Do Outreach Approaches Improve The Care For The Socially Excluded Social Work Essay

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What does Social Exclusion mean? A person who is isolated from the general population. Someone who lacks the skills to expand their social network because of a lack of belief in themselves and/or the system. There are certain groups of people who find using the care services and expanding their social networks difficult and knowing what services there are out there for them to use. These main groups are the elderly (mainly those who have been hospitalized), those in an ethnic minority, especially when this person does not speak English, people who are new to an area with no family near by, people with learning or physical disabilities, and those with mental health issues. There are care services out there that help these vulnerable or disadvantaged people who would otherwise lack the means of developing their own social supportive networks.

A sense of belonging: In the Pre 1960's communities were tightly knit, people had a 'close web of family members living in the same neighbourhood' (B3 U10 p.66). Most had a large social network of family, friends and neighbours with whom they could rely on. These communities provided a 'sense of belonging' (Stacey, 1969, quoted in U10 p.67), a 'shared sense of identity' (B3 U10 p.67). However, with the coming of the War families, communities began to be split up because of the bombings. Thus people would be sent to new estates, into new communities where they possibly didn't know anyone, and with this there once large social network changed. These days a lot of families are spread throughout the UK if not the world. Children grow up and leave their family homes and may move across the country. I will now look in more depth how Social Exclusion is overcome through the work of Outreach and Advocacy and the limitations of these services.

Advocacy: 'Taking action to help people say what they want, secure their rights, represent their interests and obtain services they need...Promotes social inclusion, equality and social Justice.' (resources p.64)

The groups of people that benefit most from advocacy are:

Older people with communication difficulties

Adults with learning difficulties

Young people looked after by the local authority.

People with mental health issues including those detained in a psychiatric hospital.

To help the Elderly overcome boundaries Age Concern have set up 5 HACSR (hospital after care social rehabilitation) projects as stated in Resources page 44, that focus on the requirements of the service users after an injury or trauma or loss of any kind. To provide the best possible service, interviews were sort and feedback provided by the users themselves. The profile (p.44 resources) was set around these headers Age, Gender, Ethnicity, Sexual Orientation, Socio-economic position, Household Composition, Health Impairment. The study showed that ( all of the following figures have been taken from Resources 8 p.44) the majority of users where in their 70s and 80s, in this study only 2 out of the 17 were men, and only 1 was from a minority background. The Sexual orientation of the service users never came up and neither in the feedback did anything about their socio-economic situation, however some users did mention in interviews that this is an issue. Nearly all of the users lived alone, with only 5 out of the 61 interviewed living with a spouse and 4 out of these 5 situations the spouse was the main carer. The users in this case all had multiple problems combined with various forms of impairment. 'Social care workers needed to work as advocates in negotiations' (Resources p.45) These may include helping obtain the correct financial benefits, speaking to the users bank, or helping to adjust the users home ie phone adaptations. Helping obtain the correct specialized health care that the user may need after a spell in hospital. They are also there to help users acquire new or 'forgotten' skills to reintegrate into social activities helping the user step by step overcome these anxieties and thus giving them back their personal sense of identity that may have been lost. Without such schemes the likely hood of elderly people who have come out of hospital after suffering a trauma would become housebound because of lack of motor skills and confidence is high. With these schemes in place such people are able to carry on with daily activities, gain the self worth and become more confident.

Simon (B3 U10 3 p.87) is an unemployed male in his 20's. No one knows how he gets his food or pays for his bills. Although he has been seen rummaging through the trash cans at the back of the stores. Simon's dad died a year ago and he now lives alone in the flat. There is a probability that he has a mental health problem and he will not speak to anyone. There is also the possibility that he is an alcoholic. He dislikes authority figures. Simon has been literally excluded from parts of his estate including the pub and community centre, both of which are very social places. Simon suffers mental and physical abuse from other residents. The neighbourhood groups and activities set up do not meet his needs. George who used to speak with Simon's father may be able to slowly build a relationship with Simon. But will Simon trust George? Even though he would see him in the flat speaking to his father, I am unsure that Simon would completely trust George because of the hurt and suffering that the community has caused him. If it was George who first built a relationship with Simon it would probably take time for the trust to develop. If Simon is diagnosed with a mental health issue depending on where it is he lives he would be 'legally entitled to advocacy' (B3 U10 p.94). Would the community also accept him? They have rejected him for such along time. Surely this would be a massive boundary to over come. Here the advocacy worker could help Simon by going with him to the doctors to treat any wounds, deal with any physical issues he may have and to also diagnose his mental health. This could be the first step back into the community as I am sure word would get around that he is receiving help. The process to Simon becoming socially included has started.

