Blogmas Day 12: Build it Where They Are

“If you build it they will come” That’s what the creepy dream told Kevin Costner in a corn field in the aptly named Field of Dreams, and some years later that’s what the Naked Indian and Jim Morrison told Wayne in Wayne’s World 2. But we’re not in the business of building baseball fields or putting on concerts. Designing services for people experiencing homelessness, addiction, mental health and offending we need to do more than building a service and hoping people will come and utilise it.

Across health and social care services countless hours, staff time and resources are wasted on appointments where service users do not attend. Then more resources and time are spent on researching how to get people through the doors of the buildings their appointments are being held. “If you build it they will come” isn’t working, so maybe we should try a new approach: “build it where they are.”

There is an argument that attending an appointment at a specified location at a specified time shows motivation, a willingness to engage and make changes; but there’s always more to none attendance than just a lack of motivation:

Have they visited the building before? Are they nervous or anxious about it? Will there be people there that they would rather not see? Meeting our service users on the car park and walking them into the building might allay some of the fear that makes some people miss appointments.

How are they going to get there? A weekly income of £73 doesn’t leave much change once you’ve paid your bills, fed and clothed yourself; towards the end of the week raising a £4 bus fare can be an impossible task. If we took the appointment to the customer, opening the front door and inviting you in shows just as much motivation as showing up at your office and has the added benefit of making them feel more comfortable.

When people are living in supported accommodation, being seen right there in the hostel by the nurse, their substance misuse worker or probation officer has the added bonus of professionals being able to talk to one another face to face; ensuring their are no gaps in the customers support and everyone is on the same page.

There are times when vital appointments need to take place in a certain location, particularly medical appointments. People with multiple needs are expected to attend more appointments than most people over the course of a week; maybe if the services who could go to them, went to them, they would be left with more disposable income to get themselves to appointments that are immovable. Your car can be a great place to engage with people, and giving someone a lift can mean they access an essential hospital appointment they might otherwise miss.

Seeing people away from a specified building also offers opportunities to show service users what their community has to offer. Meeting someone to a local community cafe or library could show them what’s on their doorstep and give them the confidence to use this resource again without you; it could build their social networks, develop meaningful use of their time and benefit their recovery.

That’s why I believe that wherever we can outreach should be our go-to model when designing services for people with multiple needs. We are showing people we care enough to take the support to them. Where the appointment takes place is not important; what the customer takes away from it is.