A month or so ago, I received an email asking: ‘Will you #walkthefrontline with Birmingham Changing Futures Together’’, from one of the Multiple and Complex Needs Strategic programmes to have received National Lottery funding to support people and communities with complex needs. I was intrigued. The invitation from Programme Director Natalie Allen went on to say:
‘The challenge for the city to support individuals with multiple and complex is significant. That is why [we invite you to] walk the frontline with a colleague in the Birmingham Changing Futures Together programme who works directly with people with multiple and complex needs, helping them address their needs and achieve sustainable change.
Changing Futures Together improves the effectiveness of service provision to people with complex needs (individuals struggling with two or more of homelessness, substance misuse, offending behaviour and mental ill health). The programme employs Peer Mentors, people whose ‘lived experience’ means they can quickly build a trust-based, productive relationship with service users.’
Having once been a frontline worker myself, I was keen to spend time with Peer Mentors and frontline staff. Off I went to visit clients with Nina, an experienced frontline staff member employed by Shelter, one of the delivery partners for the programme. The clients we spent time with had some of the most extreme, complex and entrenched needs I had come across in my working life.
What did I learn from my day? Perhaps nothing earth shattering, but all thought-provoking.
The Programme as whole- frontline staff and peer mentors (through their own experience and listening to beneficiaries) probably have some of the best ideas about ‘systems change’. They had very practical recommendations about small (and large) changes to processes and systems which would make beneficiaries lives better and easier, as well as an understanding of the various (often contradictory) cultures of the many organisations and professionals involved.
Host Organisation- Shelter – one of the delivery partners for this programme – has had to rethink their recruitment, training, and induction processes as a result of taking on Peer Mentors with lived experience. This has been positive for them as an organisation. Working side by side with Peer Mentors has forced individual front line professionals to analyse their own practice and what they can learn from peer mentors, in addition to the clear potential for development for the peer mentors themselves.
Frontline staff– my goodness what a hard job. The frontline staff and Peer Mentors are truly taking a person centred approach and it is slow, painstaking work over many years. The frontline staff focus on building up relationships and trust, and asking over and over again what the beneficiary wants. Consistency and tenaciousness is key, as well as compassion, empathy and a deep understanding of the system and how to navigate it on the beneficiaries’ behalf.
Peer mentors – I desperately (and naively) wanted to learn about the one thing that helped to turn their lives around. Of course that one thing does not exist, but it was very clear that the Peer Mentors’ insight into the system, the behaviour and thinking of beneficiaries with similar backgrounds is a huge advantage. They were considered to be real, expert advisors and peers working alongside frontline staff.
The Beneficiaries themselves– I learned so much in one day, but clearly it was just the tip of the iceberg in terms of their individual situations. I was overwhelmed by the sheer complexity of the issues connected to mental illness, being an alcohol and substance misuser, homeless and in and out of prison. I also found that money itself is a complex issues. In the case of the clients I visited, they freely admitted that they use every pound they receive through benefits or begging for alcohol or drugs until their money is completely gone, and the cycle starts again. Giving money or even food to those begging on the street can often mean there is little reason for them to access any services at all. One of the clients we visited was in a secure mental health institution, and I learned (and could see first-hand) that BAME communities are overly represented in this type of acute facility, which the frontline staff suggested was due to mental health needs not being addressed early enough.
All in all, a fascinating – though difficult – day, and one I was very glad to take part in. The frontline staff and Peer Mentors clearly use a People in the Lead approach to working with this extremely disempowered client group, and there were glimmers of hope that their personal approach, and that of the Big Lottery Fund’s Multiple Complex Needs programmes more widely, were having a positive effect on people’s lives and the systems around them.