Domestic abuse and Covid-19 what next?

Domestic abuse and Covid-19 what next?

Covid-19 has had a direct impact on the rise of domestic abuse. Ciara Taylor summarises the issues, how Government has responded and what we need next to support survivors.

 

Since the UK-wide lockdown began in March 2020, there has been an increase in cases of domestic abuse. Domestic abuse charities such as Refuge and Solace Women’s Aid have reported an increase in demand for services; calls made to the Refuge national domestic abuse helpline increased by 66% over the last three weeks of May and visits to the Refuge website increased by 957% in the last two weeks of May. The rate of domestic abuse killings per week doubled in the first three weeks of lockdown; there were at least 16 suspected domestic abuse killings, four of which were children. Instructing people to stay at home has exacerbated existing problems of domestic abuse and in some cases has led to new perpetrators. As survivors cannot leave the home for extended periods of time it is more difficult for them to escape abuse.

To address this, the Government has:
1. Waived the stay at home rule for people experiencing domestic abuse.
2. Committed £76 million to support survivors of domestic abuse, sexual violence, vulnerable children and their families, and victims of modern slavery during the pandemic.
3. Raised awareness about domestic abuse through the daily coronavirus briefings including encouraging use of the silent ’55’ calls where individuals can call emergency services and press ‘55’ without speaking to alert that they are in danger.

Charities are providing the majority of frontline support for those experiencing domestic abuse. Face-to-face support has been shifted online through the use of emails, live chats and forums, whilst resources such as ‘survivor tips’ from Refuge and ‘how to cover your tracks online’ from Women’s Aid have been made available. Campaigns from organisations including Southall Black Sisters and Compassion in Politics have asked hotels to open up their rooms to those fleeing domestic abuse.

Changes to service delivery during COVID-19, alongside an increase in demand for these services brings several challenges. While organisations are unable to run in-person advice sessions, the provision of effective support relies on staff being equipped to work from home and service users having access to electronic devices and internet connectivity. Survivors face additional barriers to accessing help online as perpetrators of domestic abuse may closely monitor their use of the internet and they are unlikely to be able to speak freely over the phone for fear of being heard.

Building on the innovative and important work of the sector there are three key areas of intervention needed to support organisations supporting survivors of domestic abuse:

1. Invest in organisations to ensure they have the resources to respond to demand: Funders and commissioners must ensure that organisations and services have the resources that are required to respond to need and manage increased demand. The true scale of domestic abuse during this time and the impact it has had may not yet be realised; staying at home during lockdown has meant some survivors of domestic abuse have been unable to access support networks and as a result there may well be an increased caseload of people who look to access services post-lockdown. Resources might fund psychological support for staff as they experience an increased caseload and lack of face to face support themselves, and new homes/refuges for service users as survivors might have been cut off from other housing options due to COVID-19.

2. Recognise that domestic abuse is a complex issue which appears in many forms including economic abuse: Economic abuse is a form of domestic abuse that may consist of the control and restriction of the acquisition and use of money and economic resources. Typical financial advice services may not be suitable for those experiencing economic abuse and may put them at further risk. As such, advice services must implement a person-centred approach providing tailored financial advice to ensure that service users are kept safe.

3. Invest in longer term stability and support: As lockdown ends it is important to move from interim, crisis-response type support to a sustainable approach that guarantees maintained support of survivors through secure housing, secure income, psychological support. This will require greater coordination of resources and funding. The parliamentary Domestic Abuse Bill Committee met this week (04/05/20) to hear evidence from specialist domestic abuse organisations and survivors and to discuss the enhanced domestic abuse bill.

It is important to utilise this bill to deliver the reform needed by this sector.

https://www.bbc.co.uk/news/uk-england-52755109
https://www.theguardian.com/society/2020/apr/15/domestic-abuse-killings-more-than-double-amid-covid-19-lockdown
https://www.theguardian.com/lifeandstyle/2020/apr/22/every-abuser-is-more-volatile-the-truth-behind-the-shocking-rise-of-domestic-violence-killings

Ciara is a Consultant at Rocket Science based in our London office.  You can check out her profile here.

We need to prevent Covid-19 halting the progress we have made on health and work.

