Critical Analysis and Social Care Concepts
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2006_feantsa_magazine_participation.pdf
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IN THIS ISSUE
2 Editorial
3 Why is client participation in welfare services a problem? Danny Lescrauwaet
4 My experience on the Board of Directors of the Dublin Simon Community Brian Brady
5 A greater say for people who are homeless at local level? The Dutch practice of participation of people who are homeless in client councils Trudi Nederland
8 Participation of service users in Hungary Péter Bakos
9 User participation: a right in the making Nathalie Latour
12 The “Council for Socially Marginalised People”: 4 years down the road! Preben Brandt
14 Organising for action: the Federal Initiative of people experiencing homelessness in Germany Roland Saurer
16 Giving a voice to people who are homeless – the work of Groundswell Amarjit Kaur
18 Homeless Empowerment Action Research Team (H.E.A.R.T.) – an example of peer research in Ireland Bill Heaney
Autumn 2006
Participation of service users: giving a voice to the experts
User participation: a right in the
making
FEANTSA is supported financially by the European Commission. The views expressed herein are those of the author(s) and the
Commission is not responsible for any use that may be made of the information contained herein.
Participation of service users: giving a voice to the experts
User participation: a right in the
making Page 9
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The term participation refers to the idea of ensuring the full inclusion of all who are affected by decision-making; in processes at political level but also in non-political bodies seeking to operate in an inclu- sive and democratic way. Participation can be particularly empower- ing for groups whose opinions may all too often be sidelined, such as people experiencing homelessness. To be given this chance may contribute to the reintegration of excluded groups and to the devel- opment of a new understanding of their own capacities.
In the social services sector the concept of user participation has gained importance over the past 30 years. It can be defined as the involvement of service users in the service design and/or the deci- sion-making processes affecting the services that they use. The ori- gins of user participation can be traced back to the civil rights move- ments, when in particular organisations of people with disabilities or people with mental health problems started to question the image of service users as passive victims and objects of charity. Instead, they viewed themselves as autonomous individuals and actors in their own right.
Another notion that has influenced the debate on user involvement is consumerism. This concept describes how consumers exert control over the goods and services available to them. Today, there is the general understanding that the active involvement of people who are homeless in the design and implementation of services dedicated to them is key for a successful reintegration plan. In the context of a growing demand for quality assessment of serv- ices and increased professionalism in the sector, users have been given more opportunities to make their voice heard.
The level of user participation varies from organisation to organisa- tion and country to country. In several European member states, the participation of people experiencing homelessness in the organisa- tions providing care has become a legal obligation. Homeless or for- merly homeless people are represented on executive boards of some organisations or participate in councils designed for consultation with socially disadvantaged groups.
However, the establishment of systematic participation procedures at the level of the organisation providing the services, as well as in pol- icymaking processes, remains a challenge in all countries. User involvement happens, but it is often not yet well established or occurs only in an ad-hoc way.
The aim of this edition of the FEANTSA magazine is to present expe- riences of user participation in different European countries. The examples describe different approaches to participation and high- light their positive outcomes without neglecting the problems that remain.
The first article, written by Danny Lescrauwaet from Belgian FEANTSA member Steunpunt Algemeen Welzijnswerk and chair of the FEANTSA participation working group, is a general introduction to user involvement in homelessness services. Danny Lescrauwaet refers to the consumerist approach to user involvement. He argues that in the case of voluntary organisations, the power of its consumers – the service users – to influence service provision is only limited, as a third party, the funders, who actually pay for the services, intervenes. Therefore, organisations should themselves become more active in the area of user involvement in order to ensure that service users’ needs are met in an effective way.
This recommendation is in line with the article written by Brian Bradey, who reports on his experience on the Board of Directors of Dublin Simon Community. As a person who was homeless for five years, he stresses the positive outcomes of stronger user participa- tion for both the organisation providing the services as well as its users.
The next articles describe how different countries and organisations have implemented the legal obligation for user involvement. Trudi Nederland and Maarten Davelaar, who work as researchers at the Vervey-Jonker Institute, present the main findings of their evaluation of client councils in the Netherlands. The authors highlight that, despite a continuing democratisation taking place at local level, the participation of people experiencing homelessness in these councils is still very limited. They present recommendations how this might be improved in the future. Péter Bakos, from FEANTSA member Refomix, provides a similar analysis of the Advocacy Forums which were created in Hungary in order to promote participation and to protect service users’ rights. While recognising the positive potential of the Advocacy Forums, he underlines the need to further develop the systematic involvement of service users in Hungary. Nathalie Latour describes how user participation has been integrat- ed into the work of French FEANTSA member Fnars. She explains the functioning and the role of the Social Life Councils (“Conseils de Vie Social”) and presents a number of success factors that were identified in the context of a members’ survey on user participation in 2005.
A rather positive first assessment of the Danish Council for Socially Marginalised People is provided by Preben Brandt, who works for the Project Udenfor. Preben Brandt is chairman of this Council, which was set up by the Ministry of Social Affairs four years ago. Although homelessness has not been tackled in an adequate way, the author is confident about the positive impact of the Council on policies affecting the lives of people who are socially disadvantaged.
The following article deals with the organisation of people experi- encing homelessness in Germany. Roland Saurer from the Bundesbetroffeneninitiative Wohnungsloser Menschen e.V. (BBI) describes the history and current activities of his organisation, which has been fighting for the rights and interests of people who are homeless in Germany since 1991. Supporting people who are homeless to create their own solutions to homelessness is also the mission of Groundswell, the first organ- isation dedicated to increasing user involvement in homelessness services in the UK. In her article, Amarjit Kaur, director of Groundswell, presents the various activities of her organisation and in particular its work with homeless charity St Mungo’s on increasing the level of resident involvement in all aspects of the organisation. An example of peer research is described by Bill Heaney who was member of the HEART project support group in Ireland. The HEART project was designed to explore homeless people’s experiences of the services in the Galway area. The innovative aspect was that all of the research was conducted by people who had experienced home- lessness themselves.
As always, FEANTSA extends its sincere thanks to all contributors of the magazine for their time and expertise. We hope you will enjoy reading the FEANTSA magazine. Your comments are welcome. You can send them to [email protected].•
Editorial
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This article deals with client participation, and is based on a course text written a few years ago at the Steunpunt Algemeen Welzijnswerk. Later contributions from members of FEANTSA's par- ticipation working group have further developed the subject.
SERVICES REQUIRE PARTICIPATION Social services can only function with the client’s participation. The service is created only through the active involvement of the client. The client is thus not only consumer, but also “co-producer.” If a doctor wishes to make a diagnosis, the patient will have to cooper- ate and give correct information. If one wishes to teach or tutor, the student will have to do the learning. If a person who is homeless wishes to stay in a reception centre, he/she will have to comply with all sorts of rules and requirements. In order for the service to be delivered, the user - by definition - must actively participate.
Any service that does not keep in touch with the reactions and input on the client’s part, will eventually become redundant. That sounds pretty obvious, but how many organisations are inclined to incorpo- rate client’s feedback into their own structures? How many organi- sations are inclined to create a structural setting, such as complaint books, complaint services, consultation meetings, client boards, etc. where clients can comment freely? Of all the organisations obliged to take such steps, how many consider it a waste of time and unnec- essary bureaucracy? What worries them? Do they feel heard?
WHAT DOES PARTICIPATION MEAN TO THE USER? Despite the fact that a service can only be rendered in conjunction with the client’s participation, the client still tends to feel dependent on the service provider. Much is organised without much input or choice for the user. The social service is pre-structured into several phases. The user must often do a number of things without know- ing why. The individual often has only a hazy understanding of the goals and the meanings involved in the whole process.
