Dansk

How do we help or support people that live in situations that do not fit into the system’s categories? This question is constantly reoccuring in the development of our public service systems. A very obvious example of this is the area of social care for vulnerable families which is increasingly becoming a nightmare scenario for Western nation states across the world. These are often families at risk accessing a large amount of different services and are involved in several case plans at the same time. How do we coordinate and integrate services that are addressing such different issues like child behaviour and education, domestic violence, drug or alcohol abuse, unemployment or work injury, financial crisis, unstable housing, physical or mental illness or other common hardships of everyday life?

Currently, most interventions focus on one family member or in relation to one aspect of the problem. This is one agency maintaining its responsibility by living up to the standards that is defined within their own formal area of responsibility. While the direct result is that families usually have to adapt to the agenda of the system rather than the other way around, the consequence for the families is that they often experience rejection from the system and an inability to live up to what is demanded from them. Instead of being helped into a productive process, the system becomes an additional risk factor for the families and a barrier to (rather than driver of) change.

This is not only an inefficient and ineffective use of public resources, but becomes a question of public legitimacy since prolonged involvement with services without achieving progress is resulting in a general mistrust in the system’s ability or even intention to help them. In the UK, they have called this the ‘gyroscope problem’ (see figure). Outside of the family, a lot of agencies, organisations and institutions ensure a tremendous amount of system activity. Yet on the inside, for the family, nothing changes. All this money and effort is being used simply to maintain the status quo.

(The Life Project)

Working with the leading Australian design consultancy ThinkPlace, MindLab took part in a project that set out to address these issues and transform the service system dealing with vulnerable families in the ACT region of Australia. The purpose was to develop new capabilities and processes to co-design and co-produce services with current service users as part of introducing a new human-centred, systemic approach to improve outcomes for vulnerable families. Through design research of the actual experiences of families at risk in the ACT region, new perspectives for collaboration between public agencies, community sector organisations and citizens were created through a new empathetic relationship in relation to the experiences of citizens. New ideas and policy proposals for rethinking and reshaping the service system were developed in the continuous interaction between strategic decision makers, frontline staff and the families.

Perhaps even more important, there was a profound recognition of the project as a first iteration in a larger cultural change consisting of building a capacity for a more human-centred and outcomes-focused approach. This not only meant that, in relation to every insight or idea, the question of its systemic implications was raised as an inherent part of the process. It also implicitly implied that the project productively questioned the current perceptions of what ‘a system’ is or could be. What the project largely showed was that in every positive progress experienced by families, an unscripted approach had been applied in the service system. Usually this was done by community organisations working from the approach that problems, as well as what kind of activities that were needed to address them, were to be defined with the families themselves.

You can read and view more about the project in the link provided below. For now, I want to question if we are somehow caught up in an unproductive understanding of ‘a system’? The insights coming out of the project to a large extent coincide with some general points from our general work in MindLab. We continuously see how the involvement of citizens and other users in innovating public service systems and taking the complexity and context of their situation seriously at least poses three important design challenges that all seem to expand our current perceptions of what a ‘systemic’ approach can consist of:

-  Professional generalists: how do we become systematic in an ‘unscripted’ way? There is a need for becoming less scripted and work with citizens rather than deliver services to them. Working unscripted with focus on outcomes will necessarily pose the question of whether we have to work silo or sector-based to provide the accountability that is needed to secure civil and legal rights?  

-  Building relationships: how do we go from ‘referral’ to ‘connection’? There is a need for taking ownership of the whole problem by building and facilitating effective relationships and networks around citizens to ensure continuity, coordination and ‘case-handovers’ in their situation rather than focusing on ‘finishing’ their cases. Does sharing responsibility in a relational way counteract a consistent and systemic approach in dealing with citizens in complex situations?  

-  Providing context: how do we go from ‘episodes’ to ‘stories’? There is a need for an approach that can ensure that the whole contextual complexity of the situation is taken into consideration when decisions are made and case plans are defined. Rather than mainly relying on fixed standards or individual or social crisis to emerge, could the system to a lesser degree be crisis-driven and reactionary and instead build on the ability to relate to the contexts and experiences of citizens? 

Co-designing better outcomes for vulnerable families in the ACT.

For more inspiration, see also the Life Project in the UK.