We need to prevent Covid-19 halting the progress we have made on health and work.

Caroline Masundire reflects on our learning and experience of innovations in health and work and what we can do to minimise impacts Covid-19 will have on employees with health conditions

 

Covid-19 aside, May was quite a momentous month for me. For the past two years I have been leading Rocket Science’s role in managing the Government’s Work and Health Unit’s Challenge Fund and in May, I completed our overall programme and learning reports.

The Fund, launched in the summer of 2018 was designed to test innovative approaches to help people with Musculo-skeletal and/or mental health conditions stay in work, avoid long term sickness and unemployment. It was part of the Government’s ten-year strategy to get a million more disabled people into work.

We worked closely with 19 Initiatives, ranging from providing rapid access to occupational health support in clinical and community settings, through to direct support and advice in workplaces to capture their learning, understand their impact and identify what worked and what did not. During this time we were also working with other organisations on health and employment issues, including evaluating Fair Start Scotland. All of this experience combined illustrated the difficult challenges both individuals and employers face when managing health conditions at work.

The Challenge Fund was launched at a time of near full employment, we can argue about the quality of employment, but nonetheless the policy and funding focus had shifted to supporting people in work to stay in work and progress or to help those furthest away from the labour market move towards work.

During the Fund, the disability gap was closing (by 5.6 percentage points from July -September 2013) reducing by 1.6 percentage points just in 2019. Evidence was developing about the role of work in giving people the motivation to better manage their health condition and slow down its progression keep them in work for longer and improve their health. There was increasing recognition of the role of good work and conditions in helping to manage workplace wellbeing, reduce staff turnover and help reduce the skills gap. Mental health was widely talked about and supported and funds such as Access to Work provided a lifeline to help people to stay in work.

The arrival of Covid-19 will seriously impact on the progress we have made on health and work.

As services shift to get Britain back to work and the need to prioritise those that can get back to work quickly, the focus and resources supporting those furthest from the labour market are at risk. Our fortnightly Covid, Coffee and Catchup sessions with people in employment services is highlighting how precarious the situation is and the risk that resources will inevitably have to be redeployed to focus on those who are ready for work. There is also the risk that any announcements for the Chancellor in his emergency budget on support programmes will focus on helping people who can easily get back to work more quickly.

We are yet to understand the impact of Covid-19 on the employment rates of people with health conditions, but it is fair to assume that furloughing will have had an impact with the potential for redundancy and likelihood of unemployment for some. Older people are more likely to suffer from health conditions and the latest data on Universal Credit claims showed that around a fifth of people claiming were over 50.

Some people will also have been at a greater risk of contracting Covid-19 because of their work, statistics from the ONS in May 2020, highlighted that 15% of key workers who had a health condition were at moderate risk of contracting the virus. This begs the question on how sustainable is ‘key work’ for people with a health condition, especially if there is a second wave.

 

These are uncertain times and we are still finding our way on the road to recovery, but we cannot afford to lose sight of the progress we were making and the learning we were developing on how to keep people with health conditions in work.

At the heart of any  approach must be how we:

• support employers to protect employees with health conditions already in work
• help those who have been made redundant or need to change careers because of their health condition
• assist those in need to access other services and support so they don’t fall into crisis.

Three things we can do!

1. Our learning from working with employers is that they are more likely to engage if they need help with a particular issue. As local authorities and other agencies are supporting employers to provide them with grants and business support, it is an ideal opportunity to work with them to identify employees who are at risk of losing their job and because of their condition will find it more difficult to find an alternative role. This includes reviewing workplace adjustments so they can be adapted to new rules of working, negotiating working hours if people need to reduce or increase working hours and offering help to the employee so that they can stay in work.

We found that businesses including SMEs do want to engage, they just need help to understand what they can do to help and a positive experience leads to greater opportunities to support them with staff and workplace practice.

2. We know that for employees who are working insecure, temporary or low paid work, reductions in their income can be make or break for them. The rise in Universal Credit claims illustrates that people are using this safety net, but we know that people will need help navigating the complexities of this as well as help with income maximisation.

Our learning has showed that the kinds of support offered to people to help them get into work such as benefits, housing and debt advice is equally important to help people in work avoid crisis. This can be effective in helping them sustain their employment as well as support their mental health.