WHY DO NON-PROFIT ORGANISATIONS OFTEN SUFFER FROM A LACK OF CLIENT PARTICIPATION? In Belgium there is a common expression: ‘wiens brood men eet, diens woord men spreekt’1. In order to secure their funding, not-for- profit organisations are obliged to ensure that their sponsors and subsidising authorities keep them in mind. At the same time, they need to keep attracting new clients. Thus, there is a structural need to keep focused on two very different groups of people. In order to survive, a non-profit organisation must continually prove that their existence can be socially justified. There is a danger that this can become more important than providing high quality services.
For private companies, profit is the reason of existence. Increased profitability is seen as an expression of client satisfaction. The gener- ated profit is the direct feedback from the market to the company.
In the non-profit sector this price signal does not work. The client’s contribution says nothing about the value the person attaches to the services he/she receives. Consequently, non-profit organisations do not receive clear, tangible and financially relevant feedback from the client.
As most of the money comes from governmental authorities and donors, the chances are that much of the attention of the organisa- tion will shift to their relationship with the funders. Non-profit organ- isations invest much time and energy in proving their usefulness to the funding authorities: they write policy reports, policy statements, work reports, evaluations, project applications, etc. This time cannot be spent on the actual provision of services. Non-profit organisations therefore risk detaching from their target groups. Because a third party disturbs the classic market mechanism, there is no direct and effective feedback from clients about the usefulness and quality of the services provided. Not-for-profit organisations are obliged to find an alternative guide. They must clearly define their mission, vision and target audience and regularly evaluate their services.
IMPACT OF THE THIRD PARTY ON THE CLIENT As a third party (public authorities, donors) intervenes to finance a particular service, the service becomes available at a price which is below the market level. Client feedback and complaints will have less impact on the service and are not easily translated into policy making. If no conscious action is taken to continually evaluate the services and to request feedback from the clients, it becomes diffi- cult to be aware and responsive to changing client needs. When clients are not satisfied, they do not always have the option of going elsewhere. Client dissatisfaction is often the reason new organisations are set up, using new methods, rather than transforming existing services. Because the market mechanism cannot play its role, not-for-profit organisations are scarcely dependent on their clients. A strong client focus is not necessary for survival. Services are dependent on third parties for their funding, and clients are dependent on the services. The client has very little impact on determining whether a particular service is necessary or not. The client is not given a voice and is dependent on the social, political and ethical choices others make.•
References: - Staut,P., Op zoek naar de eigenheid van social-profitdiensten,
Opleiding leiden van een organisatie (course text), Balans. - Verbeek, G, (1993) Wat zeggen onze cliënten, Gebruikers-
raadpleging als middel voor kwaliteitsbevordering, Nederlands Instituut Voor Zorg en Welzijn.
- Driessens, K., e.a., (1998) ‘Welzijn en cultuur’ in: jaarboek armoede en sociale uitsluiting, Acco.
1 Dutch expression, meaning ’you speak the words of the person that feeds you’.
Why is client participation in welfare services a problem? By Danny Lescrauwaet, Steunpunt Algemeen Welzijnswerk, Belgium and chair of FEANTSA’s participation working group
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“The most important work you and I will ever do will be within the walls of our own homes.” Harold B. Lee
I am starting my second year on the Board of Directors of the Dublin Simon Community (an organisation based in Dublin, Ireland whose goal is the eradication of homeless- ness). Last year I sat on the Strategic Planning Committee and this year I have been given the honour to serve on the Audit and Organisation Sub Committee.
This may all sound fine and noble to the average person. The unusual thing about my situation is that I was homeless for five years, and have first hand experience of the chal- lenges that people who are homeless face.
When the Dublin Simon Community held an open election for the board in 2005 a number of homeless people who used their services stood for election. Two of us were elected and by the high number of votes we received, it was clear the Community thought our presence was needed at board level. As it transpired we were the first peo- ple in our situation to take such positions in any organisation in Ireland.
The whole issue of participation boils down to those that are willing to get involved; only 30% of the population voted in the 2004 EU elections. Just think of all people who are homeless, alienated, disenfran- chised: people who are dealing with mental health problems, addiction to drugs or alco- hol or just serious financial issues. How can they be expected to become involved with what, to some, seems to be an extension of the establishment that has marginalised them in the first place?
Not everybody who is using a homeless service will want to participate, or indeed believe that it is worth their while partici- pating in the organisation. Before you can
have participation you need change and from my experience with the Dublin Simon they are more than happy to listen to the people they are here to help. This in part is a result of the Dublin Simon taking a more business-like approach to the business of helping people. One major change was that if the Simon is providing a service then they should listen to their customers. Having two members of their target demographic sit- ting on the strategic planning group was a major display of the Communities willing- ness to “walk the walk” and try to meet the needs of the people they are set up to help.
“The ordinary acts we practice every day at home are of more importance to the soul than their simplicity might suggest.” Thomas Moore
The main challenge to the organisation was to change from providing services that they thought were useful, to providing support and trying to meet the needs of each indi- vidual that came to the Simon for help. Let me state what seems the obvious: most people who are homeless want somewhere secure and safe that they can call home, knowing that when they go out they will still have a home to return to at the end of the day. This is a serious issue as it brings the local and national government authorities into the picture! It is the job of voluntary organisations to supply the means of hous- ing that is by rights a government issue.
The work FEANTSA is undertaking to bring awareness to the European Parliament or other relevant bodies is hopeful, but as we know the wheels of the EU turn slowly and in unexpected ways, any policy change can be ignored by the member states ad infini- tum. This leaves the organisations set up to end homelessness at a distinct disadvantage in finding or providing suitable properties in which to house the people they are trying to bring into society where they will be
treated as equals. Later this year one of our fellow NGOs – Focus Ireland – is hosting a major conference on the challenges of cre- ating housing for people who have no home, and I look forward to its outcome.
As I recover from the causes and effects of my homelessness, my time with the Simon has shown me that one of the most impor- tant symptoms of being homeless is alien- ation from society. Here in Ireland a recent poll revealed that 52% of the population thinks that it is an individual’s own fault if they end up living on the streets.
Increasingly the various kinds of addiction and their numerous causes are now being recognised as diseases. The flawed plan of leaving suffers of mental heath problems to fend for themselves in a community where it is all too easy to fall through the cracks in Ireland’s completely inefficient health sys- tem must be tackled.
By becoming involved with the Simon I have been placed in different situations and met many new people, this has been ‘character building’ for me (a euphemism for some- thing that hurts). I hope I have shown oth- ers that the fact that I was once homeless does not mean I am unable, with the help of the housed community, to return and be a useful member of that community. I feel that an open mind is important for all wish- ing to help in this area, be it the newly clean and sober homeless person or the busi- nessperson wishing to give something back to the community they live in.
“A Journey of a thousand miles starts with the first Step” Confucius
It’s a journey that not all are willing to make but I feel for those that are willing to help bring homelessness to an end (which in a rich western country like Ireland should be no problem at all), it will be a most reward- ing trek.•
My experience on the Board of Directors of the Dublin Simon Community By Brian Brady, Director, Dublin Simon Community
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In this article, we describe the involvement of people experiencing homelessness in develop- ments regarding client councils in Dutch munic- ipalities. Research conducted by the Verwey- Jonker Institute into the current state of munic- ipal client participation shows that the partici- pation of people who are homeless is still in its infancy.1 People experiencing homelessness also run the risk of getting insufficiently involved in policy developments that are relevant to them in the future. We will sketch the municipalities’ view of the involvement of people experiencing homelessness. Next, we will describe how the advocates of the interests of people who are homeless consider the issues of either the involvement in, or the rejection of, client partic- ipation. Finally, we will address the question of how the involvement of people who are home- less in municipal policy might be improved.
THE CONDITIONS FOR THE PARTICIPATION OF PEOPLE WHO ARE HOMELESS IN CLIENT COUNCILS In the Netherlands, the conditions and opportu- nities for people who are homeless to have a say in the provisions set up for them seem to improve constantly. Legal rights have been adopted with regard to care institutions, income support and social support. The question remains, however, how people who are home- less can exercise these rights.
