‘Push where it moves’ — Operating in a psychologically informed manner within the wider system’…

27.05.2022: As I write this week’s PIE blog, as the lead for Psychologically Informed Environments (PIE), at the national youth homeless charity — Centrepoint, I have been reflecting back over the past week wherein my personal and professional worlds have somewhat collided. As we continue to support the Ukrainian family we are hosting as refugees from the war in that country, I have been reflecting on the experience and my learning from it so far, in particular what I can apply to my role within Centrepoint. So far, the experience has been both enlightening and humbling, with definitely more positives than negatives. For example, I have been rediscovering our capital city, as we have shown our guests the sights, through the eyes of someone new to London. I had almost forgotten post lock-down how much there is to see and do within the city! However, it has also been a humbling experience as I have realised again my privilege in living in a safe, comfortable home — something that many of the homeless young people that we support in Centrepoint have not had until they come to our supported accommodation services.

Moreover, over the past few weeks, one of the main things that has dominated my time outside work has been ‘paperwork’. For example, the many forms and documents that it takes to register an individual within the wider UK systems of health, education, welfare and other services not to mention the process of obtaining a visa giving the right to remain in the UK (and not just to enter). It has almost been a job on top of my regular job at Centrepoint! However, it has also made me reflect on the challenges that many homeless individuals face when trying to gain access to statutory services, register for health and welfare, and obtain legal status in the UK if an unaccompanied minor seeking asylum in our country. As a British born national, I have only ever had to do ‘one thing at a time’, and it is only when the full list of what is needed to access support is attempted in one go, have I realised the complexity and challenge that this can present.

Even though I do not consider myself naïve to the wider UK systems having worked within the NHS and Criminal Justice system for several decades, and as a university educated individual with English as my first language, nevertheless even I have been challenged to navigate and complete the required processes and paperwork for my Ukrainian guests. This has led me to reflect on just how difficult this may be for a homeless young person who may not have high levels of literacy, understand written English or have the time (and internet access) to learn what to do and how to do it, in order to obtain everything they are entitled to and move on from their current situation. This is why one of the key tasks our supported accommodation staff undertake with young people is to support them to complete this paperwork. Many individuals who become homeless have ended up ‘outside the system’ or wider society, and are in effect discriminated against as a result in terms of access to health care, welfare and education or training opportunities (e.g. Homeless Link, 2014; https://cdn-homelesslink-production.s3.amazonaws.com/media/documents/The_unhealthy_state_of_homelessness_FINAL_1.pdf?AWSAccessKeyId=AKIATD3QUTG2CGEGRSWQ&Signature=PwM4fpWypNorTkJyjTtF984bMJ0%3D&Expires=1653560882). This is also, why our Health and CP Works (Educational, Training and Employment) Team(s) in Centrepoint are so important to ensure that the homeless young people we support can access what they need when they need it.

I have also noticed that during ‘frontline’ reflective practice sessions; staff often raise the issue of these wider systems within which an organisation like Centrepoint must operate. Commonly, staff rightly express their frustrations about how they are set up or operate. Only this week, I attended a supported accommodation service wherein one of our Housing Support Workers was sitting with a young person trying to help them to access a travel card and welfare benefits. The online process (and telephone helpline) was clearly frustrating for both the homeless young person as well as the staff member, although it was positive to see both persevere together in order to sort the issue out. It made me reflect on just how psychologically informed (or not) many of these forms and processes were, and just how much added trauma or stress that they can impose on already traumatised individuals who are trying to seek help through them.