3. Finally we need to help people to think broadly about their skillsets and the types of alternative work they can do, especially if they have been out of the jobs market for some time. We know that focusing on an asset-based approach can help people to think more broadly about what they can bring to a role, open their eyes to opportunities they would normally dismiss and support them with job search.

Building people’s skills in job search is really important as is giving them coaching and support to work through the role, the workplace adjustments they might need to have in place and to be confident in having these discussions with their employer.

We can go someway to minimise the impact of Covid-19 for those more vulnerable workers, but we must ensure longer term, that this does not become a reason to stop the progress we were making on healthy work.

Get in touch to find out more about our work.

[email protected]

Caroline is an Associate Director at Rocket Science based in our London office.  You can check out her profile here.
Shifting to “employerability”

Shifting to “employerability”

Clara Mascaro and Hamish Linehan discuss good work, health and “employerability”

Our work commonly sits within the intersections of different areas including health, employability, housing, and poverty. Considering issues at the point that they intersect with others can often shed light into ways to approach some of the more intractable challenges in policy and service provision. In the spirit of intersection, we have teamed up with Clara Mascaro, a former Rocket Scientist and current PhD student at the University of Edinburgh, to explore how considering employment and health alongside each other makes it clear that the quality of the job is paramount. We have also drawn on the work done by Inclusion Scotland, Scotland’s main Disabled People’s Organisation (DPO), who coined the concept of ‘employerability’ during a Disabled People’s Annual Summit in 2018.

For me, this interest stems from our work with those who are unemployed and the services that offer support to them. People I’ve talked to have often commented on how their unemployment has contributed to their poor health, reduced life satisfaction and feelings of social exclusion. Their experiences are supported by an increasing body of literature that demonstrates how being in good employment can improve individual health and wellbeing and a growing understanding of ill health’s hidden economic cost.

In 2019, the UK government reported that 131 million working days were lost to sickness absences, and it was estimated that sickness and worklessness costs the UK economy approximately £100 billion annually. These findings are pertinent given that nearly a third (31%) of all working age people in the UK report a long-term health condition.

In addition, there is currently a significant gap between employment rates for those with disabilities (51.7%) and those without (81.7%).

As people live and work for longer, the number of those with a long-term health condition or disability both in and out of work is likely to increase. 

Helping people with long-term conditions and disabilities stay in work for longer or find employment can have a significant positive impact on both individuals and the wider economy. So far, the challenge seems simple: “there are a number of people who aren’t in work who would benefit from employment, so let’s get them into jobs!”.

However, we see the challenge as more nuanced than this. Evidence has shown that “bad work”  (low-paid, insecure, with low autonomy over tasks, resulting in low satisfaction) can actually have negative effects on a person’s health. This stands in contrast to the positive effects that good work (work that is well paid, secure, autonomous, with a good work life balance and opportunities to directly participate in organisational decisions) can have.

So, moving those with health conditions and disabilities into any job won’t guarantee individual and economic benefits – it may even exacerbate the problem. With this in mind we can reframe the challenge from: “How do we help those who are disabled or have long term health conditions stay in or find employment?” to “what can we do to make sure that the work that’s on offer is good quality?”.

When thought of in this way, we can see that both employers and employability services have a part to play in ensuring this challenge is met.

What can employers do?

The social model of disability states that people are disabled not by their impairments or health conditions, but by structural, environmental and attitudinal barriers in society. Adopting this perspective with regards to work and health puts more of an onus on employers to make workspaces more inclusive. Examples include making reasonable adjustments, job carving (tailoring jobs to make them suitable to specific workers), promoting flexible working practices and implementing accessible recruitment processes. However, employers – particularly smaller employers – often lack the knowledge or capacity to make these changes and need help to improve their ‘employerability’.

 A number of projects we work with are aiming to change this. We are currently working with the Department for Work and Pensions on their Challenge Fund– a multi-million pound fund that is looking at different approaches to keeping people in employment with MSK and mental health conditions through 19 test to learn initiatives. A number of these initiatives focus on the views, sense of responsibility, knowledge, skills and confidence of employers to increase their employerability. Traditionally, employers have been only passively involved in employability support programmes as the recipients of job seekers. These projects illustrate a welcome shift in the expectations placed on employers.

