Troubled Lives, Failing Systems: Meeting the Challenge of Multiple and Complex Needs

This project will build on a growing understanding of adults whose cumulative needs mutually reinforce one another to trap them in a state of multiple exclusion. There are an estimated 60,000 people in England who combine homelessness and criminality with mental health and substance misuse problems to place them at continuous risk of repeat imprisonment, hospitalisation and premature death. Recent research has focused on the parts played by family background, systemic failure and structural injustice in generating multiple exclusion and has begun to explore what works in transforming lives.

The proposed project will make use of a unique opportunity arising from collaboration with local agencies involved in the Big Lottery’s ‘Fulfilling Lives: Supporting Adults with Multiple and Complex Needs’ programme. Framework in Nottingham is one of twelve agencies that have secured long-term funding to undertake the national roll-out of this scheme by co-ordinating a consortium of local agencies to manage a programme of work with adults with multiple needs. Multiple needs are to be understood as homelessness, offending, substance misuse and mental ill-health. The Nottingham programme, called Opportunity Nottingham, combines one-to-one work with individual beneficiaries to achieve personal transformation and empowerment, with a programme of work with a network of support agencies in pursuit of the kind of system change that will improve their effectiveness in tackling multiple needs. There will be opportunities for a PhD bursary student:
• To deepen our understanding of the evolving life narratives that have trapped people in multiple exclusion in order to predict the early interventions that might forestall this outcome;
• To develop and evaluate experimental methods of working with this group that enable them to overcome multiple exclusion and lead fulfilled lives;
• To explore the place of systemic failure in the production of multiple exclusion and critically evaluate innovatory patterns of agency collaboration and service commissioning.

The project will appeal to applicants with sociology, policy studies or psychology backgrounds, and lends itself to a participatory action research design that makes use of multiple methods of data gathering. Thus there will be opportunities for:
• Secondary data analysis of a rich source of quantitative data routinely gathered from Fulfilling Lives participants;
• Repeat interviewing of a cohort of Fulfilling Lives participants to explore the impact of the programme on complex needs;
• Interviews with case workers, agency managers, service commissioners and policy-makers to understand the process of system change as it evolves;
• Participatory methods that recruit and train teams of Fulfilling Lives participants to serve as partners in the research process.

The project is expected to generate a rich and varied data set that will provide opportunities to pursue research issues other than those implied by the research aims. For instance, there will be opportunities:
• To test theoretical models exploring the mechanisms by which complex needs reinforce one another;
• To develop research methodologies, such as life story interviewing, working with peer researchers, or multi-media methods;
• To explore comparisons between variables, such as gender, ethnicity, nationality, locality and age, around the generation of complex needs and the effectiveness of interventions;
• To focus on the distinct role played by a particular complex need in generating damaging life trajectories, such as substance misuse or mental ill-health, evaluating the role of helping agencies in changing life courses;
• To explore issues that relate to particular sub-groups in the multiple needs population, e.g. women, people with challenging behaviour, or foreign nationals;
• To evaluate innovatory models of support for adults with complex needs, such as peer mentoring.

The result is expected to inform policy and practice by showing what patterns of early intervention might prevent multiple exclusion, what methods of support might empower multiply excluded adults to lead fulfilled lives and what models of agency collaboration and service commissioning might deliver the best social return on investment.

Specific qualifications/subject areas required of the applicants for this project (e.g. First degree in specific subject area):

Minimum of a UK 1st Class / 2.1 Bachelor’s degree (or UK equivalent according to NARIC) and either a Master’s degree with a social research methods component, or equivalent social research experience.