Since 1996, the Act on Client Participation has been effective in the social service sector. The Act’s objective is to secure a body for client participa- tion on the institutional level. These client councils are obligatory within relief centres as well.
People experiencing homelessness using these facilities can participate in these councils. In practice, however, a closer examination of the institutions’ fulfilment of this obligation reveals serious gaps. Research reveals that not even half of all the relief centres has a client council.2
Furthermore, another study on the functioning of this Act shows that the institutions’ boards
do not take much notice of these councils’ rec- ommendations.3 Moreover, the councils often also function only with difficulty, due to a lack of facilities and the lack of representativity of many of them. A recent study recommends that client participation in relief centres will only function properly when it has become an inte- grated part of the organisation’s thinking and actions. For this, there still is a long way to go.4
At local level, a continuing democratisation is taking place, since municipalities are obliged to involve their citizens in their policies in ever more areas. Client participation is a legal obli- gation, for instance, with respect to all policy regarding income support and reintegration of the labour market. Since 2004, when the Reformed Social Assistance Act (WWB) came into effect, the municipalities have been respon- sible for the execution of both. The legislation requires a specific form of client participation. Within municipal policy, this obligation to have client participation already existed with regard to transport provisions for the elderly and the handicapped. As a result, in most Dutch munic- ipalities, both senior citizen councils and coun- cils for the handicapped have emerged.
As of 1 January 2007, in addition to these transport provisions, the municipalities will also be responsible for the support of vulnera- ble citizens. The Social Support Act (WMO), which will then come into effect, obliges a municipality to provide services for people who, because of their situation, are unable to manage by themselves. The transport provi- sions are a part of this, as are social welfare and care provisions. The Social Support Act (WMO) presents the municipalities with two requirements: participation and accountability. Citizens are to participate actively in both pol- icy development and policy implementation, and are to exercise their influence on these processes. In addition, the municipality must give account to its citizens and local institu- tions by publicizing its results.
A greater say for people who are homeless at local level? The Dutch practice of participation of people who are homeless in client councils By Trudi Nederland and Maarten Davelaar, researchers at the Vervey-Jonker Institute, Utrecht, Netherlands
ABSTRACT
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THE PARTICIPATION OF PEOPLE WHO ARE HOMELESS IN CLIENT COUNCILS IN PRACTICE Research on the current situation in the Netherlands with regard to client involvement in municipal policy-making shows the elderly and the handicapped to be strongly represent- ed within the advisory structure. This is much less the case for other target groups, like men- tal health care clients and volunteer aides. People who are homeless are hardly represent- ed at all. Furthermore, it seems that they will stay out of the picture for the near future, too. The municipalities are planning to actively involve clients in policy regarding domestic care and the putting in place of information centres, however, the area of social relief has not been given priority. This position at the bottom of the priority list carries with it the danger that there will be no renewal in the services provided for people who are homeless, and that the involve- ment of people who are homeless will stagnate.
This unfavourable trend is strengthened by the municipalities’ focus on restructuring the proce- dures of client participation. The city of Amsterdam, for example, is setting up one large organisation for the approximately eighty organised interest groups in the field of care and social welfare. The municipality expects the interest group for people who are homeless to join this organisation. However, this focus on the procedural side of client participation makes a far from inviting impression on the advocates of the interests of people who are homeless. Thus, the Amsterdam interest group for people who are homeless states that it does not want to participate in the shortly to be formed organ- isation, saying: “we don’t want to get caught in a bureaucratic straitjacket.” This group also rejects consultations with other groups, like the elderly and the handicapped: “For us, this is also remote. We will deal with care issues when the need arises.”
Generally, advocates of the interests of people who are homeless carefully choose the bodies in which to participate. Thus, one such advo- cate is a member of the client council of the Reformed Social Assistance Act (WWB). This membership is directly related to the social security benefit policy of this municipality. A short time ago, a differentiation policy was introduced into the social security benefit for
people who are homeless. Before, people who are homeless received 70% of the minimum wage (the common social security benefit). But now, they receive 50% of the minimum wage if they live on the street, and 60% if they use night shelter facilities. If they are involved in a reintegration plan, they are entitled to 70%. The problem is mainly for those people receiv- ing 60%. If they indicate that they sometimes sleep on the street, they get a so-called ‘shrub- bery visit’. This is similar to the house calls made to applicants for social security benefit. Officials set out to check whether homeless individuals really spend the night at the locations they have indicated. To prevent these ‘shrubbery visits’ is an important issue for the advocates of the interests of people who are homeless. In addi- tion, this particular advocate regularly consults with other local organizations working for and with people who are homeless. This consulta- tion is useful: here, concrete issues are tackled. One example was the cooperation around the issue of the use of a hostel for homeless people. The hostel was intended to provide occasional shelter for those homeless people permanently living on the street, in order for them to have a proper meal, a rest, and a bath. But the beds were occupied by the regular clients of one of the relief centres, preventing the intended tar- get group from being reached. Beside this, there were complaints of women being harassed by the male hotel guests. By address- ing these issues during the consultation, con- crete measures could be taken to improve the situation. For example, men now get a repri- mand for harassing women, and the second time they are thrown out.
When we were making our circuit of the munic- ipalities, we seldom encountered any vision con- cerning the client participation of people who are homeless. An exception to this was the city of Enschede, in the east of the Netherlands. An official stated: “Formal client participation is something done by people who dare to speak out. Because of this, you only get to know 10% of what vulnerable people are concerned about. But as a municipality, it is precisely the needs of the other 90% of the people that you want to know more about.” In order to reach that 90%, municipalities need to develop other methods of participation. One of the examples mentioned by the official is to organize panels in the winter relief centres for people who are homeless.
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THE IMPROVEMENT OF PARTICIPATION ON THE LOCAL LEVEL The participation of homeless people in the for- mal client councils of the Social Support Act (WMO), which are now established all over the Netherlands, still seems to be one bridge too far. The positions of the municipalities on the one hand, and people who are homeless on the other, represent colliding worlds of mutual incompre- hension. The municipalities have yet to occupy their new role in the social support of people who are homeless. Homeless people and their advo- cates will have to present their concerns more clearly to policy makers, in order to exercise some influence on the preparation of policy.
We can conclude from the above, that the inter- est representation of people who are homeless focuses on concrete, negative issues, which sur- face during the implementation of policy. All the more reason then to involve the advocates of the interests of homeless people in the develop-
ment of a specific policy for this group. To bridge the gap between the two worlds, we propose that more attention be given to setting up employment projects for people who are homeless. Until now, the municipalities have primarily focused on care, shelter, and the city’s public safety, but not on work. In our study on employment projects for people who are home- less in the Netherlands, we concluded that doing ‘real’ work provides an important contri- bution to the identity formation of homeless people.5 To live an (adapted) working life means breaking out of the hopeless vicious circle of the frequently multiple problems many people who are homeless have to face. The social participa- tion of these people is a first condition to turn around the negative spiral that holds them cap- tive. When municipalities take the social sup- port and the involvement of homeless people seriously, they will start by setting up projects for employment and activation for, but especial- ly with, people who are homeless.•
1 In January 2006, only 9% of the municipalities had passed a policy document on the Social Support Act (WMO). This is shown in the report Adviseren over maatschappelijke ondersteuning. Cliëntenparticipatie bij gemeenten (2006). Utrecht: Verwey-Jonker Institute.
2 See, for instance, the report Evaluatie Wet Medezeggenschap Zorgsector (2000), Utrecht: Verwey-Jonker Institute. 3 See Bewijzen van goede dienstverlening (2004), The Hague: Scientific Council for the Government’s Policy [WRR]. 4 See the report De grenzen en mogelijkheden van cliëntenparticipatie in de maatschappelijke opvang (2005), Utrecht: NIZW. 5 See our report Aan de slag in de Rafelrand. Werk en activering voor daklozen en verslaafden. Assen: Van Gorcum.
