with a known drug dealer. His worker told me that the man was being taken to the cash point where the drug dealer would take all his money in return for drugs that was forced upon him. A pattern repeated often over a long period of time

The man was receiving the traditional support, but however well-intentioned we were, what real impact would referrals to drug rehabs, or engaging with mental health services or help with keeping his room tidy really have. Would it stop him feeling threatened, scared and intimidated, would it stop him being a target for the drug dealer? With all our blanket policies and rigid offers, would the man feel safe to trust us enough with what was really going on in his life?

People don’t have complex needs, the situation has become complex

As a homeless sector and as a community we must focus. We need to find good homes for people in the community where people are safe. We need to treat people as people, not clients, and as individuals we need to respond to real world and impactful solutions, we must build trust, listen and not assume that everyone needs a service some people just need to belong, find a purpose, a way back to belong and be part of the community. As a sector, we must not be distracted by government agendas or all the many debates going on in the homelessness sector. Our resource is limited and while austerity has brought about many new and interesting responses to homelessness, the place to start is by listening to people, listening to frontline staff and really trying to understand what is happening. This is what Mayday has tried to do over the last 5 years.

I would like to sincerely thank Oxford City and County Councils who gave Mayday this opportunity to deliver the Proof of Concept. The authority with other providers have often supported what we were doing, other times questioned, concerned, challenged; and overall made a huge contribution to over two years, the richness and depth of what we have learnt, the changes that we have experienced has been invaluable.

This is why it has been so difficult, so challenging to produce a report that is just a straight forward model evaluation. Thank you to our funders who have bared with us. And great thanks to a member of our board Andrew Meehan, who very succinctly categorised our report into 3 areas:

Advocating for the PTS

From our qualitative evidence and experience, the period of the proof concept makes us even more committed to advocating for personal transitions – personalised and strength based approaches. The feedback and individual achievements of people we work with have told us that people feel respected and treated with dignity. To me, that is a fundamental element of what people experiencing homelessness have asked from us and absolutely deserve. Small numbers who started with us just over / years ago have sustained positive life changes which give us great motivation to continue to a larger scale research project.

Independent evaluation

The report also contains Logical Thinking’s independent evaluation of our service model, despite 5 years of evolving and co-producing a personalised and asset-based approach, I don’t think we are there yet but the work and results have demonstrated the scale of the task in not only introducing a new model but one which demands cultural, structural and system change both for the organisation and staff involved. A total new way of thinking and acting around the problem.

Learning and experience

Finally, the report discusses our overall learning and experience of delivering the Personal Transitions Service. During the Prooof of Concept, we inadvertently discovered what system change was and just how failing a UK needs and deficit approach was in helping people out of homelessness.

My hope for today is not to persuade you that Mayday has discovered the magic solution to ending homelessness but to ask that you play a role in bringing about the paradigm shift that is needed to radically transform our approach to tackling this problem. Whether you are  an interested party, a provider, a funder or commissioner, it can’t happen without all of us coming together starting with each one of us challenging our own thinking and perceptions. Start by helping to deconstruct this broken system. Homelessness can be a brief transition in someone’s life, we can make that happen if we chose to believe it. We at Mayday believe that with personalised responses, seeing an individual’s strengths, helping them see a different future for themselves, believing in them, can make this happen.

The Unspoken Truth of the Frontline

Anna Suswillo, Mayday’s Asset Coach, shares the unspoken truth about working on the frontline and her experiences of being in and against the system.

When I tell people what I do, they often tell me how worthwhile it is, and how “good it must make you feel”.

In many ways, this is true. There are few feelings better than seeing someone you have worked with reach that milestone or make that decision. It’s what we’re about.

But it is also true that there are elements of the job that can leave you feeling frustrated, useless, powerless and not at all “good”. These are the ones that aren’t talked about, because it’s not fun to hear and it detracts from the successes. The closest reference people might make is, “I couldn’t do your job”, but the presiding belief is that every day you must go home with a glow of do-gooder satisfaction.

Some days, I go home feeling that I do very little good, for anyone, ever.

The origins of this feeling operate on two different levels.

On the one hand, the people you work with can contribute to chipping away at self-worth. If you do not have thick skin, a strong understanding of emotions behind abusive behaviour, and a robust support system (professional and personal) you will very quickly find yourself on a train ride to low self-esteem-ville. There will always be people who take their frustrations out on you; it’s not personal, they need to express the injustice of their situation. But this does mean that you will repeatedly hear that you are useless, that you don’t care and that, actually, they don’t like you at all.

As someone who comes into the sector because you fundamentally do care, and want to be useful, this can be very demotivating to hear. Especially when it is your job to pick yourself up, bounce back and approach the same person again with no judgement, resentment or fear. But you must do it. You don’t need to be liked to help. You do need to be there.

