Research reveals opportunities to improve services for people experiencing multiple disadvantage

Results of our new in-depth peer research reveal that current systems do not always acknowledge the complex and interconnected nature of multiple disadvantage. However, the results also highlight that when people feel listened to, are supported by people with lived experience and are seen holistically as a person rather than a ‘collection of issues’, outcomes can be improved.

Our research – published as part of Research and Evaluation partnership with Groundswell, New Philanthropy Capital, Sheffield Hallam University and the Centre for Regional Economic and Social Research – gathered feedback from people experiencing a combination of interconnected challenges living in Lambeth, Southwark and Lewisham.  The people we spoke to were at different points in their journey towards recovery and were either experiencing or had experienced mental ill-health (90%), homelessness (85%), substance use (73%) and contact with the criminal justice system (48%).

Our findings suggest that the complexity of people’s lives are often misunderstood by the system. Participants talked about journeys to recovery, and ‘where they were at’; people’s journeys were complex and non-linear. They also described being passed around the system ‘from pillar to post’,  and needing to ‘hit rock bottom’, ‘tick a box’, ‘jump through hoops’, ‘and ‘look like someone who needed help’ in order to receive the support they needed. We also found that attitudes within the system can also be detrimental to people’s wellbeing and recovery.

People also told us that they valued ‘lived experience’ and peer support and how increasingly services, and the people working in them, are developing an understanding of trauma and it’s impact. Participants described how feeling listened to, having access to drop in spaces and having the opportunity to build meaningful relationships were key.

Key challenges

Our research identified key challenges for people experiencing multiple disadvantage who are trying to access support systems:

  • The inter-connection between the experiences of substance use, mental ill-health, contact with the criminal justice system and homelessness are overlooked by services
  • Services are not designed to accommodate the realities of living with multiple disadvantage which can mean that people’s journeys will have bumps and obstacles, and that the current system can seem to ‘punish’ these setbacks
  • Mental ill-health is often misunderstood by services and needs were not always recognised as being ‘serious’ so people can find it difficult to ask for help
  • ‘Dual diagnosis’, where people experience co-existing drug and mental health issues, was described as a ‘catch-22’ situation where participants found it difficult to get support
  • Support services that put value and judgments on the choices participants made sometimes had a negative impact on their ‘progress’

Creating better services

People we spoke to were clear about what worked better for them:

  • Building trusting and meaningful relationships is key to the well-being of participants, both during transitions and in their journey away from multiple disadvantage
  • Where people were viewed holistically as a person rather than a ‘collection of issues’, the support they received and relationships they formed led to better outcomes
  • Being listened to and being given ‘choice’ is important to people
  • People told us that shared experience – whether it is peer support groups, employing people with lived experience, involving people with experience of multiple disadvantage in designing services or contributing towards systems change – is very powerful
  • Approaches which are informed by gender and culture can have a significant  impact on building better relationships, changing the attitudes of service providers and improving the environment for people trying to access services

Read the full results of our Peer Research exploring people’s experience of multiple disadvantage in Lambeth, Southwark and Lewisham here.

Further reading

Executive summary Executive Summary: Peer Research

Importance of peer research blog Embedding coproduction in research – why peer research is important

Literature review Understanding Models of Support for People Facing Multiple Disadvantage: A Literature Review | Fulfilling Lives (

Trauma informed guidance Trauma-informed approaches | Fulfilling Lives (

Systems map A Systems Map : Thinking about the system as a whole | Fulfilling Lives (

Barriers and challenges around Dual Diagnosis – could connect to DD report  Dual Diagnosis and access to support | Fulfilling Lives (

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Paula Scott 07932 740221,