The possibility of self exclusion
*Names have been changed to protect identity.
Simon had been picked up onto VOICES caseload via the outreach partnership work between VOICES and the Police in the town centre. He initially refused most help offered to him including support to claim benefits, access accommodation and access primary healthcare, simply stating that he was working on “healing” his back so that he could return to work. Through small interactions the SC (Service Coordinator) built up trust with Simon and Simon agreed to go to his GP with the SC to ask for help regarding his back pain. Simon’s long-term aim was to heal the back enough to be able to work again; he felt that he managed the pain well but wanted to strengthen and rehabilitate it. Simon received a prescription for pain killers and a referral to Physiotherapy from his GP, he seemed happy with this outcome.
The SC introduced Simon to a Citizen’s Advice Bureau benefits advisor and a service which works with immigrants to see if they could explore any support which may be useful. The outcome was that Simon may not be able to claim benefits but it wasn’t clear due to Simon’s lack of documents and with the information that Simon was giving. Without benefits usual routes to accommodation would be difficult. The only way forward seemed to be to try applying for benefits and go from there but Simon did not want to act on any of the advice and believed there would be no point.
The SC and Rough Sleeper’s Team continued to engage with Simon and Simon did make a claim for UC on his own and informed the SC of two following appointments to attend for this. Due to his initial reluctance to claim and things that he had said he had given the impression that he did not believe he would be able to claim due to being a migrant. It therefore came as a bit of a surprise that he had started a claim on his own. With this progress as well as the plans in place for his physical health it seemed that he was beginning to trust and listen to the information and advice offered.
After the first Job Centre appointment Simon decided he did not wish to continue pursuing the claim, this was despite the first appointment seeming to go well and it arising that Simon had in fact claimed benefits previously and therefore was likely eligible to claim again. He stated there was no point continuing and he had to concentrate on healing his back. The SC had supported him to the appointment and observed that Simon sometimes seemed to struggle to find the words he wanted to use and in turn may struggle to always understand what is said to him. This potential language barrier had been apparent before but it seemed an opportune time to ask about bringing in an interpreter to help ensure all communication was happening effectively. Simon refused stating he did not need one and needed to speak and understand English. The SC tried a few more times to persuade him to attend the next Job Centre appointment but this was refused.
Simon then refused to pursue the Physiotherapy appointment when a letter was sent regarding this, stating there was no point going. From the SC’s perspective it seemed that the chances of supporting Simon were again fading away and the reasons were difficult to fully understand.
From seeing Simon interact at the job centre and at the GP appointment there were signs that sometimes professionals were quite abrupt and Simon would respond in a similar way or sometimes vice versa. The language/culture barrier could explain Simon’s reluctance to engage with services, especially ones which could be considered high in bureaucracy or have little time to spend listening to an individual.
Other potential reasons for Simon’s self exclusion could stem from pride: Simon came to the UK to work but unfortunately suffered 2 separate injuries to his back and it very much seems that he doesn’t want to rely on others. Equally there could be hidden mental health issues being disguised by the culture/language barrier. Finally Simon shows great reluctance to be around other people, he was assaulted by a group of men last year (adding to the back problems) and this may contribute to his refusal to access night shelters, hostels and drop ins offering support and breakfast.
Simon is continuing to sleep rough and refuse support, the barrier to services seems to be himself and perhaps his perception of services and the people who access them. Possible ways forward would involve patience and perseverance, without pressure to allow Simon to come to solutions which he is happy to pursue. The SC and Rough Sleeper’s Team continue to see Simon weekly to make sure he is ok and ask about support they can offer him going forward. There may be further options that could be explored with Citizen’s Advice Bureau and the SC intends to support Simon to a drop in as and when Simon is ready. The SC has identified that there may be a learning opportunity regarding working with migrants and understanding their rights and ways to support them which may differ from usual support routes.