What can Employability Services do?

For employability services, adopting this perspective implies that it is crucial that services support jobseekers with a disability and/or health need to find a ‘good’ job that matches their skills and meets their health needs in a sustainable way. This requires flexible, personalised employability services and a shift away from what is referred to as a  “Work First” approach – ie aiming to place people into any employment as quickly as possible.

We have recently worked with a number of services who are doing just this – offering individualised support that is intended to move people with long-term health conditions into good work.  Through working with these services, we have been able to identify a number of key lessons that have contributed to their success. These include:

Service users’ needs and ambitions need to guide support. Good work will look different for everyone. In order to ensure that service users are moving towards what they feel is good work services need to align employment outcomes with their ambitions, skills, and health requirements. We have seen this be particularly effective when service staff work in collaboration with participants to identify and source a variety of different training and employment opportunities.

Health often intersects with other issues. We have found longstanding health problems can be both a cause and consequence of issues in other areas. Specifically, we have found that poor physical health and mental health can often intersect with issues such as insecure housing, poverty, and social isolation. Services can help respond to these intersecting issues by having well-trained specialist staff and strong referral links with relevant organisations.

Moving someone into employment is a first step. Often, moving someone into work is just the first step. When in work individuals may need to continually manage their health and, as discussed previously, workplaces made need to make active adjustments to accommodate individual need. Services need to provide users and employers with the skills and knowledge to manage their health conditions and adapt their work environment. In some instances, this will require that services provide ongoing support to help service users transition into work.

Managing expectations

While there are many steps that employers and employability services can take to ensure that good work is provided for those with disabilities and long-term conditions, it is also important to note that providing good work will not guarantee economic and individual benefits in all cases. There are, for instance, some health conditions and disabilities that will mean employment is not a feasible option for some people, a reality which employability services must navigate carefully.

Clara is a PhD student at the University of Edinburgh researching work-disability and social security in Germany and the UK, find out more about her work here: https://bit.ly/35qsj1z. Hamish is a consultant based in our Edinburgh office. For more information about anything discussed in this blog, please get in touch on 0131 226 4949. 

Can trauma informed practice transform the criminal justice system?

Can trauma informed practice transform the criminal justice system?

In this blog, Dina Papamichael explores the relationship between experience of trauma and involvement in the criminal justice system; and outlines the emerging approaches from Scotland which have potential to transform justice outcomes across the UK. 

Links between childhood adversity, trauma and involvement in the criminal justice system are well evidenced. Those with four or more adverse childhood experiences (ACEs) are significantly more likely to be a victim of violence; perpetrator of violence; and be incarcerated during their lifetime. Experience of prolonged stress in childhood can disrupt healthy brain development and lead to risk-taking and offending in adulthood. Amongst those in prison in Scotland, just under half report personal experience of violence in their home as a child and 80% of those in prison in Wales report at least 1 ACE.

Links between adversity and offending can be broken

The association between childhood adversity and involvement in the criminal justice system informs two essential types of initiatives:

1. Recognising the impact of ACEs and trauma on individuals to prevent initial experience of the criminal justice system

2. Providing trauma informed interventions to those who already have experience of the criminal justice system to ensure risks of re-traumatisation are minimised.

In implementing these approaches, there is a need to ensure that those with ACEs are not stigmatised through implications that childhood adversity is inevitably associated with involvement with the criminal justice system.

There is a need to prevent initial involvement in the criminal justice system

Criminal justice processes such as being arrested, going to court and being imprisoned are often traumatising in themselves and should be avoided altogether wherever possible. Several innovative approaches which seek to understand the behaviours associated with adversity and reduce the likelihood of offending can be pursued:

Ensuring that at risk young people are not excluded from early crucial support: The Interventions for Vulnerable Youth (IVY) project is based at the Centre for Youth and Criminal Justice at Strathclyde University. It seeks to prevent offending amongst high risk youth by acknowledging and addressing traumatic experience, and providing risk assessment and treatment

• Extending support to the children of those with mental illness or problem alcohol or drug use: Having a parent with mental illness or problem alcohol

or drug use are types of childhood adversity. Health and care professionals can adopt holistic approaches which consider the whole family’s needs and extend support to children

Finding innovative ways to access those who may not be already linked in with support: Violence Reduction Unit Scotland’s Navigators reach out to those with traumatic injuries in accident and emergency departments to explore which support is needed to reduce the impact of violence on their lives.

