Multiple disadvantage

Severe and multiple disadvantage

We aim to pursue a problem solving approach, and we have therefore developed a theory of change to underpin our work. This is a ‘live’ document, and will evolve over time as our learning deepens.

We identify three types of change that we are trying to achieve: systemic, structural and cultural. To find out more: Theory of Change.

Why “severe”? 

When people struggle to get the support they need, there is a strong chance that the disadvantages they face will become more severe. This means that when they do present to support agencies, the focus is on managing problematic behaviours and the risks these present rather than addressing the person’s underlying issues. This can escalate the severity of their problems even further.

Why “multiple”?

There is rarely ever one problem in isolation. People are usually hit by a number of linked problems at once, including homelessness, substance misuse, mental illness, extreme poverty and violence and abuse.

Rather than responding to what the person is experiencing, a range of disconnected services each tackle individual problems. This means that people who most need support find it difficult to navigate a complex structure of help, meaning they access services late or not at all.

For example, homeless people are rarely just homeless. Our research shows that two thirds of people in homelessness systems are also in drug treatment and/or criminal justice systems.

Why “disadvantage”?

A much more common term is ‘needs’, as in ‘multiple and complex needs’. However ‘needs’ suggests that the problem lies in the person, rather than in the relationship between the person and the services and systems that are meant to help. We want to stress that people have more severe problems than they should in part because they have been disadvantaged by the response of services and society.

What creates severe and multiple disadvantage?

Severe and multiple disadvantage has many and complex causes, which are unique to each person. There do however seem to be broad patterns:

  • Early experiences: neglect or abuse at an early age can lead to delinquency and mental health issues in later childhood and adolescence. This in turn can create difficulties forming trusting relationships, resulting in social isolation. When this happens, other parts of a person’s life can go awry.
  • Decision making: people often stress that they made bad decisions on their way towards severe and multiple disadvantage (see Bringing Everything I Am Into One Place). This hardly makes them unique, but the consequences of their bad decisions can be hugely magnified by their precarious circumstances. It is important not to gloss over personal responsibility: just as poor decisions can lead to severe and multiple disadvantage, so good decisions can lead you out of it.
  • System decisions: as well as poor access to services (described above), there seems to be a direct correlation between long term disadvantage and decisions taken by public systems. For example, exclusion from school and arrest have both been identified as accelerators of delinquency among adolescents, controlling for all other characteristics including the underlying behaviour and background of the person. Many practitioners and academics suggest that this is a problem with labelling i.e. that people cannot escape the labels that systems give them.
  • Poverty and structural disadvantage: severe and multiple disadvantage has a close correlation with poverty and wider disadvantages such as discrimination. It is much more prevalent in areas of economic deprivation and decline particularly post-industrial northern areas, seaside towns and some areas of London. And it affects women and people from BAME communities in ways that link to discrimination, such as violence against women and disproportionate incarceration of young black men.
  • Exploitation: people facing severe and multiple disadvantage attract exploitative attention. Across all ages, disadvantaged people are targeted for money, sex, drugs, coercive relationships and housing.

We continue to develop this analysis because we are convinced that meaningful change is only possible with a clear-sighted understanding of the problem we are all trying to address. Too many partial solutions become problems themselves over time.

The most inspiring practitioners we meet are able to see this fuller picture and reflect it in their work. But how to scale or spread their practice when systems require them to focus more narrowly? This is the challenge we have set ourselves.

Personal stories

  • Storytelling

    Makes me feel like a normal person

    This person has been in the homeless pathway for 8 years and has now been engaged with Mayday for 6-9 months Mayday offers personalised and flexible combinations of community based brokerage, advantaged thinking and intensive coaching support...

    Read more

Further Reading

  • Further Reading Item

    Using evidence to improve young lives

    Bringing everything I am into One Place, The Dartington Social Research Unit The Inquiry brought together over 100 experts, young people included, to find better ways of supporting people who face severe and multiple disadvantage....

    Read more
  • Further Reading Item

    Mass Collaboration: How can we transform the impact of public funding

    For the potential of mass collaboration to be realised, the bad habits of the top-down, mass-production model need to be unlearned by central government. Above all, the current experiments with 'payment by results' for funding public service...

    Read more