The other hand hitting you is what we murkily refer to as ‘The System’. The System is ever-present and it is rarely your friend. If you are not careful, The System will take all your motivation, good intentions, innovations and eagerness to help and flush it down the toilet. That referral will be rejected due to an obscure technicality; that person’s case will be closed when they can’t attend an appointment for mental health support because they are enduring an episode of poor mental health; this person won’t be treated because they are not ill enough.

Sometimes it can feel like it is the people in the other organisations and services that are standing in your way, but it isn’t; it is their part within The System that is. They, too, are frustrated and upset with the way things work but feel it’s impossible to change them. Constantly slogging against The System, trying to negotiate your way through it, or trying to creatively work outside it is tiring, especially when you know that things could be so much better.

These are not the heart-warming elements of front-line working that people want to hear at a party. And, as a person, these are not feelings that you want to have. But how can you combat them and still stay in the same role? Because, certainly, if we want the system to change, this can only be done by combating it and persistently shouting out when you see something wrong.

Firstly, personal disposition cannot be overlooked. That is not to say that everyone needs to be exactly the same, but there does need to be an element of passion, motivation and positive belief threaded through with a solid line of steel. This does not mean that you cannot be emotional or compassionate; it means you need to be able to reason your way through complicated behaviour and, more importantly, ‘bounce back’.

These people need to be put together. Combating a system and sometimes verbal abuse is going to be more difficult if you are not surrounded by people who share your core values and mission. You need team members who can understand that sometimes things hurt and are upsetting, but who are also able to give you a perspective on why that person did that or how you can work around that barrier; or when you need to lay down a reasonable boundary.

Finally, you need to be appreciated by those that employ you. Not in the “worthwhile” sense, but in an organisation that respects the work you do and the difficulties you encounter every day. You need to feel trusted and empowered to make decisions, but also supported to say when things are building up. I think this is something that a lot of organisations need to work on. Sometimes it is not enough to say that you respect staff; you need to show it too. And showing it can take the form of practical support, such as supervisions and reflective practice.

For me, personally, this is the work that I love and enjoy. So in many ways, the decision to work on the frontline is not a “selfless” act; I would go mad if I had to sit in an office all day. I work with people, not damaged objects, and there is always an emotional toll of working with people. We must not romanticise the roles of people working on the frontline, but accept the roles in all their gruesome detail and come up with better plans to support, encourage and enable those who are striving to support, encourage and enable people facing difficult situations.

A Disorder for Everyone

Nikki Aitchison, one of Mayday’s Asset coaches, blogs on how frontline workers can challenge diagnosis and the ‘let’s fix it culture’ prevalent in mental health and homelessness services.

Last month, I attended an exciting conference called ‘A Disorder for Everyone’ in Bristol. The day explored how strength-based and personalised interventions could offer an alternative to the current biomedical framework and the ‘let’s fix it culture’ prevalent in our public services.

More people are being diagnosed with mental health problems every year, this is partly due to the success of public campaigns aiming to destigmatise mental health problems. But as Carl Rogers says “the shoe that fits one person pinches another”, simply speaking out about mental health problems and relying on more diagnosis, and more professional support is not a recipe that will appetise everyone.

‘A Disorder for Everyone’ challenges the current system within mental health and looks at every single individual case. Instead of saying ‘what’s wrong with you? They ask ‘what happened to you?’ – A language shift surely makes less severe subconscious stamps and makes recovery an option. Clinical Psychologist Lucy Johnstone explained that if each individual case is to be looked at uniquely using a method called “formulation” there would be far less diagnosis and less prescribing. It is a person-centred process that creates a unique intervention.

In other words, ‘diagnosis’ is a generic identity – for example, hearing someone has been diagnosed with depression, tells very little about the influencing factors that brought to person to feel and behave in a certain way. The diagnosis of depression tells nothing about our interaction with the environment, culture, media, parents and social networks around us. So the question we should be asking at the frontline is not ‘what diagnosis should this person receive (or should they have received)’ but ‘how can I include the person in their recovery and encourage them to recognise their strength so that they can bounce back from tough times’.

Alongside this, I recognise that the reliability and validity of ‘mental disorder’ remains contested by people who survive the psychiatric system – but for the purposes of this blog, I will not go into a debate about how well the diagnostic manuals measures what they purport to measure – it is not a field I am trained in – but I will reflect on my experience of coaching people who received a mental health diagnosis, and how, if at all, this should have an impact on how we work in the frontline.