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DEFINITION AND PRACTICE In 2005, FEANTSA and its member organisation Off the Streets and into Work (OSW) conducted a small survey among some of FEANTSA member organisations on the participation of service users. The results of this Participation Audit1 showed that the levels of involvement of service users in the service design process rank from informal exchanges between the staff and service users, to the highest level of participation which is to empower users via specific training on participation in decision-making processes that affect them beyond the framework of the given organisation.
If we strictly insist on the definition of participation used in Participation Audit, namely „the involvement of homeless people in service design and/ or the decision-making process affecting the services that they use”, we have to admit that participation in Hungary is in its infancy.
However, the modified Hungarian Social Act which came into force in January 2003 has established a so-called Advocacy Forum in insti- tutions providing residential care. It can be considered as an initia- tive measure, which promotes the participation as well as the pro- tection of basic rights of services users who are homeless.
Certainly, prior to this statutory obligation, certain forms of informal participation did exist in homeless institutions, depending much on the culture and the leadership style of the given organisation. There can be big differences between local authority run and church or NGO run organisations regarding the level of participation beyond what is regulated by law.
In institutions and shelters providing long-term residential care, reg- ular assemblies are organised every month. These occasions make it possible for service users to have their voice heard on issues con- nected with the services they use or their actual problems. Some service providers collect the remarks of their service users by placing a suggestion box in the common premises and seek to take into account their advice and wishes in the development of services. In many cases, there are financial barriers that hinder the provision of better quality conditions.
In general, the input of service users is restricted to less important decisions, such as, what leisure activities they would like to partici- pate in, or how their belongings can be locked away safely. The level of involvement does not go as far as participation in the organisa- tion’s governing board or involvement in the recruitment of staff as indicated in the above mentioned Participation Audit.
WHAT THE LAW REGULATES The law on social management and social services2 names the above mentioned Advocacy Forum which is to be compulsory in all long term residential institutions. The director of the institution providing residential care is obliged to define the rules of the establishment and the activities of the Advocacy Forum. The Advocacy Forum is the body that aims to enhance service users’ rights and interests in residential institutions.
In accordance with the law, members of an Advocacy Forum are
• elected among service users, - two persons in institutions with less than 200 beds, - four persons in institutions with more than 400 beds,
• one person elected among the relatives as well as legal repre- sentatives of service users,
• one person elected among the staff of the institution, • on the basis of assignment, one person representing the owner
of the institution.
An Advocacy Forum gives its opinion in advance about some of the documents drafted by the director of the institution which are relat- ed to the service users and the internal life of the institution. The Forum has the possibility to discuss and comment on the vocation- al programme, the annual work plan, the rules of the institution as well as leaflets prepared for service users.
An Advocacy Forum also discusses the complaints of the residents – except for complaints on entering and leaving the institution and transfers of services users – and presents its own proposals to the director of the institution. The Forum can ask the director for infor- mation on issues that affect service users and responsibilities associ- ated with the organisation of services.What is more, the Forum can intervene if it believes that the service provider organisation or other relevant authorities did not respect certain rules.
The rights of service users are also advocated by the Public Foundation of Patient’s Rights, Rights of Service Users and Children’s Rights. This organisation was established in January 2004 and employs advocacy experts on different client groups. The Public Foundation provides the necessary equipment for the experts and organises and monitors their vocational work. There are representa- tives of all three major target groups represented in the name of the organisation in each county of Hungary.
CONCLUSION Hungarian legislation regarding the participation of service users is a favourable initiative, but its effect should not be overestimated. The fact that there are fewer complaints made by people who are home- less in winter than in other periods of the year, for instance, is most- ly due to the fear of exclusion from services and should not be explained by the improvement of services through user participation.
People who are homeless represent a special target group among people in residential care. During the process of becoming homeless they have lost their self esteem, their hope to improve their lives, their communication skills, etc. All of this would be important to take part or influence decisions affecting their lives. It would not be fair from service providers to simply provide the possibility of partic- ipation to those who are not able to exploit this right because of the above mentioned lack of skills. Therefore the encouraging first ini- tiatives in the area of participation should be further developed by service providers in order to empower service users and ensure a more democratic involvement. Participation of people experiencing homelessness can be considered as a direct feedback from service users which provides important information to feed into the process of creating more needs based services.•
Participation of service users in Hungary By Péter Bakos, Refomix, Hungary
1 FEANTSA and OSW Participation Audit 2 Social Act 1993/III. § 99
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The federation's avowed aim is to support a real shift from an assistance approach to a stakeholder one.
ACT 2002-2: THEORY AND PRACTICE The Act of 2 January 2002 reforming the 1975 Social Care and Community Health Provision Act lays down a number of guidelines, including an express requirement to promote rights for users of institutions and services. It reflects a gradual shift in the approach to users from being a recipient of provision and services to being a stakeholder to be accounted for.
Section 1 of the Act of 2 January 2002 sets out “to promote the individual’s autonomy, social cohesion, the exercise of citizenship, prevent and address the consequences of exclusion”. Seven fundamental principles of “care” are laid down in the section headed “Users’ rights”: respect for the user’s integrity, privacy, safety and security, free choice of services, guaranteed receipt of quality individual support defined with the user, and confidentiality of their per- sonal information. Institutions must provide users at intake with a resident’s handbook, indi- vidual resident’s agreement, and the house rules. They must also set up and run a users’ consultative body known as the “Conseil de Vie Sociale” (“Social Life Council”).
The Social Life Council gives opinions and can make proposals on all matters relating to the management of the facility: the organisation of daily life, activities, social and cultural events, day-to-day organisational matters, etc. It also has to be consulted on drawing up and changes to the operating plan and house rules. Users’ representatives elected by secret ballot hold the majority on the Social Life Council, which also includes employee representatives and adminis- trators appointed by the administrative council. The Council must meet at least three times a year. The Act, which sets out to make user par- ticipation in services the rule, also suggests more flexible consultation procedures (user opinion groups, satisfaction surveys, etc.) that may be appropriate in services such as shelter or home services. The approach stems from a desire to engage an ongoing dialogue between the different actors in voluntary welfare provision, which includes users. It is all about fostering the introduction of a form of social democracy within institutions.
USERS IN THE FEDERATION This new legislative and regulatory affirmation of individuals’ rights in dealings with institutions is an irreversible part of societal change. One of the key priorities in Fnars’ five-year plan adopt-
ed in 2004 concerns the place of users in the network and community life. The federation’s avowed aim is to support a real shift from an assistance approach to a stakeholder one, focused mainly on service users’ own needs and plans. It aims to achieve that by:
• promoting users’ voice and participation in member associations and organisations, especially through collecting and disseminat- ing experiences,
• setting up a users’ committee in each of Fnars' regional associations,
• promoting participation by users’ representa- tives in Fnars’ regional and national bodies,
• supporting and training users to be actors in local, national and European social policy- making bodies,
• supporting user participation in local civic life and encouraging them to vote (by rallying associations behind a campaign to be run from autumn).
Fnars has run a series of initiatives on the first objective1.
THE STATE OF USER PARTICIPATION IN THE FNARS NETWORK The national users support group received more than 200 replies to its questionnaire on “Social Life Council and other forms of user participa- tion: how providers took ownership of the Act 2002-2 measures” between July and September 2005.
Analysis of the responses shows that service providers have made efforts to set up formal participatory bodies, although these are still far from the Social Life Council as envisaged by the implementing order of March 2004. 30 to 35% of bodies can be regarded as Social Life Councils, with administrator and employee rep- resentatives and user representatives elected by secret ballot, chaired by an elected user-chair- person, with formal agendas and minutes sent out to all actors of the association. .
According to the respondents, things are mov- ing, but there is still not enough involvement of administrators in Social Life Councils, because even where an administrator attends the meet- ings, the minutes are not always circulated back to the administrative council. So the Social Life Council is not yet an independent institutional body. However, interviews with 43 residents in 20 establishments2 reveal real satisfaction that these participatory bodies exist, and a desire for
User participation: a right in the making By Nathalie Latour, Policy Officer for European Affairs, Fnars, France
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them to continue being actively involved out- side meetings.