Developing safe environments, promoting resilience and avoiding re-traumatisation are crucial for those with experience of the criminal justice system

When supporting those who have past or current involvement in the criminal justice system, services can be mindful of traumatic experience and take steps to build trust, reduce barriers to access and avoid re-traumatisation:

• Developing supportive, safe and trusting environments: Tomorrow’s Women Glasgow is a multi-agency centre which provides a wide variety of services to address the needs of women involved in the criminal justice system. The centre’s approach is trauma informed in that it prioritises safety, collaboration and trust for those accessing it. Services are offered in a low security environment which is important for supporting women to feel at ease and has not led to any increased risk for staff or other clients

• Equipping individuals with strategies to cope with the effects of trauma to support their resilience: Courses such as Survive and Thrive which explain the effects of complex trauma and provide coping strategies can be adapted for use in prison settings. This approach has been shown to lead to reductions in symptoms of anxiety and depression amongst clients

• Supporting staff to be mindful of trauma when interacting with clients: Staff working in criminal justice and related services can be provided with training on the behaviours associated with trauma, creating trauma informed environments and avoiding re-traumatisation.

Overall, the current climate of growing recognition around the impacts of adversity and trauma provides an opportune moment for innovation and collaboration in approaches to criminal justice. A growing body of evidence from trialled Scottish initiatives can be drawn on to inform trauma informed approaches across the UK.  

Dina is a Consultant in our London Office. For more information about our work in trauma informed practice and criminal justice, get in touch on 020 7253 6289

What makes a good outcomes framework?

What makes a good outcomes framework?

Cristiana Orlando and Clare Hammond reflect on what makes an outcomes framework work

A fundamental must do across public and third sector organisations is to be able to understand and evidence the change you are creating. Measuring outcomes is the bread and butter of organisations, and certainly the area of focus of a large portion of our work here at Rocket Science.

There is a huge range of complexities to bear in mind when measuring your outcomes for example:

  • Making sure you are measuring the right things – as you tend to do what you measure
  • Trying to articulate impact on soft and often intangible changes you are seeing in those you work with
  • Tracking long term impact so that you can report on impacts achieved after your work with an individual or community finishes.

However, the complexity we want to focus on in today’s blog is around how to coordinate impact measurement. For example, where Scotland-wide reporting is required, but activity and impact is occurring across 32 local organisations or partnerships. Scotland’s (and many other jurisdictions’) answer to this is to have a national outcomes’ framework. There are frameworks for community justice, mental health, alcohol and drug, social care etc – all seeking to build a comprehensive picture of impact at a national scale.

A framework has to let partners do their own thing but measure impact with consistency

The purpose of these frameworks is to enable a range of partners to do their own thing, but track progress, change and impact in a way that enables success to be aggregated, and in some situations compared.

An unused framework is a pointless framework

For a framework to be useful it has to be consistently applied and applicable for the vast majority of partners. More importantly a framework has to be used to be helpful.

We are all very good at creating amazing and theoretically perfect frameworks that are:

  • Impossible to lower onto delivery on the ground – if it doesn’t enable local partners to tell a story that makes sense to them it is difficult to use the framework in practice.
  • Not useful to those completing the data – if it isn’t useful to them then why divert already stretched staff time using it?