In my experience of working with people who are going through tough times like homelessness, leaving prison, care or psychiatric hospitals, I find three key principles ensure a quicker and more positive transition:

1- Challenging identities based on diagnosis, as any label, including those given by medical profession attempts to neatly categorise individual experience. The language and labeling that comes as a result of the diagnosis can give someone a false generic identity that can leave them feeling hopeless and discourage their drive forward

2- Challenging our ‘let’s fix’ culture of the overly diagnosed and prescribed generation, and instead of offering a new psycho-active drug, or even a psychological framework, sitting down with the individual and having a honest conversation about who they are, what matters to them, and ask what, if any, support they want from us, rather than assume what is best for them.

3- Recognising “what happened” that led to someone experiencing tough times, but focusing on “what is next”, what their dreams and aspirations are, and what strengths they already have and can build on to get there.

Let me illustrate this with my experience of working with Peter:

Peter made it very clear from the beginning that he does not want any support with his mental health diagnosis. For years and years, he was pressured to engage with mental health services and was feeling sick and tired of people nagging him about the same issues. We agreed we would focus on his aspiration – developing his knowledge and skills in Street Art. We spent much time walking across East of London, looking at street art, talking to artists, building positive networks and finding exciting projects for Peter to get involved in. Focusing on what Peter wants to do became a positive motivation to tackle and overcome challenges, including those caused by previous mental health problems, and Peter continues to learn to work through what life throws at him and build the resilience to overcome challenges in the future. In other words, Peter has better mental health, because he has not focused on it!

Starting the conversation with dreams and aspirations, focusing on strengths, and slowly building on what is already good (and important for) people is far more empowering and useful. This strength-based and personalised approach gives people hope, whereas a support to fix problems based on a diagnosis leaves people hopeless. Labeled as mad, bad, sad, client, service user doesn’t motivate anyone to take a positive step and move forward – instead, labels reinforce people’s insecurities, ‘places in hierarchy’ and makes them dependent on services. We all go through a rough patch – some rougher than others – but these difficulties should never define us!

I hope this blog encourages other frontline workers like me to consider strength-based and personalised practice, and together we start a front-line revolution by putting people (not the labels) at the centre of every decision and action.

Mayday, Soundworks Studio & Midcounties Co-op broker a new tune for Rob

On Sunday 12 March, Rob and our volunteer, Chris Williams have been interviewed by Sophie Law on BBC Radio Oxford. The powerful interview can be listened to at the bottom of the page, with kind permission of BBC Radio Oxford.

Rob has been picking up a guitar on and off for the past 20 years and has never progressed past the same song and the same few chords. He is a massive music lover and his knowledge on the subject is outstanding. He knows the lyrics to countless Bob Dylan and Black Sabbath songs but he has never been able to play and share them. Rob has been on the streets and in and out of services for years but he was never asked what he liked or enjoyed, he has not been given the chance to further this positive hobby. This changed when he was given the opportunity to expand his music repertoire and explore his love of music further by visiting the Soundworks Studio in Oxford. Access to the studio came about through local brokering conducted by Mayday coaches and this has been funded through successfully applying for a grant through Midcounties Co-op which will keep this exciting project going for the next year. Here Rob worked with a Mayday volunteer who was able to teach him guitar and move on from that 20-year-old tune. By the end of 4 weeks, he recorded himself playing and singing a Bob Dylan song.

Rob was delighted. As we sat over coffee, he proudly presented me with his CD. He said he couldn’t get across how much this meant to him and how pleased he was that he was able to do it. He walked into the studio and never thought he would be able to record a song. He left with a CD; a solid tangible outcome which demonstrated to him he is capable and he can achieve. He was proud of how far he has come.

Rob decided it was OK not to have a drink the night after he recorded a song, he felt that the buzz he got from his studio experience was enough. We talked excitedly about it for some time and hatched plans for future musical adventures. Rob found something positive, something he deeply cared about, that he could grow and build on.

These moments are very special. As a coach at Mayday, we do not identify needs and deficiencies, provide fixes and constantly measure progress, we focus on the strengths of individuals so that they realise that they have the potential and ability to achieve their own aspirations. Developing this self-belief and providing suitable platforms to facilitate it is central to everything we do. We do not direct people to a sector-specific, trivial social activity centre, we broker real life opportunities (such as recording a song at a studio) and work with volunteers to nurture people’s interests.

Rob surprised himself and saw himself in a different light. He was able to redefine himself from the guy who wished he could play more than a few chords to someone who records songs in a studio! This single triumph can then percolate through his whole being and allow him to reimagine many areas of his life where he had defined himself as inadequate.

Rob is going to send his CD to his daughter so she can enjoy it and he can share his new found skill. He is excited about her reaction and to know her thoughts on it. He knows his daughter has always believed in him and here is his evidence for her. Rob has planted a seed of belief and our job now is to nurture this in order for Rob to change other 20-year-old tunes.

