Simple Solutions for Complex Needs

Magical thinking and multiple, complex needs in the UK

In the UK at present, we appear to have an epidemic of magical thinking about the lives of the unhoused victims of universal credit (UC), the ‘20%’ with multiple and complex needs.  Much of this magical thinking can be traced back to Iain Duncan Smith’s (IDS), time as the Secretary of State for Work and Pensions. He was appointed to this role in 2010.  Before this, IDS was David Cameron’s advisor on social breakdown and was well known for lamenting the broken ghettos that had emerged from Britain’s council estates. He called for a “fundamental policy shift” to halt the decline of housing estates because

“….our housing system has ghettoised poverty, creating broken estates where worklessness, dependency, family breakdown and addiction are endemic.”

Universal Credit was to be his flagship policy to address what he called institutionalised dependency. The denizens of these workless and broken estates were to be disciplined into a work mindset. The idea was that they would be paid monthly and in arrears, because this better matched the pay patterns of working people (lets park for a second the explosion in zero hours work). Initially, the rent would be paid directly to the recipient rather than the landlord. People would need to learn to budget and take responsibility for their affairs. They would need to organise computers to sign up for it and to open bank accounts and thus have an address, and a passport or driving licence information.

For IDS, this would be the way to eradicate dependency and discipline people into responsible working lifestyles. The question that we ask here is how the theory of Universal Credit speaks to the complex lives of often vulnerable people.

At this point let’s introduce David, Jane and Emily. They are all based on real-life cases are developed to represent the homeless people Sally currently works with on the South Coast:

• David is a twenty-year-old man, bought up by his mother, who was a single parent. David witnessed a lot of domestic abuse as a child – his mother had multiple partners who ‘knocked her about’. He had a very unsettled childhood, and was excluded from school. Eventually left home at 15, with his dog, and slept on the streets. Alcohol was a normal part of David’s childhood – he started drinking in early teens and this escalated when he lived on the streets. He has very high levels of anxiety – he is restless and unable to focus. He drinks a minimum of 15 pints per day. At the time of writing he was trying to claim Universal Credit and although very articulate, lacks literacy and IT skills due to disrupted education. Mental Health Services will not accept referral due to alcohol intake. He’s currently sofa surfing and working with homelessness services as far as possible.

• Jane is a nineteen-year-old female with moderate learning difficulties. She grew up with family, but parents have recently separated and neither is able to accommodate her. She seemed to have fallen between services: she was under the care of the Children’s team, but not transferred to Adult Services as she was living with family and doing relatively well at that time. Her mental health went into decline after becoming homeless; she was very aware that none of the family wanted to accommodate her. She started risk-taking behaviour, her physical and mental health were in decline and she reverted to childhood behaviours like thumb sucking. Staff who work with Jane have concerns about the possibility of financial exploitation by family and peers.

• Emily is a 27 year old female living in homelessness services. She grew up with family but was sexually abused by a family member. She has a long history of mental distress from teenage years, preceded by multiple incidents of self- harm. As a young adult, she engaged in risk-taking behaviour, substance abuse and destructive relationships. She was groomed by dealers running the County Lines and also engaged in sex work. She has recently also developed bulimia but is unable to attend MH appointments.*

We don’t present these examples to make the point that all people using Universal Credit have lives marked by abuse, chaos and suffering. However, as a Credit Union manager in the South of England once told us, Universal Credit has been catastrophic for ‘the 20%’ with multiple and complex needs. This 20% is the significant number of people whose complex lives are marked by significant constellations of disadvantage and where chaos and struggle are commonplace.

Set against such chaotic and complex lives, the responsibilising precepts of Universal Credit, the monthly payments, the five-week wait for money, the money paid directly are a perversely simple set of prescriptions an solutions. They are so perversely simple that it should be clear that they simply cannot work. Such magical thinking is founded on the world that Duncan Smith and his Centre for Social Justice acolytes wished existed rather than the one that actually exists.

And far from simplifying the social conditions around this 20%, the changes have made things more difficult. For example, consider how landlords responded to such ideological naivety. Membership surveys by the National Landlords Association reveal that the numbers willing to let properties to recipients of UC – or the local housing allowance that predates it – has fallen sharply from 46% in 2010 to 18% with many private landlords saying they will no longer rent to universal credit claimants because the risk of arrears is too high.

The landlords are right in one regard. The five-week wait for Universal Credit has been a major factor in pushing some claimants into rent arrears and eventual evictions and thus many people with multiple complex needs have become homeless since 2010. Rough sleeping in England has “rocketed” by 165% since 2010. Polly Neate, chief executive of Shelter, said: “The combination of spiralling rents, a faulty benefits system and lack of social housing means the number of people forced to sleep rough has risen dramatically since 2010”. The evidence is stark. We know that there is a high prevalence of mental illness and alcohol and drug dependency among rough sleepers with four in five homeless people suffering from a mental health problem. A recent study by Homeless Link found that 45 per cent of homeless people had been diagnosed with a mental health issue, with 80 per cent reporting some form of mental health problem.

Local authorities have already lost almost 60p out of every £1 the Government had provided for services since 2010. The Local Government Association says that it was becoming “increasingly difficult” for councils to prevent homelessness and rough sleeping from happening as they faced a “funding gap” of more than £100m in 2019-20.

But is gets worse. Iain Duncan Smith’s ideologically informed financial discipline is, unfortunately, only the tip of the magical thinking iceberg. It appears that whenever the institutions of modern Britain try to engage with the people with multiple and complex needs who have been made homeless since 2010, a stark refusal to acknowledge complexity is almost always the prescription of choice. This is no better seen than the blunt removal of poverty from the streets via the magical thinking solution of arresting them, even if no one complains about them.

Much of the media reporting of homeless lives is similarly framed with simplistic misunderstandings, ideological injunctions and inconsistencies. Where we live in Sussex, street drinking, antisocial behaviour, homelessness and rough sleeping are often bundled together and seen as one problem,  into a homogenous mass that acts as a repository for the anxious to project their ideologies, fear, guilt and confusion on to. While this stigmatization is due, in part, to people feeling threatened by a group of people that they cannot understand, it leads to approaches that ignore, distort or diminishes the humanity of homeless people.

The reality is that the financial pressures on lower-income households, and especially on those with multiple and complex needs, have increased considerably in recent years due to a combination of depressed real wage growth, the Government’s programme of welfare reforms, and a broken housing market.  A three-pronged attack of brutally underfunded services, pitifully crude forms of political denial and problematic local media reporting combine to fail the vulnerable people who need our support the most.

*  These vignettes were developed to represent the homeless people that Sally Smith currently works with on the South Coast.

About the Author: Sally Smith trained as a General Nurse in London then as a Mental Health Nurse. She worked in a variety of mental health settings including the Community, Education, and the Voluntary Sector. She is now working in the NHS supporting patients who are homeless or insecurely housed