Persistence and flexibility are key when supporting people facing multiple disadvantage, says Melanie Pellicci.
People experiencing substance use, homelessness, poor mental health and contact with the criminal justice system are too often passed between services that treat each issue in isolation. They are told they’re ‘too complex’ for one service, but not meeting the threshold for another. Support arrives late, and often when crisis has already escalated.
After more than a decade of working alongside people facing multiple disadvantage in Essex, Phoenix Futures and Essex County Council have learned that recovery rarely happens through rigid referral pathways, short-term interventions or appointment-led systems. It happens through trust, persistence and services designed around real lives.
Futures Together was commissioned in 2016 following national research into severe and multiple disadvantage, building on years of frontline experience supporting people whose lives do not fit neatly within traditional service boundaries. The service works with people affected by substance use, homelessness, mental ill health, offending and deep social exclusion, often all at once.
Systemic exclusion
Over the years, one lesson has remained consistent – people facing multiple disadvantage are often excluded by the very systems designed to help them. Fixed appointments, strict engagement expectations and time-limited interventions frequently fail people living with trauma, unstable housing, poor health and financial insecurity. Missed appointments, relapse and disengagement are often viewed as non-compliance, but in reality they’re often signs that someone is struggling to survive. That’s why Futures Together was intentionally built differently.
Support is not withdrawn because someone relapses, misses appointments or struggles to engage. Through assertive outreach and community-based support, staff meet people where they are, physically and emotionally, removing barriers that prevent people from accessing help.
Persistent presence
This approach requires persistence. If someone disengages, staff continue reaching out. If someone relapses, support continues. If someone faces a setback, they’re not pushed back to the start of the process. As James, who had been trying to access mental health care for many years before finding support through our service, shared: ‘I was in a mess… I’d worked all my life and had my own house, and it was a shock to lose so much so quickly. I got to the point where I didn’t care anymore. But they never gave up. If they couldn’t get me, they kept trying, and if that didn’t work, they came to the door.’
Low caseloads allow staff to provide intensive support that addresses both immediate needs and long-term stability, from housing, benefits and healthcare access to recovery planning and wellbeing support. Just as importantly, staff often act as advocates, helping people navigate systems that can feel confusing, inflexible or punitive. As Susan explained after finding the service after trying for many years to navigate the complexities of the healthcare system: ‘Mental health isn’t something that just goes away. But I feel better knowing I’ve got someone in my corner. Someone who listens and pushes to get answers.’
Building bridges
This learning has also shaped wider partnerships. A recent pilot between Essex County Council, Phoenix Futures, Tesco and Open Road offers early intervention for people affected by substance use who come into contact with store security due to shoplifting. Rather than defaulting straight to criminal justice responses, people are offered access to specialist support that addresses the underlying causes of offending behaviour. It’s a practical example of what can happen when organisations respond to vulnerability with intervention instead of punishment.
The same principles are also embedded within Phoenix Futures’ enhanced support and access team (ESAT), which works with people from Gypsy, Roma and Traveller communities who often face significant health inequalities and barriers to mainstream services.
Traditional models that rely heavily on assessments, referrals and formal appointments can reinforce exclusion, particularly where trust has been damaged by previous discrimination or poor experiences of services. ESAT instead delivers outreach in environments where people feel comfortable, building relationships over time and offering practical support with everything from identification and housing to healthcare access.
As one person from the Gypsy, Roma and Traveller community who had been struggling with their drinking prior to accessing our support explained: ‘I’ve been really happy with the support. I wouldn’t have known how to do any of this without her help. She’s helped me get my birth certificate, benefits, ID, my first bank account and is supporting me with housing. She’s convinced me to see a GP – I hate needles – and is taking me to alcohol support classes. She’s even going to teach me how to cook, and I’m going to teach her to cook coddle.’
The evidence is clear – relational, flexible and persistent support works for people facing multiple disadvantage. The bigger challenge is whether systems are willing to adapt. As public services face growing pressure, there’s a danger of becoming more risk-averse, more fragmented and more focused on quick outcomes. But people facing the most complex challenges rarely fit into neat systems or short funding cycles. If we want better outcomes, services must be designed around people’s realities and not organisational convenience.
For the people who have spent years being turned away, that shift could make all the difference.