Living on the streets, you get accustomed to that lifestyle. It takes a while to adjust to living on the mainstream. You take it for granted that people don’t care about you. When you work with Mayday, they do . . . Never in my wildest dreams, I would have thought I could be recording in a studio. (Rob)

On Sunday 12 March, Rob and our volunteer, Chris Williams have been interviewed by Sophie Law on BBC Radio Oxford. The powerful interview can be listened to below, with kind permission of BBC Radio Oxford.

In Memory of Martin

Anna Suswillo, one of our Asset Coaches discusses how people like Martin struggle to navigate through a complex system of homelessness, care and health.

Whenever I pass the high street early on a weekday, I always half-expect to see Martin sitting there, waiting to meet me. Usually complaining that he had been there half an hour already – he was always early. Always so early, in fact, that I often had to warn him not to be when it was raining or very cold. He could be conscientious to a fault.

Our meetings would always be short, in line with his attention span. We would laugh about different DVDs or the TV shows he watched religiously. He would tell me which superhero comic he had taken out at the library that week (and which he would be sure to return on time). Sometimes, he would tell me proudly of an achievement, such as putting on weight – one of his regular goals from the doctor.

Over the time we worked together, I gathered the snippets he would offer me. I knew his jokes, what he found funny, what enraged him, and that he put on a suit and visited his parents at the cemetery every week. He took no sugar in his coffee because he was, always, “sweet enough” and he loved fish and chips on a Thursday. I knew he liked to walk his friend’s dog. I knew he had a sister, with whom he had fallen out of touch, but who he always recalled warmly and wished they spent time together.

We focused on the things that he liked. He enjoyed making models out of matchsticks. We provided a personal budget for the necessary supplies, and we went to buy splints, baselwood, and glue. I remember the confidence with which Martin talked with the shopkeeper about his plans and techniques; I had not seen him do so anywhere else. He confided he hoped that modelling would mean he would feel less inclined to go out drinking. He attended cooking lessons, which he loved, and he would enthusiastically call me to tell me what they had made.

Did Martin have complex needs, or was he stuck in a complex system?

Life has not been kind to Martin. He had suffered several losses – from his mother’s death which had made him homeless; to his fiancée; and then his best friend.

Martin was struggling to navigate his way through homelessness, care and health systems and was also physically unwell. It was suspected that he had a learning disability – by both ourselves, his doctor and previous workers – but as he was in his fifties, and had never been officially documented as having one, he was not entitled to support.

Martin lived with his mother until his late forties. He had never paid rent, never managed bills and never cooked for himself. He did, however, pride himself on his cleaning and regular laundry. He struggled with reading and writing and comprehension of complicated matters. He had no concept of the value of money. He wanted to be in a supported living scheme, because he didn’t feel safe on his own. But he was not eligible for the support he wanted, and in his distress and confusion, he was self-medicating.

We approached the social care services, but the reply we received depicted a very different man to the one I knew. He was identified as “an alcoholic, who did not want to engage with abstinence services”. The tone painted the picture of a contrary man who refused to make things easy, even though he was one of the most engaged and reliable people I worked with. Everything hinged on his alcohol use, and his ‘choice’ to continue drinking. Any chance of a learning disability was disregarded in the face of his drinking. The reasoning was that so long as he stopped drinking, he would be able to receive help – “stop drinking; then we can talk”. There was no consideration of the fact that Martin was drinking to cope with an unstable situation that he could not understand.

Pieces came together, only too late

Martin died in the ICU, following an ongoing and complicated lung problem. He did not want to go to hospital. He did not want to give up smoking and he had remained drinking down by the river. In his mind, if drinking and smoking made him feel good, while everything else made him feel bad, why on earth would he stop? For Martin, drinking was not a ‘choice’, but a survival tool. Alcohol and cigarettes were steadfast companions that brought him drinking buddies, warmth and moments of positive feelings.  Although our work together had begun to offer feelings of friendship, warmth and well-being from a source besides alcohol, I was just too late.

While he was in the ICU his sister was found. It was a bittersweet moment that she was, finally, there – but he was unconscious and would not wake up. I was grateful then, that I was a person who had vivid, human memories of the time I had worked with him. I knew his jokes, what he found funny, what enraged him and that he put on a suit and visited his parents at the cemetery every week.

As a worker, the death of someone you work with is devastating, and it is hard not to question yourself and to feel blame.

Martin was let down by a broken system: a system that slammed doors shut tohim, because he did not meet the desired criteria of ‘sick enough’ or ‘well enough’; a system that could not see him as an individual rather than a shopping list of problems.

It was a privilege to get know him and listen to his story. It is not easy to push aside what ifs, but it is important so that we can turn to what now; now, Martin’s memory motivates me every day to always see the person first, and everything else second.