Of course, many of the wider systems that a homeless charity like Centrepoint operates within (e.g. Social Services, NHS, Department of Work & Pensions, and Housing Services) are outside of our direct control. Whilst this can cause frustration for our staff and the homeless young people that they support, it is not sadly always within our gift to change them. Despite this our brilliant Policy Team do lobby when they can to bring about changes when possible to make access and support easier and fairer for homeless young people. One recent example of this has been the campaigning work on Universal Credit and the Shared Accommodation rates for young people (c.f. https://centrepoint.org.uk/what-we-do/policy-and-research/briefings/). Enabling those that make social policy nationally to ‘see’ the impact of their decisions on homeless young people and lobbying for change within the wider system is important as this not only benefits Centrepoint young people, but all young people that might be facing or experiencing homelessness within the UK. We can also try to develop innovative ideas to solve wider system challenges such as the lack of social housing (e.g. our Independent Living Programme; https://centrepoint.org.uk/what-we-do/independent-living-programme/) that can serve as a model for the wider system to adopt.

Nevertheless, I would argue that one of the broader aspects of becoming a psychologically informed organisation, is to reflect and consider changes within our internal processes (i.e. those we can control and change) to ensure that they are easier to navigate and put the homeless young person (and staff) at the centre of them. In other words, we can change what is within our gift to control. For example, over recent weeks the PIE team has been supporting the organisation to reflect upon and modify where necessary our policies and procedures to make them more psychologically informed. There are many things we need to do to function as an organisation but if we can ensure that we keep ‘people’ at the heart of these and use evidence based approaches to decision making, then we can hopefully improve the experience of those that use our services and/or our staff that work within them. Other recent examples of this have been discussions within our People Strategy work streams as well as reflecting on how we move forward in terms of the digitisation of the organisation. A PIE approach would be to ensure that we don’t just do ‘what we have always done’ but reflect and consider what ‘works’ and if not, why not, in order to make changes accordingly.

Reflecting back upon the wider system that Centrepoint works within, I have also been speaking with staff this week in reflective practice sessions about how we can manage the challenges that we can face. Over the course of my psychology career to date, I have often felt that I have been ‘swimming through treacle’ when trying to support a client to access different services or support. However, what has always helped me in this situation has been to come back to the systemic therapy mantra shared with me by a very wise supervisor of the importance of trying to ‘push where it moves’. This essentially means that sometimes instead of trying to keeping forcing something to change when it can’t, won’t or is beyond our control, it can be helpful to take a step back, pause, reflect and try to see the bigger picture. If we can do this, perhaps in conjunction with the person we are trying to support, we may be able to see another way to approach the issue that can work instead.

For example, over the past few weeks instead of being overwhelmed by the amount of paperwork that I have needed to complete with our Ukrainian guests, we have tried to list what we needed to do, worked out which tasks can be completed first, which tasks will then follow from this, and which tasks we can’t complete right now or may need some support to deal with. This ‘step by step’ approach has enabled us to remain focused and motivated, as well as attempting to manage the processes in a psychologically informed manner (i.e. not creating further trauma or stress). Even despite this, the challenges of this wider system have certainly increased all of our resilience, something that I have also been reflecting upon. This quality of ‘resilience’ is something that I see a lot in our homeless young people (even if they do not recognise it within themselves), many of whom have often have survived very difficult or traumatic early experiences before coming to Centrepoint.

Moreover, I also see it within our amazing staff in both ‘frontline’ or ‘support’ roles who persist and advocate for homeless young people within these complex wider systems even when this can be challenging or exhausting for them. This ‘going above and beyond’ for homeless young people in the UK is something that makes me proud to work for an organisation like Centrepoint. Nevertheless, sometimes we need to recognise that we may not be able to change everything we want (or need to) as we can ‘only do what we can do’ and although this can be frustrating, it is important to keep trying where and how we can. It might feel like an uphill battle at times, but the power or significance of even a small break through or positive step forward should not be underestimated or go unrecognised. This is a challenging sector to work within, for many reasons, but as long as we keep remembering to ‘push where it moves’ with the homeless young people (and our staff) at the heart of everything we are doing as an organisation, then I would argue that we are continuing our journey towards a creating truly psychologically informed environment or system that will benefit all those within in…