GOOD PRACTICES FOR ORGANISED PARTICIPATION? Activities run within the network have revealed what is needed for Social Life Councils to be implemented successfully. There are seven key recommendations:
1. Involvement of the management and the administrative council: The members of the administrative council and the man- agement must support the Social Life Council, be involved and recall the issues at stake. Training must be provided to mobilise staff and manage the cultural change that the introduction of a new form of social work to supplement individualised support represents. The way the institution operates - decision-making channels, budgets - needs to be made understandable and users have to be empowered in order to have an actual impact on their environment: improving intake, thinking about house rules, devising activities, being consulted on investment plans, meeting other institutions. The man- agement must provide the Council with what it needs to operate - a budget, free time for elected officials, material resources - and invite its representatives to attend administrative council meetings to explain the work of the Social Life Councils.
2. Spell things out in detail: The role of each discussion body in establishments and the role of user, employee and administrator rep- resentatives towards nominees and electors must be spelled out in detail.
3. Training and information: Users must be given information and training about service provision and institutions to develop a better understanding of the system within which they live; this includes the terms and acronyms used, what they stand for, and methods that enable them to fulfil their role better: listening, self-advocacy, summarising, reporting, motivating. Joint training of users, employees and administrators should be organised in order to facilitate the develop- ment of common projects.
4. Provide guidance and help to users’ rep- resentatives: Users’ representatives must be able to ask for guidance and help in such things as drawing up meeting notices, preparations for organising meetings, writ-
ing minutes, etc. This can be provided by a person working in the organisation or a “neutral” individual with no personal involvement in the Social Life Council.
5. Address user turnover: As service users may be only short-stay residents, thought must be given to the case that users who are elected to represent their peers in the Social Life Council leave the institution. This prob- lem can be overcome by electing alternates to take over from members who leave, and/or by setting up a former users’ commit- tee that maintains a collective memory.
6. Devise ways and means of putting the Social Life Council to work: Beyond the scope of the executive order, it is possible to identify common issues which will raise the interest of all service users (e.g. living in indi- vidualised accommodation, for example). Ways of communicating and creating all kinds of media to support and extend debates (newsletter, notes posted in shared areas, etc.) are crucially important to moti- vate users.
7. Open up the establishment to the out- side world: Organising open days can be a way for users to gain ownership of their life place or accommodation by presenting it to others, and thus starting an ongoing exchange. Users should be encouraged to meet with other institutions and other actors in community life, and to participate in local, regional, national and European fora.
THE OUTCOMES All stakeholders of an organisation (employees, users, administrators) discover the value of working together. It sets a powerful institution- al momentum going which results in the devel- opment of new projects and encourages user- originated suggestions and ideas. This co-oper- ation generates creative conflict: discussions on a seemingly innocuous paragraph in the resi- dent’s handbook or on the creation of the Social Life Council lead the participants to call into question the “easy consensuses” around values, principles or unexpressed working prac- tices, which may not be shared, get to grips with different views and arrive at an informed, reasoned and shaped consensus!
In some cases, the work done by groups of rep- resentatives from different services and facilities revealed existing inequalities and helped to generate a reflection on how to bring more
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Participation raises service users' awareness of their own value and restores their confidence and self- esteem.
consistency between practices. Schemes that have brought together outside partners or a set of associations have helped improve the ways they work together, bringing about change in mutual perceptions, clarifying areas where co- operation is possible, making exchanges more spontaneous, reactive, and effective. Users also refer to benefits from participation: pride in hav- ing produced something worthwhile during their stay, pride in having put forgotten or hith- erto unknown skills to use, feelings of member- ship/identification, the desire to do other things, the incentive to become involved.
While in most cases only a minority of users are motivated in this way, the effect of their partic- ipation is still seen as very positive and as a con- tributing factor to future changes. This form of participation raises service users’ awareness of their own value and restores their confidence and self-esteem. They learn how to consult, how to advocate, how to vote on proposals, which are fundamental aspects of the demo- cratic process. What is more, social workers learn a new way of working. They get to know this new form of collaboration, working with users and partners, and gradually adapt it to other activities, such as community work, medi- ation, and collective problem resolution.
THE SUPPORT WANTED AND PLANNED Members and in particular users want exchanges with nearby services and regional discussion. The focus should be on the local level; in the form of thematic seminars with plenty of opportunity for discussions about existing practices.
For several years, Fnars’ national users support group has aimed to support regional and departmental users committees to make up for the fact that the impetus for participation still too often depends on the commitment of one director or one social worker. Two interregional meetings - in Tours on 25 and 26 October 2002 and in Lille on 18 and 19 January 2005 - have already given residents/users, professionals and volunteers/administrators the opportunity to have their say on user participation in the provi- sion of services and in the network (there were more than 500 participants, including 300 users). Fnars’ 50th anniversary Conference in November 2006 will be an opportunity to affirm the recognition of the user’s role. 100 user rep- resentatives will attend the conference in Strasbourg. Two of the 6 workshops will be specifically on user participation (we would like to invite European partners along). There will also be a round table on “The users’ role and voice in establishments, associations and the federation in light of the pledges given in the five-year plan”.
Fnars (Fédération nationale des associations d’accueil et de réinsertion sociale) brings together around 750 voluntary welfare agencies that run almost 2 200 institutions and services working to help adults and families facing exclusion from society and/or work. According to its statutes, Fnars’ mission is “to develop ini- tiatives striving for the dignity, self-realisation and autonomy of individuals, couples, families with or without children finding it hard to cope with or integrate into society, without discrimi- nation of any kind”.•
1 - A 2004 programme entitled “Innovative Actions” funded by the Social Welfare Department and coordinated by Fnars focused entirely on “Implementation, support and evaluation of institutional changes arising from Act 2002-2 for users”. 85 projects were supported. 5 inter- regional feedback days on activities were held in 2005 bringing together 530 participants. An account of the good practices and issues aris- ing out of the projects supported is available in French.
- The Fnars Aquitaine and Poitou Charente regional associations did a qualitative study in 2005 on the Community Life Councils and other forms of participation developed by the members in both regions.
- A questionnaire on “Social Life Councils and other forms of user participation: how providers took ownership of the Act 2002-2 measures” was launched by the federation’s national users support group between July and September 2005.
2 Qualitative study done in 2005 by the Fnars Aquitaine and Poitou Charente regional associations on the Social Life Councils and other forms of participation developed by the members in both regions.
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Founded in 2002, the Danish “Council for Socially Marginalised People” is now four years old. The time is ripe for mak- ing a first assessment: Can professionals and people with experience of exclusion work together in one council? What are the outcomes of the Council so far?
BACKGROUND It was the Minister for Social Affairs who set up the Council for Socially Marginalised People. With this decision, the government was seeking to increase the collective responsibility for the weakest groups in society, in the light of the idea that the val- ues of a welfare society can - to a wide extent -be measured in terms of initiatives aimed at its weakest citizens. In our terms this means those who live on the periphery of the social community on account of drug misuse, mental disorder, homelessness or other serious problems.
It is a characteristic feature of Danish society that virtually all groups have an advocate to promote their specific interests – and most of the time they are very large, efficient organi- sations. However, the weakest groups are often forgotten and neglected since they do not have their own advocate. To ensure that the Council actually speaks on behalf of the socially marginalised groups, it is independ- ent of the Ministry of Social Affairs, and all members of the Council are appointed per- sonally by virtue of their special insight into, and practical experience of, the areas in question and not as representatives of some kind of organisation. More than four of the
twelve members have personal experience of exclusion due to homelessness, drug or alco- hol addiction, mental illness, prostitution or ethnic minority background. Like the other members of the Council, some of them now carry out practical work or work as leaders in the field of exclusion.
The Council is required to prepare an annu- al report on the situation of the weakest groups and to present proposals for improved initiatives aimed at these groups, including proposals for a better involvment of civil society organisations in the policy making process. The government is required to consult the Council.
