These are complex problems - thank you for your work!
2
A lot here and it makes sense to look at and try to tackle social problems “together,” “holistically,” or with a “full frame.” A few thoughts. It might be important, for theory and practice, to have a sense of when such an approach can work and when it can’t. These terms imply you’ve got a sense of, and are addressing, the big picture—but there’s almost always going to be an even bigger picture that, at some point, you have to leave unaddressed (at any given time). As a change-agent in the sustainability field, which is weak in the social area, I’ve taken a part time position in the social services field, in part, to better understand the interrelationships between environmental and social aspects. I’m finding some, such as more energy inefficiency than I would have expected, a part of the bigger picture not mentioned here, but critical if you accept that climate change is the biggest problem of the 21st century. Now I may or may not be able to do anything about it because vulnerable consumers might need that extra energy consumption (such as tv sets on that no one is watching to hold off possible anxiety), or social services staff stretched to meet even current expectations of them. But, still, perhaps “full frame” needs at least an implicit “somewhat” before it. A suggestion. As there’s going to be a Part 2, it would be interesting to know more about how non-compliance can be due to “a higher sense of self than the case worker imagines.” I’ve never seen that point.
1
A profound article, digging deeper than most. From my vantage point as a social worker, there are other contributing factors. First, the government contracts on which many social service agencies rely, require a limited, short-term response, and do not pay enough so the organization can hire experienced and educated workers who can work holistically. Second, we have moved from evaluating how the client is actually doing, to how the program is doing. These are different things.
6
People want shortcuts, the easiest, fastest cheapest solutions. They want to be a Phoenix without going through the fire to be reborn. They don't realize the short cut (for the long term) is going through the fire.
That means processing the root cause of dysfunctions experienced in childhood, in war time, etc. To do that you need to re-experience the pain to get rid of it. This takes a long time and it can be so painful that a reasonable choice is to live with every day pain, rather than live in agony for a while to get past the pain.
Social services aren't set up for long term investments in solutions. They can offer a weekly 10 minute check in, or a 2 month addiction rehab. That's a start, like war veterans and victims of domestic abuse need to share their experiences with people who've gone through similar experiences.
But to get to the point where you can function in a healthy interdependent way, you need a lot of support. I was lucky that I experienced a tragedy that qualified me for a medicating psychiatrist. I used to look at homeless people talking to themselves on the street & think "there but for a good support system go I".
I've seen people go through short term therapy that helps them just enough to get by. Without processing the root cause, the next setback puts them right back where they started. We need to invest more in people's basic needs, safety, food, education, physical & mental health, ongoing support systems, addicts helping addicts, etc.
4
I have noticed in observing family members and acquaintances that some people really just need more structure to survive or thrive. Unpredictable situations can be really hard for people.
3
What undermines well-being the most is the willingness of many people to jump to conclusions about another person's behavior and then stick to those conclusions in spite of evidence proving them wrong. Then we have the one-size-fits-all solutions which often backfire in the worst ways on the people who need help.
I remember what it was like to be abused (verbally and physically) by my parents, bullied by my peers, and how things got worse whenever anyone stepped in to "help". What I learned from this help was that it wasn't worth it because I wound up being hurt even more. If I had to bear the brunt of the anger from my parents and peers, especially from the former who claimed to love me, I was going to learn to live without being loved, liked, or cared about. I didn't need to be hurt every day of my life. I made that decision as an 11 year-old.
Nothing that has happened to me or been done for me has convinced me that being loved or cared about is worth it. The interventions that were done didn't help me. They did give my parents grounds to scream at me more and hit me more. I was told, whenever I tried to get help, that I had to do it the therapist's way. That usually involved their contacting my parents because that would be best. It didn't matter that I knew better.
It's these sorts of experiences that convince people to refuse to ask for help and governments to cut funding. Help isn't help when it isolates one even more.
10
As a young social worker fifty years ago working with broken families, I soon discovered that the problems affecting these families were mostly rooted in unhappy childhoods, poor or absent parenting and abysmal social conditions.
I still recall one family I worked with whose house lacked a front door, so I arranged to get it replaced. A few months later I discovered it had gone missing again.
You do what you can, no matter how insignificant. The agency I worked for had a small fund available to it for helping families with transportation. So I was always a big one for handing out street car tokens.
Coordination of services between agencies and programs has long been spoken of as an ideal solution, but in actual practice these efforts have often been found impossible to achieve.
When social agencies find a way of providing troubled people with some semblance of the good families and happy childhoods they never had, highly coordinated efforts will make a lot of sense.
Until then, I fear they will remain --
"... boats against the current, borne back ceaselessly into the past."
7
Make that:
So I was always a big one for handing out street car tokens,
whether or not they were needed,
2
institutional turf issues are the biggest barrier to service integration .we're are in the midst of that Michigan in attempting to integrate behavioral and physical Medicine for the Medicaid population. I take a slightly different View this approach, in order to manage Healthcare cost we need case management the pulls all these services together and that understanding all of us need a sense of purpose and community.
5
Having been both a mental health counselor and consumer, I have seen this up close. As long as people see others from a bias of troubled, in trouble, addicted, immoral for being poor, or sick, etc, progress will be slow. You can't truly help someone if you feel superior to them. I have found that tribulation eventually reaches everyone's door and we do ourselves and society a great favor by embracing compassion.
20
@MKathryn I have found, on the basis of personal experience, that a great many in the "helping" professions, have no idea how their views influence the way they treat the rest of us when we're in need of help. If we're not believed, or solutions are offered that we've already tried (and that's why we go for help in the first place) that we turn down, or things worsen, often we're blamed. It's our fault that we're homeless or jobless or friendless. The attitude is that we could have what we want if we try hard enough.
At some point those attitudes hinder people in need of help. We might do better if someone showed us how to do it or did it for us. Then we can see how it works and decide if it will work for us. It's similar to learning how to write: we all start with the same model but each person has their own style and, as long it's legible, no one cares. Someone is ready to help us when we first start. The same goes for learning how to walk. Parents don't put their infant or almost ready to walk child on the stairs and expect him/her to master it at once. In fact, when the child first begins to walk they are holding both its hands. It's a process.
Helping people to become better is a process. If helpers want it to be linear they will, almost without exception, do more harm than good.
7
It is getting worse as we invite private companies to address social issues. They operate precisely with philosophy of Wealth of Nations--a single product or service to yield singular a outcome.
21
@Ms B: Agree with this to a degree....maybe we need to look at a combination of government and some private entrrpise. However, we need compassionate leadership and not just profit driven strategies. I worked for a large non-profit in Memphis, TN for about four years which embodied some of these ideals. Very successful and enjoyed my work. It is called MIFA and the people were a delight to work with and the staff is very dedicated. The board is made up of business, religious, and community leaders.
1
@Diane Thompson
I think the trouble comes in when those private enterprises that government teams up with (or contracts out to) are for-profit companies, especially the ones with shareholders who feel they deserve a return on their investment.
@Diane Thompson it makes my day to see that you worked for an agency you have positive feelings about. There is so much burnout here in these comments and in the field in general - and it is tough, tough work, so I completely understand. How great that there are success stories in the field in terms of agencies as well as in terms of individuals.
Law enforcement see crime everywhere they look; clergy see evil everywhere they look; educators see ignorance everywhere they look; social workers see dysfunction everywhere they look. It comes easier than seeing a human being.
18
@Ed
Yes.