'People with a high number of social contacts are 'likely to live longer than people who are poorly integrated into social networks.' (Putman (2000) quoted in U10 1.3 p.75).

Outreach: 'Actively seek out people who might need their services.' (B3 U10 p.91)

An outreach workers role is to put out a hand to those who are disadvantaged in any way. To show them the services that are available to them. To show that there is someone out there to help them.

I am going to start here with 'Mina' from Block 3 Unit 10 as 'based in' Thornhill. Mina is a pregnant mother of two very young children, who has recently moved to a new area with no local family. Mina does not speak English very well and is of an ethnic minority. Although Thornhill has many activities, groups etc these will not help Mina as 'poor physical (and perhaps mental) health makes it hard for her to actively seek out and join groups' (B3 U10 2.1 p79) In this case her local family support is the lifeline she would need. The majority of the time access to Thornhill family Support id through referral by health visitor. Family Support offer 'practical help and assistance to families, children and young people in the area' (p.58 resources). Unlike Sure start who cater for families with children under 5, the Thornhill family support caters for families with children under 17. As in all care cases these care workers are there to provide a service and 'not to be a friend' (p.58 resources). However as a user of this service stand point, when someone comes in to your life at your blackest time and shows you the way forward, helping you through every step of the way. Until you become strong enough to do things on your own. It is hard after what can be sometime to not somewhat emotionally associate them as a friend. A family member of mine whom is an outreach worker too says that it is hard to detach yourself sometimes because you can know them for such a long time and go through so much with them.

Another group that Block 3 looks into are the Sussex Gypsy travellers. Here the FFT (friends, family and travellers) Set up the ' Sussex Traveller Womens Health Project'. This project was set up with these figures in mind â€" Traveller men live 10 years less than their peers, with women living 12 years left than their peers. The rate of Stillbirth is 17 times higher than the National average and Infant mortality is 12 times higher. This statistics are from Power, 2004 p.36 (block 3 Unit 10 p.91). The project set out 'to get to know residents and identify community leaders and advocates' (B3 U10 p.92) Through trial and error it was discovered that although some of the women were willing to become volunteers they were not able to leave the site to train. Hence the project bought the training to them. This outreach approach inevitably worked because during the informal sessions these statements were met:

' - the worker came from the same background

activities were organised with culture in mind, such as flower making. Together they made a recipe book which included artist illustrations for step by step instructions.

The women bought up health issues that were important to them and the community

The training took place on site. ' (p93 B3 U10)


There are however limitations for both these services. Both services rely on funding, Outreach relies on short time and insecure funding. With Advocacy once funding has finished the project relies mainly on the volunteers recruited to carry on the good work. In both cases sources of new funding have to be identified long before the initial funding ceases. Chris Lee says about Thornhill advocacy it is 'quite a difficult thing to find people ready to make the commitment required for advocacy work' finding 'people who have got the right values and who believe very much in what they are doing' (B3 U10 Dvd). In both cases I see this as a major limitation because the people who are socially excluded are those who maybe the hardest to convince that they require help or will not accept it.

In conclusion I feel that the work of Outreach and Advocacy workers is most important. It is in my opinion from the work I have covered in Block 3, the barriers and cultural stigmas that prevent more people coming forward for help. From what I have read the outreach workers and neighbourhood projects have a mammoth task! What is obvious is that a lot more funding is needed to keep these projects running longer and without the danger of closing down after starting up. However, having said that I believe that there will still be people who fall through the system because for example if in Simon's case George didn't care who would it be that helped Simon? Even with a project on the estate Simon was going unnoticed. It may take projects being set up in every village or town and for everyone to become aware of social exclusion for every person to be identified.

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