COUNCIL STRATEGIES Based on its terms of reference, the Council for Socially Marginalised People works to improve both short and long-term condi- tions for the group of socially marginalised people. Our strategy calls for a two- pronged approach. This aims firstly to increase the understanding of socially mar- ginalised groups in society. The second aim – closely related to the first – is to increase socially marginalised people’s own chances of making themselves heard in the public debate.
The Council believes that a better under- standing must be based on the premise that socially marginalised people are citizens and not inferior to anyone else in society. Far too often, the perception of people who are socially margnalised is that they are irre- sponsible and that the only solution is to
patronise them and to demand their “treat- ment” and normalisation. Many people think that their opinion is of no value and that we – the professionals – know better than they do what their needs are.
The Council uses the term ‘socially margin- alised people’ which includes people who are homeless, drug abusers, prostitutes or people with mental illness or an alcohol addiction within its scope. However, there is a more nuanced understanding underlying this term, as we decided not to take such an unsubtle and diagnosis-oriented approach to the issue. We define marginalised people as people who have to face multiple prob- lems and, in this way, we focus less on peo- ple with simple needs – such as, for exam- ple, an otherwise well-functioning person, who suffers from a mental illness or alcohol misuse. The Council focuses rather on peo- ple with complex profiles, such as people who live in isolation with a mental disorder and whose primary contact with the out- side world is the legal system; people with a history of substance abuse who have no education and work experience and who do not have a stable home; and people who work as prostitutes and suffer from a drug addiction, who live on and off with friends and acquaintances and have had their chil- dren taken away.
We do not work with individual cases but concentrate on the cross-cutting factors that play a role in the process of exclusion, i.e. everything ranging from prevention, political initiatives and legislation to integration.
The “Council for Socially Marginalised People”: 4 years down the road! By Preben Brandt, chairman of the Council for Socially Marginalised People, Denmark
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OUTCOME The Council’s objectives, as set out in its work plan, refer to three interconnected dimensions: social inclusion and integration; a reasonable level of living; and participation in activities, including the labour market.
Most of the Council’s work in its first and second years concentrated on measures to increase awareness of the actual living con- ditions of socially marginalised people: how they are affected by general trends in socie- ty and how planned and current political actions affect their living conditions. But during this period we also presented some concrete suggestions. These included calls for increasing the possibilities in the area of indebtedness support and debt con- solidation for socially marginalised groups; further development of the government policy on ‘Special housing for alienated peo- ple’, improved conditions for people who are homeless in order to reduce the number of people in need of long-term shelter acco- modation; as well as a call to set the objec- tive in the NAPs 2003-2005 of reducing the number of people living on low-income.
The Council won’t and shouldn’t work only on behalf of socially marginalised people, but rather it must also cooperate with them to improve their chances of promoting their own interests. Since our second year we have organised an annual ‘user bazaar’ in alternating Danish cities in order to create a space for an open dialogue. At the ‘bazaar’, people who are marginalised meet with other citizens, professionals, politicians and government officials in a context of enter- tainment, musical performances and discus- sions.
In addition to our annual report, we publish a series of leaflets. One of the leaflets focused on homes and looked at barriers to accessing ordinary housing and, in particu-
lar, on conditions that have to be met in connection with temporary residential facili- ties for people who are homeless.
We should of course focus on concrete measures, and as a matter of fact we do take concrete action on some issues. But over the years we have – in my view – come to the conclusion that it actually makes a difference to address the issues in a broader context, even if the results are not visible right away, or maybe never to the extent we hope. Every year we therefore organise a survey on local, regional and national gov- ernment budgets in the activity areas of the Council. As we both publicise and discuss the results, I feel confident – especially in view of the fact that both the media and Members of the Parliament pay a lot of attention to our figures – that these surveys have a preventive effect on budget cuts in the area, as well as encouraging the plan- ning of special activities in areas that used to be neglected.
One of the areas that has not been ade- quately addressed is homelessness. We observe with great concern that the number of users of homeless agencies has not declined in the past few years. During the same period, the number of persons evicted from their flats has increased and more peo- ple are living on the streets and the level of begging has gone up. The same is true for the field of social psychiatry where – in spite of substantial investment in activities – we observe a growing number of court orders for psychiatric treatment.
During the last two years, the Council has particularly focused on the consequences of financial inequality in Denmark. The Council believes that various cuts in transfer pay- ments to particularly vulnerable groups of the population – such as migrant families, mentally ill young people and long-term
claimants of assistance suffering from severe psycho-social problems – are the primary cause of increased poverty and related prob- lems such as poor education, low work experience, chronic psycho-social problems in general, health problems and an increased vulnerability to crime, homeless- ness and negative intergenerational trans- mission.
CONCLUSION I dare conclude that the Council is consult- ed, and not only the Council in general, but also its individual members. The press regu- larly publishes our point of views, either in the form of summaries of our publications or through reporting on our activities. And the government pays attention to our views. Many of our proposals for improved legisla- tion have been adopted and implemented. Our discussion of the special circumstances relating to debt has brought about changes. The government has put more than 20 of the Council’s proposals into effect. However, in some areas where – I am tempted to say – attitudes of a more ideological nature are at stake, it has been extremely difficult to move the government. An example is the proposal to raise the financial assistance to socially marginalised groups. Finally, I dare to further conclude that we have managed to establish a form of cooperation in the Council that is based on mutual respect among people with very different views and experiences of marginalisation. I firmly believe that we would not have been able to achieve the same success without the importance balance in our membership. It would not have been possible without the vital contributions of both the members who have the experience as experts and the members who have the experience as users.•
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14 The BBI aims to lobby
for structural improvements in the
area of housing exclusion.
The Bundesbetroffeneninitiative Wohnungsloser Menschen e.V. (BBI) is the federal initiative of peo- ple experiencing homelessness. It brings together organisations of people who are homeless in Germany. It was created in 1991 when several local organisations of people experiencing home- lessness, mostly from Berlin and Braunschweig, decided to work together. An official association was set up in Bielefeld in 1994 with the support of German FEANTSA member BAGW, the federa- tion of service provider organisations for people who are homeless in Germany.
The BBI’s activities are based on respect of the fundamental rights of every human being. It aims to lobby for structural improvements in the areas of housing exclusion, social justice and better involve- ment of civil society actors in the policy making process.
BBI members live in around twelve different cities and regions in Germany. Its executive board con- sists of homeless or formerly homeless people. For instance, the director, Rolf Bünger, from Cologne, lived on the streets for several years.
All of BBI’s work is done on a voluntary basis. The association has almost no own financial resources and depends on the support of homeless charities. So far, all requests for funding from the federal government have been declined by the responsible ministry.
The BBI meets four to five times a year, generally in a central location, like Frankfurt am Main, where it can use the meeting rooms of local associations, such as the Frankfurter Verein or Caritas Frankfurt. The meetings are held on a Saturday afternoon, as most delegates need the morning for travelling. They serve to coordinate and prepare events and conferences as well as the policy state- ments of the organisation. For example, one of the main policy actions that the BBI calls for is the creation of a Federal Commissioner for people experiencing poverty in Germany.
The BBI closely works together with its “sister organisation” the BAG W. Through its director, the BBI is represented on the executive board of BAGW. In addition, the BBI is systematically involved in the preparation of BAGW’s national conference. Members of the BBI organise their own forum on “Participation and user involvement” and take part in other fora and working groups at the con- ference. Unfortunately, the participation in BAGW’s working groups on issues such as health, employment, data collection or housing are still limited. This is mainly due to the lack of financial resources. However, since 2006, one activist of the BBI, Wolfgang Jeckel, is member of FEANTSA’s participation working group.
