A Trouble Shared - new evidence on "clusters" raises a number of questions
A new research report confirms that clients of advice organisations often experience "clusters" of problems and raises questions about the extent to which organisations are able to identify and deal with such "clusters".
The research
The authors Richard Moorhead, Margaret Robinson and Matrix Research and Consultancy, examined the existence of clusters amongst clients of a small number of advice organisations, focusing on clients with housing, welfare benefits and debt problems. They observed interviews with 178 clients and conducted follow up interviews with a number of them. They also asked advisers to provide information about the problems experienced by clients in a larger number of recent cases.
The clusters
- 43% of clients whose interviews were observed had two or more problems – frequently involving a mixture of housing, benefits and debt problems.
- 56% of clients whose cases had been taken on had two or more problems.
- Amongst this group the strongest clusters found were: rented housing, benefits, debt, and mental health problems; relationship breakdown, children, home ownership and domestic violence; discrimination and employment.
- Problems that involved relationship breakdown/children, home ownership, mental health, domestic violence, employment and homelessness gave rise to the most complex (and arguably the most serious) problems.
- Subsequent interviews of 58 clients revealed that 29 had further problems over and above those presented. About half of these problems appeared to have some link with the presenting problems.
- 37% of the clients whose interviews were observed had problems that involved their local authority.
The advisers
- Generalist advisers and specialists faced with problems outside their expertise are less able or willing to deal fully with such problems.
- Generalists were most likely to advise clients to deal with problems themselves.
- Specialists were reluctant to refer/signpost outside their own organisations.
- There may well be a relationship between interviewing style and/or competence and the likelihood that clients reveal more than one problem.
The report concludes that vulnerable clients suffering complex clusters of need are likely to benefit from a form of case management. A case manager might seek to engage with health professionals, housing practitioners, local authority welfare benefits officers, family counsellors as well as solicitors and advisers, in order to achieve the desired outcomes for the client. This would be a new role as far as the CLS is concerned.
The full report.
