Syndicated Columnists

Western welfare systems are broken. Here’s one fix

Ella is a British woman who grew up in a broken home and was abused by her stepdad. Her eldest son got thrown out of school and ended up sitting around the house drinking. By the time her daughter was 16, she was pregnant and had an eating disorder. Ella, though in her mid-30s, had never held a real job. Life was a series of endless crises: temper tantrums, broken washing machines, her son banging his head against the walls.

Every time the family came into contact with the authorities, another caseworker was brought in to provide a sliver of help. An astonishing 73 professionals spread across 20 different agencies and departments got involved with this family. Nobody had ever sat down with them to devise a comprehensive way forward.

In her mind-shifting book, “Radical Help,” British social entrepreneur Hilary Cottam tracks how one of the social workers in Ella’s case spent his days. Roughly 74% of his time was spent on administrative matters — recording data, making referrals to other agencies and meeting with other agencies. Only 14% of the social worker’s time was actually spent with the family he was meant to be serving. And that face-to-face time was mostly with a clipboard, checking off boxes on the forms that went back to central administration.

The administrative system around Ella and her family costs roughly 250,000 pounds ($317,000) per year.

Cottam asked the government workers involved in Ella’s case if they could recall a time when they’d transformed a family so it no longer needed government help. They couldn’t think of one.

I met Cottam in London last month and she made the point that welfare systems are often designed to manage needs, but they are not designed to build capabilities so that families can stand on their own.

Moreover, most Western systems were not designed to confront the kind of poverty prevalent today. When these systems were put in place in the 1950s and ’60s, unemployment was more often a temporary thing that happened between the time you got laid off from a big employer and the time you got hired by a new one. Now, economic insecurity is often a permanent state, as people patch together different jobs to make ends meet. Health issues for people in the welfare system are often chronic: obesity, diabetes, many forms of mental illness.

Our legacy welfare structures are ill suited to today’s poverty.

Cottam has spent the past decade or so helping local authorities across Britain build new welfare programs. Her solutions start by shifting power to the former recipients of services. The programs ask, “What sort of trajectory would you like to be on?” Then the programs build social networks around the families to help them achieve their goals.

For example, Ella was asked if she would like to lead a “Life Team” unit that would help her family turn around. She agreed. She was given the power to select the eight people from across agencies who would comprise the team. She chose people from social work, the housing authority and the police force.

Members of the team spent 80% of their time with the family and only 20% on administration. Ella and the team worked together to stabilize her most immediate issue: negotiating away eviction notices. Then the team worked to improve interfamily dynamics so there wasn’t so much violence and screaming.

After a family is stable, the team and family work on building skills and telling stories of success. By 18 months, many of the families involved in the Life Team program no longer need the team. Ella got her first office job and assumed more responsibility for her family. Her kids were back in mainstream schooling.

In the old welfare model, social workers are detached and overwhelmed, bound by bureaucratic rules and often slipping into emotional permafrost. At Life Team, it’s about relational accompaniment, giving social workers the discretion to do what they think is best.

Cottam has designed other programs with a similar collaborative ethos. Backr is a program that takes people who are detached from the labor force and helps them join extended social networks where they can connect one another to job openings and develop skills. Circles is a program for the elderly. It brings together lonely seniors into small groups that are part social club, part concierge service and part self-help cooperative. Wellogram is a similar social structure for the chronically ill.

Basically, Cottam’s programs create villages within the welfare state. Her systems are not designed around individual clients, but around relational networks. People tend to have better outcomes when they are held accountable by a network of peers. Three-quarters of the smokers in Wellogram successfully quit; 44% lowered their blood pressure and 64% started work or went back to school.

The old legacy welfare programs were designed for people enmeshed in thick communities but who had suffered a temporary setback. Today many people lack precisely that web of relationships. The welfare state of the future has to build the social structures that people need to thrive. This is one way government can build community.

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