Bridge the Gap is Surrey’s first trauma-informed outreach service for residents facing multiple disadvantage. Lisa Byrne explains.
A specialist trauma-informed outreach service is showing that partnering with local charities is leading the way for individuals facing multiple disadvantage.
Bridge the Gap (BTG) was launched by Surrey County Council as part of the government’s Changing Futures programme in a bid to improve the lives of Surrey residents experiencing multiple disadvantage.
These people have almost always experienced some kind of early trauma which, over time, can lead to issues such as mental ill health, substance use, contact with the criminal justice system or homelessness.
These individuals are usually known to traditional services, having sought support many times before. However, they can end up falling back through the gaps due to their complexities and, through no fault of their own, fail to meet service criteria and expectations. That’s when people can become ‘re-traumatised’ by the very services set up to help them.
The Bridge the Gap consortium is made up of a group of 11 local charities that have partnered with Surrey County Council to provide a specialist offer of support. The charities form part of the Bridge the Gap VCSE Alliance, supporting people experiencing multiple disadvantage. BTG support is provided by a team of 24 specialist outreach workers – some bring lived experience to the workforce and are employed through an Alliance of Surrey’s voluntary, community and social enterprise (VCSE) organisations.
‘Through Bridge the Gap we’re providing support to the most traumatised and socially excluded people,’ says Joanne Tester, CEO of Guildford Action – one of the 11 charities, which has supported residents with multiple disadvantage for more than 30 years. ‘Forming relationships with these vulnerable people is a crucial part of Bridge the Gap, which considers the underlying trauma someone has experienced in the past. The programme focuses on a person’s strengths, rather than their issues and complexities. By taking a trauma-informed strength-based approach, the service sees beyond a client’s presentation and supports them towards their own personal goals.’
This way of working is a ‘game changer’ for Surrey, she adds. ‘I cannot imagine us going back to how things were before Bridge the Gap, and the powerful vision that now shapes our work.’
Clients don’t have to be abstinent from substances to receive support. Workers are trained to continually assess dynamic risks, offering a service that is risk aware, while providing a co-occurring conditions support pathway. This includes timely access to mainstream substance use and mental health treatment services, if and when the client desires or is ready for it. This aims to avoid, wherever possible, failure and re-traumatisation.
‘Our specialist outreach workers are skilled at offering harm reduction advice,’ says programme manager Lisa Byrne. ‘At the same time they motivate individuals to engage and benefit from wider social care support, healthcare, benefits, housing, and other services, while reconnecting with their communities. Workers keep small caseloads and shape relationships built on trust. They understand that complex multiple disadvantage takes time to address, and they support people to make positive life changes, while making sure they don’t fall through gaps between services.’
The system can be overwhelming and complex, leading people to become ‘service weary’, she continues. ‘The only targets we aim to meet are those the individuals set for themselves such as improved self-esteem, greater sense of physical and mental wellbeing and increased confidence and agency.’
BTG workers continue to support people over time to make positive life changes. Workers provide leadership and advocate for their clients, sometimes challenging operational and strategic obstacles that can present themselves when people are seeking support. When the client is ready the workers will help to engage with specialist services at the request and pace of their client.
Bridge the Gap outreach workers are clinically supervised by a consultant clinical psychologist, and the service follows an evidence-based approach that addresses the degree of childhood, prolonged and on-going trauma that people facing multiple disadvantage experience.
‘Perhaps the most important thing to remember is that a lot of early trauma is relational,’ says Byrne. ‘It can have occurred at the hands of people who can sometimes be in positions of power or were caregivers of some kind. Those affected by relational trauma often need to engage in effective relationships to access the care, support, and interventions they need. However, the impact of their trauma means they may be the least likely to seek or receive this help and support.’
BTG adheres to the trauma-informed principles of: safety, trust and transparency, empowerment, voice and choice, collaboration, intersectionality and respect for diversity and peer support. By doing this the service aims to provide a person-led service, as far as is possible, which is always genuinely person-centred.
This approach means the person’s own language and preferences are used, and there is no reliance on diagnostic labels or definitions to access support from Bridge the Gap.
‘My story, strengths and hopes’ is a Bridge the Gap psychological approach to capture and understand an individual’s story, strengths and goals. This formulation model is then utilised to inform their outreach support plan, including ways in which they and others can promote keeping them safe and well. It provides a means of capturing the key details of conversations with clients, ensuring their strengths and priorities are known and can be shared with other services. This is used as a passport and guide when engaging with other services to ensure the support provided aligns with their personal goals.
The VCSE consortium, in partnership with Changing Futures Lived Experience and Recovery in Action, has co-produced this human learning system approach that continues to evolve. Jamie Poole, lived experience project manager for the Changing Futures programme with Surrey County Council, said his own lived experience has helped to shape the person he is today. ‘Having accumulated more than 18 years of experience in recovery, and through my work in the fields of addiction, mental health, criminal justice, and housing, I have leveraged both my personal experiences and professional knowledge to assist others,’ he says. ‘The value lived and living experience brings to the conversation when designing and commissioning community services cannot be underestimated.’
To find out more about Surrey’s Bridge the Service contact Lisa Byrne, Changing Futures programme manager – lisa.byrne1@surreycc.gov.uk