With the temporary housing of rough sleepers in response to the Covid-19 emergency, some commentators have been tempted to believe that the rising population of rough sleepers in…
Abstract
Purpose
With the temporary housing of rough sleepers in response to the Covid-19 emergency, some commentators have been tempted to believe that the rising population of rough sleepers in the UK has finally been reversed. This paper aims to examine the choices made by persistent rough sleepers and how far they are influenced by the perverse incentives of social policies, in order to challenge the view that they sleep rough out of choice.
Design/methodology/approach
Evidence for this paper is derived from two teams of frontline service providers with routine familiarity with the rough sleeping population: a street outreach team and a team of support workers working with adults with multiple and complex needs. Primary data from focus groups were combined with the secondary analysis of both numerical and narrative accounts routinely recorded by both teams.
Findings
The exercise of agency by persistent rough sleepers is constrained by a mixed baggage of complex needs, past negative risk assessments, limited resources and regulatory deterrents to generate choices to reject help that appear irrational. These need to be understood if recent policy initiatives to end rough sleeping are to be effective.
Originality/value
The paper draws on the experience and comprehensive records of practitioners with intimate knowledge of the rough sleeping population. It extends narrative accounts of causes by focusing on key choices to show how the perverse incentives of policy combine with personal factors to incline rough sleeping to persist.
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Graham Bowpitt, Peter Dwyer, Eva Sundin and Mark Weinstein
This paper aims to throw light on the value of accommodation and support services and the likely consequences of their withdrawal.
Abstract
Purpose
This paper aims to throw light on the value of accommodation and support services and the likely consequences of their withdrawal.
Design/methodology/approach
Research was completed by a team of researchers from Nottingham Trent and Salford Universities under the Multiple Exclusion Homelessness programme funded by CLG, the Economic and Social Research Council and the Joseph Rowntree Foundation.
Findings
Agencies whose priorities are influenced by other agendas arising from statutory limitations or government targets have conflicting priorities that sustain multiple exclusion homelessness in a number of key circumstances.
Originality/value
Findings from this research will enable policy‐makers and practitioners to take better account of service user perspectives, experiences and priorities.
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What do homeless young people say they want? Too often services are established without finding out, and this can give rise to voids or management problems. Macedon, Nottingham's…
Abstract
What do homeless young people say they want? Too often services are established without finding out, and this can give rise to voids or management problems. Macedon, Nottingham's largest provider of supported accommodation for homeless people, carried out research under the direction of Nottingham University. The findings provide vital information and practical suggestions to guide service planning and management.
The shift in policy discourse towards individualism is affecting service provision and access, which has become increasingly conditioned on individual agency and the…
Abstract
Purpose
The shift in policy discourse towards individualism is affecting service provision and access, which has become increasingly conditioned on individual agency and the “deservingness” of the recipient. Gendered and intersectional experiences of homelessness and excluded populations less likely to be living on the streets remain overlooked and unaddressed. This study thus aims to uncover what drives “invisibility” in services for women experiencing multiple disadvantage and the gendered constraints the women are facing when exiting and navigating multiple disadvantage.
Design/methodology/approach
The paper draws on in-depth interviews with women who face severe and multiple disadvantage and their support staff. Data is also gathered through survey data and observations with a wide range of frontline service providers, as well as support notes and numerical progress data recorded by one of the service providers.
Findings
Contradicting the common assumption that people act as rational actors in their interaction with services, the author found that women’s decisions to (dis)engage may be blinded by forces of multiple disadvantage and mistrust. These are often developed as a result of systemic and gendered constraints that limit women’s capabilities and exercise of choice. Barriers in service access often amplified the personal barriers they were facing and reinforced women’s decisions to not engage with services.
Research limitations/implications
The author hopes that this paper sheds light on the particular set of barriers women with multiple disadvantage face, which will be vital to reach women who face severe disadvantage and provide more effective policies, care and support.
Originality/value
This study gives voice to a particular hidden population: women with multiple disadvantage. It contributes to existing frameworks on agency and choice by understanding gendered barriers behind service engagement and how services themselves may be contributing to women’s invisibility.
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Graham Whitehead and Adam Barnard
The increased use of mental health interventions employing cognitive behavioural therapy (CBT) over the last decade raises the significant theme of the efficacy of such treatments…
Abstract
Purpose
The increased use of mental health interventions employing cognitive behavioural therapy (CBT) over the last decade raises the significant theme of the efficacy of such treatments for people with disabilities. Recent evidence‐based studies regarding the application of cognitive behavioural interventions for people with disabilities have highlighted issues concerning access to services, questions of engagement and efficacy of the cognitive aspects of CBT practice and service models and forms of delivery. The purpose of this paper is to explore these themes with particular emphasis on barriers to accessibility for this population and provide consideration of ethical and effective practice aspects of psychological interventions in response to the recent World Health Organisation recommendations on disability provision.
Design/methodology/approach
The paper considers the development of the “enabling environments” theme for people with disabilities within a mental health context within Europe, with a view to exploring barriers to social inclusion and service user autonomy. The paper is designed to review and enhance existing literature in the field and to question the philosophical position of cognitive‐behavioural approaches to mental health provision in a European context.
Findings
Consideration is given to the use and application of CBT and evidence‐based practice (EBP) and considers efficacy in mental health provision for this population. Consideration is also given to the efficacy and appropriateness of short‐term interventions for this population.
Research limitations/implications
As a conceptual paper, the limitations of the discussion are that the views expressed are solely those of the authors but the paper usefully develops consideration of the existing literature in the field and discusses the implications of developing inclusive practice in mental health provision for this population.
Practical implications
The issues discussed in the paper offer significant questions relevant to the delivery of mental health provision for people with disabilities from a European perspective. Practical implications relate to the development of inclusive practice for practitioners in the delivery of these services.
Social implications
The social implications of the paper are significant, as the issues discussed raise questions about how mental health services approach their provision for people with disabilities. From a social context, the conceptual discussion offers insights useful to develop effective mental health provision and promote service user responsibility and autonomy.
Originality/value
As a conceptual paper, the originality of the submission relates to questioning the efficacy of more recent developments in the mental health field re: philosophy of approach and method and recommendations are offered by the authors which may impact service delivery, the focus of relevant evidence‐based practice and service user autonomy.