Other partners who cooperate with the BBI include the two big Christian charity organisations in Germany: Caritas Germany, as well as the Diakonisches Werk der Evangelischen Kirche Deutschland (the main charity organisation of the protestant church in Germany). Together, these charities pro- vide 80% of the services for people who are homeless in Germany. In a context of a changing welfare system, both Caritas Germany as well as the Diakonisches Werk, have understood the need to deal with questions such as professionalism, sustainability and user involvement. Are service users regarded as “clients” who “pay” to receive a certain service or are they regarded as “citizens” who have fundamental rights that must be protected?
Organising for action: the Federal Initiative of people experiencing homelessness in Germany By Roland Saurer, BBI – Bundesbetroffeneninitiative Wohnungsloser Menschen e.V., Germany
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In the middle of the 1990’s, Caritas Germany started to discuss the involvement of users in the pro- vision of homeless services. These discussions were not always easy due to the discrepancy between the world of the professional service provider and the life of the person experiencing homelessness. However, the persistence of the BBI finally paid off. In 2001, Caritas Germany organised a one week seminar on participation. And in 2006, the national conference of Caritas Germany dealt with the issue of user involvement. In a resolution, which was presented in the final plenary session, BBI mem- bers defined social work as a work of dialogue and participation as a process in which power is redis- tributed from professionals to service users. This year, Caritas Germany also discussed a paper on quality standards of homeless services. The BBI took part in the consultation process and ensured that one paragraph will be dedicated to the participation of service users.
As mentioned above, in addition to its work with Caritas Germany, the BBI also collaborates with the protestant charity in Germany. The “Diakonisches Werk” will dedicate its national conference in November 2006 to the issue of user participation and empowerment.
The BBI is also involved in other social initiatives and current social movements in Germany. The BBI participated in the first Social Forum in Germany, which was held in July 2005 in Erfurt. Members of the BBI took part in demonstrations against the European Services Directive (the “Bolkestein direc- tive”) in Strasbourg in February 2006.
What is more, members of the BBI are involved in the “Berbertreffen”, the biggest meeting of peo- ple who are homeless, professionals working in the homeless sector and researchers in Germany. Since 1997, these meetings take place in Offenburg every summer. In the beginning, around 60-70 people came together. Since then, the number kept on growing. In 2006, the 10th anniversary of the “Berbertreffen”, almost 500 people from all over Germany participated in the three day event.
The aim of the “Berbertreffen” is to discuss topics related to homelessness such as welfare state, health, labour market and exclusion. The meetings also help to organise political campaigns of peo- ple experiencing homelessness in Germany. For instance, in 1998 the “March to Stuttgart” was pre- pared by the “Berbertreffen”. This year’s meeting focused on ways to empower people who are homeless to participate more actively in the design of services and the necessary conditions that need to be in place in order to facilitate this participation.
Since its creation the BBI has had to deal with many challenges and crises. However, since 2000, the BBI has become more stable. Meetings have become more regular and more effective and the coop- eration with the charity organisations has improved as well. The biggest challenge is to raise aware- ness about poverty and social exclusion in Germany. The BBI tries to contact Members of the German Federal Parliament or the regional parliaments in the German “Länder”.
There are some promising signs. For instance, Elvira Dobrinski-Weiss, Member of the German Federal Parliament, visited the homeless charity in Offenburg, which functions as a ‘headquarters’ of the BBI, recently and promised to come back: “I will continue this dialogue. First of all, I will find out who is responsible for homelessness and poverty in my political group. I just do not know.” It seems that she will keep her promise. In November 2006, she is coming back to work for one day in the home- less charity in Offenburg.•
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Groundswell is the leading user involvement organisation working in the field of homelessness in the UK. Groundswell began as a proj- ect in the National Homelessness Alliance in 1996. Its aim was to ensure that people who are homeless were given a voice in deci- sions, which affected them, and to create a network of homeless- led self-help projects. Groundswell was the first organisation dedi- cated to increasing user involvement in homelessness services in the UK. It is now widely accepted that people who are homeless should play an active part in influencing the services they use. Groundswell became an independent charity in 2001.
Groundswell’s mission:
• Supporting people who are homeless to create their own solu- tions to homelessness.
We aim to:
• Enable people who are homeless to set up and run their own projects
• Increase homeless people’s influence in policy and decision making • Increase homeless people’s meaningful involvement in the servic-
es they use.
Our objectives
• To support people who are homeless in setting up projects through grant award schemes, training and fundraising advice
• To support a network of homeless led projects to promote the exchange of ideas and best practice.
• To create opportunities for people who are homeless to cam- paign and lobby local and national decision-makers.
• To develop and deliver user involvement strategies for service providers.
The Groundswell Grant Award Scheme offers up to £700 for peo- ple who are homeless to create or maintain their own projects. In the seven years of the Awards, Groundswell has supported an inspiring range of initiatives. From user-groups in hostels and day centres, running forums, events, art projects and creating maga- zines to Travellers setting up support groups. Groundswell has dis- tributed £150,000 to 318 groups since April 1998. For 67% of win- ners, this was the first funding they had ever received. 73% have gone to achieve funding from other agencies. On average each Award winner goes on to raise a further £47,268
In 2006 Groundswell was commissioned by the Department of Communities and Local Government to undertake a consultation of people experiencing homelessness to find out their views on servic- es as part of their Supporting People Strategy consultation. The resulting report ‘Being Supported’ was recently published.
In October 2004, Groundswell began a project with St Mungo’s to increase the level of resident involvement in all aspects of the organ- isation. There are many reasons for people who use a project to be involved in deeper levels of participation. It gives people the space to reclaim their own voices and empower themselves, to express their particular needs and viewpoints rather than being drowned out by others in more powerful positions that feel they can speak on their behalf.
There are various models and definitions of participation in organi- sations from tokenistic consultation to a deeper approach to partic- ipation involving shared power and responsibility for decision mak- ing. This project was an attempt to go beyond the tokenistic to deeper levels of participation.
Groundswell’s unique approach ensured residents took a lead in all aspects of the project, beginning by auditing the current levels of participation and throughout the planning and implementation process. People with personal experience of homelessness conduct- ed all training and facilitation.
Mike McCall, St Mungo’s Executive Director of Operations, said: “I have had first hand experience of Groundswell’s training and along with other members of our senior staff team found real inspiration in their approach.”
The main objectives of the project were:
• To audit the existing level of participation at St Mungo’s projects • To identify barriers to participation • To improve St Mungo’s service users ability to influence how the
organisation plans and delivers services
• To increase the skill level and awareness of involvement among staff and residents
• To develop a range of involvement techniques appropriate to St Mungo’s diverse service user group
• To create systems that sustain ongoing involvement.
Six pilot projects were chosen to reflect the diversity of St Mungo’s projects.The project began with a participation audit conducted by residents trained by Groundswell in peer research skills. The audit revealed that, although there was a range of existing consultation mechanisms in St Mungo’s, often they were not used. 76% of the people interviewed were uncertain who was the residents’ repre- sentative at their project and 46% had never been to a residents meeting. The audit also explored what areas residents wished to be involved in. There was a high level of interest in becoming involved in a range of activities including staff recruitment, volunteering and having a say in policymaking.
Giving a voice to people who are homeless – the work of Groundswell By Amarjit Kaur, Director of Groundswell, UK
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Groundswell then began training staff and residents in user involve- ment theory and methods. Senior staff was trained first. It was felt that this was essential to ensure a high level of commitment to the project from the top of the organisation. Frontline staff was then trained. The main theme that came out of this training was that staff did not feel adequately supported or resourced themselves to involve residents.
