Jumping through hoops
The MEAM coalition, AVA, Agenda and St Mungo’s have just (5 September 2018) published Jumping through hoops: How are coordinated responses to multiple disadvantage meeting the needs of women?
Across the country, local areas are developing better coordinated responses for individuals facing multiple disadvantage. The focus of this work tends to be on the practical coordination of homelessness, substance misuse, mental health and criminal justice services, alongside a commitment to ensuring that all relevant agencies in the area offer flexible service responses.
A minority of the beneficiaries in these local areas are women. While there has been progress on gender and trauma informed approaches across the sectors mentioned, little is known about how general services in these areas are responding to women’s needs or how women-specific services, such as domestic and sexual violence services, are involved in coordinated approaches.
The research explores three key questions:
- Is there a good understanding in these areas of the experiences and support needs of women experiencing multiple disadvantage and how these needs differ from men?
- To what extent is good practice in supporting women with multiple disadvantage being followed in these areas?
- What is the impact of a more coordinated approach and what do services/systems need to do to improve support for women experiencing multiple disadvantage?
Understanding of women’s multiple needs
Women frequently described a pattern of experiencing abuse, becoming homeless and using substances to cope, potentially becoming involved in criminal behaviour or prostitution and developing mental health issues. They reported that the impacts of trauma can make it feel impossible to cope with the additional barriers and obstacles posed by other complex needs, and indeed those posed by services themselves. A common narrative was the feeling that services can often re-traumatise women by the lack of joined up approaches, causing them to constantly re-tell their stories to multiple practitioners.
The majority of women interviewed had had children removed. Many of these women had been teenage mothers and had previously been in care themselves. These women often felt as though services (in particular statutory social care services) abandoned them after the removal and that the grief and loss they felt was not acknowledged. This often led to internalised shame, guilt and a sense of not fulfilling societal expectations of what it means to be a woman (i.e. a mother, a care-taker and a home-maker). This became yet another form of trauma and could lead to more issues relating to mental ill health and substance misuse.
The research highlights 12 components of good practice:
- There should be an alignment between clients’ needs and service priorities
- Services need to understand and address power dynamics
- Mental health and other services need to be engaged
- There must be an appropriate response to dual diagnosis
- Practitioners need to build trusting relationships
- A trauma informed approach is vital
- The women’s sector needs to be actively involved
- There needs to be an appropriate response to domestic violence for women with multiple disadvantage
- It is important to have access to the right kinds of accommodation
- Services need to be shaped by people with lived experience
- It is important to understand women’s circumstances, backgrounds and experiences
- There must be the right support in place for staff
Impact of a co-ordinated approach
Research found both benefits and challenges of a co-ordinated approach. Interviewees reported feeling lost and unsupported, because of having to re-tell their stories and an overwhelming number of appointments with different practitioners. They felt that these problems could be solved through more effective partnership
working. Practitioners noted that services benefit from not having to deal with complex cases alone, gaining
a more holistic view of their clients, having a better understanding of risk and safety planning and the ability
to intervene earlier to prevent crisis or escalation of need. The research also found that women-specific services were often omitted from co-ordinated approaches.
This is a valuable report which both showcases valuable examples of best practice while highlighting that this is far from being the norm and that the development of a co-ordinated gender-aware approach is a complex business which takes considerable time and effort to achieve. The importance of listening to women with lived experience is a constant theme.