     

    In our experience of reviewing and developing outcomes framework across the social care, health, employability, community justice, and housing and homelessness we have learned that there are several good practice elements that make a framework work:

    • A good outcomes framework is concise, clear, and consistent in structure and content. Keep outcome titles short but with clear instructions on how to interpret and measure them. Keep the number of outcomes to the minimum needed. Be clear about the aim of the framework, how outcomes link together and be open about the strengths and challenges of the framework
    • Avoid obsolescence through being too vague. There is a tendency to keep outcomes very high level to ensure it is flexible and applicable for partners doing very different things. Being too vague runs the risk that the information becomes meaningless as it tries to be all things to all people
    • Create a framework that is easy to collect data Conducting feasibility testing beforehand, ensuring the framework is co-produced involving all partners, and providing guidance on the use of proxy data are three ways to mitigate the risk of including unfeasible outcomes or indicators.
    • When an outcomes framework is used across localities, it is important to balance national and local priorities. Create a clear link between national objectives and local needs by providing a breakdown of the framework’s aims at both levels. This helps partners have clarity around how they fit into the bigger picture and facilitates the collection of meaningful data locally.
    • Lastly, good frameworks are closely aligned to the way business is done already. The closer the alignment the easier it is to integrate into day to day activities and greater chance of staff buying into its value

    Outcomes frameworks are a powerful tool, but striking the balance between comprehensiveness, consistency and simplicity can be a tricky process.

     

    Clare Hammond is an Associate Director and Cristiana is a consultant in our Edinburgh Office. For more information on our outcomes frameworks and evaluation work please get in touch with the Edinburgh Office on 0131 226 4949 or [email protected]

    There is more to gain from employment than income

    There is more to gain from employment than income

    In the final of a three-part blog series on employability and mental health, Max Lohnert looks at what mental health services gain from integrating employability into their service provision

    Employment can have a positive impact on people’s mental health and wellbeing. A recent study has found that people’s wellbeing is higher if they have a job than not – even if controlled for their increased income. In the past two blogs, we have discussed mental health in the context of employability, now we explore employability in the context of mental health services.

    So, what can mental health services gain from integrating employability into their service provision? And what has been happening in this area?

    Many mental health services are now conceptualising their services using a recovery journey, similar to the concept that underpins many alcohol and drug services. Recognising the role that work can play in people’s recovery, Glasgow’s Health and Social Care Partnership funds a range of employability services for those with health and social care barriers to employment, including mental health. These services see employability as part of a recovery journey.

    During our evaluation of their employability services, we got to know Mental Health Employability Services across all stages of the employability pipeline. These started with pre-employability services providing clients who are not job-ready with the opportunity for “meaningful activity”.

    At the other end of the journey was the provision of Individual Placement and Support (IPS) schemes where people receive individualised support to gain competitive employment. IPS schemes challenge the assumption that competitive employment is too stressful for people with mental health problems. Instead, building on the insight that someone’s desire to work is a strong predictor of success in achieving and sustaining employment, they work with everyone that is motivated and committed to move into work. Access to IPS support is now available as part of the national Fair Start Scotland service.

     Bringing people into positive destinations, volunteering or employment, was also the goal of a recovery service of the Scottish Association for Mental Health which we evaluated recently.

    During our research, participants of the programme emphasised how important it was for their recovery, and for managing their mental health, to fill the void that their addiction has left behind. For many of these participants, working towards employment, no matter how far away employment was, played an important role in filling this void.

    While moving into employment can itself be stressful, there is more to gain from employment than income: a structure to their everyday life, meaningful activities as well as social connections and support. The extent to which this works of course depends on the quality of work that people move into.

    There is a considerable evidence of the negative effects of social isolation on people’s physical and mental health, for example, social isolation increasing the likelihood of depression. The importance for everyone to have meaningful connections is now high on the political agenda: in December last year Scotland published its first national strategy – “A Connected Scotland” – on tackling social isolation and loneliness and building stronger social connections. The Strategy outlines the importance of empowering communities, tackling stigma, and of supporting an infrastructure and providing opportunities for people to connect.

    Our work has shown that for people in recovery – for example previous drug users who had to leave their previous networks of active users – work or volunteering can be an opportunity to re-build their social networks. Employment can make a meaningful contribution to keeping people’s social isolation in check and can play a vital role in their recovery.

    While we have seen employability services integrating mental health support elements into their programmes and mental health services employability elements, there is still more scope for organisations to align their service offer, share resources, and provide coordinated care. We are excited to be working alongside our clients to help them ensure that both mental health and employability clients receive the right type of support at the right time.

     

     

    Max Lohnert is a Consultant in Rocket Science’s Edinburgh Office.

    This blog is part of a wider series of blogs on the intersection between employability and mental health.