Residents in the pilot projects were also given training. There was a distinct difference between the sessions at hostels and specialist projects and semi-independent projects. At hostels, the emphasis was on a greater say in resident meetings and the day-to-day run- ning of the hostel. At semi-independent projects there was less of a concern about meetings but a greater demand for more volunteer opportunities either to make use of their skills and abilities or to ‘give something back’
Action Planning Workshops followed the training in the pilot proj- ects facilitated by Groundswell. The aim was to create a safe space to enable residents and staff to come together as equals to devise a user involvement plan within each individual project. Each action plan identified five aims. For example, in one front line hostel the aims were:
• Residents meetings to be facilitated by residents • Residents to have their own newsletter • Create a democratic voting system accessible to all residents • Involve residents in the recruitment process • Make the management of the hostel more transparent and open
to residents
The project culminated in a conference for St Mungo’s staff and res- idents led by Groundswell and residents who had taken part in the project. Groundswell made a series of recommendations to St Mungo’s. These included recommending a ‘Peer Facilitator’ scheme where instead of having resident representatives, a team of St Mungos residents should receive training to go into projects to facil-
itate meetings and mediate. Recommendations were also made that frontline staff should receive adequate training support and resources to enable them to increase user involvement.
It would have been easy to gloss over the difficulties in making user involvement a reality in St Mungo’s projects. At times in the process both residents and staff voiced a concern that it might be a mere ‘box ticking ‘exercise. This project was about seeking a service that is more responsive to residents needs. Change needs to happen at organisational level and it is to St Mungo’s credit that many of our key recommendations have now been enacted.
Andy Williams, St Mungo’s User Involvement Co-ordinator said: ”Groundswell’s ethos was spot on, there were challenges, but I would recommend that any organisation in a similar position get an external appraisal. St Mungo’s took a risk inviting another organisa- tion to judge it, but it shows clients we are taking user involvement seriously.”
‘User involvement’ is a relatively new concept within homelessness. Historically service users have been placed in a passive position viewed as unable, uninterested or ‘too chaotic’ to become involved in decisions that effect housing provision and individual lives. In other sectors, user participation has recognised the expertise of service users in forging a new direction for many services. Groundswell is at the forefront of a movement to bring this approach into homeless services.•
You can contact Groundswell at:
Elmfield House 5 Stockwell Mews London SW99 GX [email protected] +44(0)20 737 5500 www.groundswell.org.uk
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The HEART Project was initiated in 2004 and was designed to explore homeless people’s experiences of the services in the Galway area, with a view to improving the statutory and voluntary services in the city. The team undertook all aspects of the research project. This included mapping experiences, research design, data collection, data analysis, and report writing.
The HEART project was designed by an interagency group including representatives of COPE, HSE Western Region and Mental Health Ireland. The interagency group formed a support group to the project and met with the HEART team weekly to provide support and information.
A Consultative Committee, consisting of agencies working with people who are homeless, also worked with the HEART project.2 It met with the researchers every two months to receive feedback from HEART and to act as an information resource, provide support and encouragement and to dis- seminate information back to their own organisation about the project.
THE HEART TEAM The HEART Team is a team of people who have all experienced homelessness. In fact, some would still be regarded as homeless, living in voluntary sector housing projects in Galway. The team was brought together in order to carry out research into homelessness and the experience of the servic- es for homeless people in Galway City.
The HEART research team was formed following a series of open information sessions which were widely advertised locally. A number of features in both local papers and local radio generated inter- est amongst both service users and providers. Information leaflets were placed in services and ven- ues frequently used by people experiencing homelessness. Current and past service users were con- tacted via outreach work by resettlement workers and residents’ meetings. A number of open infor- mation evenings in a central location gave individuals a chance to find out more about the project. One-to-one sessions were held with the support team and those individuals who were interested, in order to further explain the project. Through this process the HEART team was formed.
“Getting to the HEART of Homelessness” was the vision of the project. Its mission was: “To empow- er homeless people through inclusion: a voice in the process of change to current provision of serv- ices”
HEART RESEARCH PROJECT The aim of this peer study was to research people’s experience of homelessness and their experience of services that cater for people who are homeless, and to make suggestions for changes to those services in Galway city. Another element of the research was a postal questionnaire sent to service providers to map the existing services for people who are homeless.
The research was undertaken in a unique way. The study was entirely led by a group of people who have experienced homelessness and who have used the services in Galway city. The HEART team undertook the study with their peers. Empathy, respect and understanding were at the core of their approach to the research. The team was made up of three women and three men. They took part in a process of mapping their own personal experiences of being homeless and their use of servic- es while homeless. Through this process they devised questions and interviewed 50 people who are currently homeless or who had experienced homelessness at an earlier stage.
This process was quite challenging in that the peer researchers had to go back to experiences that often were painful and difficult to revisit. However, they all felt that when they got to carry out the interviews, they were able to empathise with each person as they had been through some of the experiences themselves.
A major challenge for the team in the early stages was to be taken seriously by service providers. It was difficult for them to make contact with organisations and this was one of the reasons the con- sultative committee was set up.
Homeless Empowerment Action Research Team (H.E.A.R.T.) – an example of peer research in Ireland By Bill Heaney, resettlement worker at COPE 1 and member of the HEART project support group, Galway, Ireland
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A major challenge for the team in the early stages was to be taken seriously by service providers.
The findings of this study have given an insight into the causes and consequences of homelessness; and the direct experiences of services from the perspective of people who have experienced home- lessness. The causes of homelessness for the people we interviewed were generally a combination of multiple factors, including mental health problems, addiction problems, domestic violence, insti- tutional care and relationship difficulties. Some of these factors, such as addiction and mental health difficulties, were intensified by their homeless situation. Many have had problems at home and dif- ficulties early in life. The findings indicate the need for a combination of adequate supports in addi- tion to appropriate housing, so that underlying issues, as well as accommodation needs, can be addressed.
The study provided an opportunity for people who have experienced homelessness to talk about their experiences and the effects on their lives. The experiences and consequences of being home- less were overwhelming. Being homeless had an extreme effect on many areas of people’s lives including their health and well being; their self-esteem; their financial situation and on their social networks. However, while there is a great need and demand for services, the experiences of those interviewed highlight that services also need to be accessible, available and appropriate to the needs of people experiencing homelessness. In particular people sleeping rough, but also people in sup- ported accommodation, experience barriers to accessing services, which include lack of information, stereotyping and inflexible procedures.
The experience of the “inverse care law” by homeless people has been described elsewhere. Essentially, this means that while the needs of people experiencing homelessness are demonstrably greater, their access to care is poorer than that of the greater population3.
While mainstream services need to understand and be responsive to the needs of people who are homeless, specialised services with expertise, understanding and back up support, are necessary. Service plans for people experiencing homelessness in Galway city need to include short, as well as medium and long-term, plans.
Some specific issues highlighted by the people who participated in this study concerned the provi- sion of information. Information on services mostly came from other homeless people, family and friends, suggesting a need to look at how information is provided by services. There is also a need to ensure that information is appropriate and accessible. The study shows that the approach within the service is key and seems to have an influence on the subsequent use of the service. The attitude of staff is crucial for those using the services indicating a need for training in this area for all front-line staff of services. It is important that referral to serv- ices is appropriate and that appropriate options are open to people in relation to services such as addiction treatment.
This study was a first step in evaluating services from the direct experiences of people who are home- less. It is essential that people who have experienced homelessness continue to be part of the plan to improve services in Galway city. The challenge for service providers is to actively involve service users in ongoing consultation. An audit of service user input in Galway city is recommended as a step to ensuring that active participation is part of the ethos of all organisations.
Many people who read this report will, unlike the HEART team, never experience the trauma, fear, poverty, rejection and ill health associated with being homeless. While many will never experience homelessness, or fully appreciate what is like to be homeless, everyone should treat those that have had this experience with empathy, respect and understanding. We should all open our eyes and ears to people who have experienced homelessness, listen to their experiences and ensure that services meet their needs.
The full report is due to be published in the next two months.•
1 COPE (Crisis Housing, Caring Support) is voluntary organisation providing emergency services to people who are homeless in Galway City 2 This committee included all agencies working with homeless people in Galway such as COPE, Galway Simon Community, Galway City
Council, HSE , Western Region, (Mental Health and Older People, Health Promotion, Social Work, Community Welfare, Public Health, Primary Care, Corporate and Public Affairs) Mental Health Ireland, Galway City Partnership, Cuan Mhuire, Threshold and Bros of Charity.
3 Crisis UK, 2002.
