The complexity of severe and multiple disadvantage

Complexity theory is the study of systems containing potentially large numbers of unique parts, which interact with and adapt to each other over time. In this new paper, Greg Fisher of Synthesis explores what complexity theory can offer to Lankelly Chase’s mission to bring about lasting change in the lives of people facing severe and multiple disadvantage – that is, people who often interact with the hugely complex systems aiming to support people with problems around homelessness, substance misuse, mental health, violence and abuse, and chronic poverty.

Drawing on existing literature, interviews with experts and project visits, the paper identifies five key implications of complexity theory for the field of severe and multiple disadvantage:

  1. The Interconnectedness of Complex Needs.  People’s disadvantages and support needs should be thought of in an integrated, holistic way, not as independent.
  2. The Social Nature of People.  Western thought is biased toward thinking of people as isolated entities whereas, in fact, we are fundamentally social in nature.  Most disadvantages emerge within a social context which enables this emergence.
  3. Idiosyncrasies Matter.  When looked at closely enough, every person is unique.  This point is invariably overlooked in top-down support systems.
  4. Contingencies Matter.  The world evolves and some future events are possible but not certain.  Support provision for those facing severe and multiple disadvantage must be agile, and services readily available to cater for multiple potential futures.
  5. Patterns and Change Coexist.  The world is not random – patterns exist and the recognition of these patterns is essential; however, existing patterns evolve and new patterns emerge, unpredictably.

The paper argues that current support systems are ill-suited to people facing severe and multiple disadvantage and have led a classic example of the ‘inverse care law’, where those in most need of support are the least likely to receive it,  This analysis leads to a number of recommendations, including:

  • Severe and multiple disadvantage must be treated as a different sort of challenge to that presented by single support needs.
  • Support systems for people facing severe and multiple disadvantage should be devolved to the local level, as their problems are too complex to fit into large-scale service design.
  • Systems should be designed and delivered by a community of ‘personal support workers’ whose experience is grounded in deep understanding of service users’ lives.

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