‘DITTO’ – Telling our story once: Why does this matter?
Author: Alicia Simmons, Project officer, VOICES
I’m going to offer you an example of an experience I had whilst working as a VOICES service co-ordinator. This particular example is by no means one of the most distressing – I have plenty of those too. This will simply highlight basic frustration for our customers in having to answer the same questions over and over again.
I had been working with Sally for a few months already, she had difficulty engaging with services and was often distrusting of professionals. She has experienced many assessments and answered many difficult and personal questions. Sally’s multi-agency team had worked extremely hard to support her back into services. Her workers often had regular conversations (phone and email) and would work together in order to ensure Sally had at least been seen during the week. Therefore, scheduling an appointment and ensuring Sally was able to be found and attend, was a precise back and forth of contact with workers. I knew Sally disliked the regular questioning involved with assessments, she often couldn’t understand the relevance of some personal questions in relation to the service she was requesting support from. Prior to the face-to-face assessment, I had emailed the service and provided much of the information I knew would be required, in order to limit the distress experienced and to keep the length of time Sally would have to remain there to a minimum. Put simply, Sally doesn’t want to be anywhere she feels judged and sadly, she hasn’t always had positive experiences with services.
Sally had engaged and disengaged with this service numerous times, this was by no means the first assessment they had completed with her.
We arrived for the assessment and had to wait twenty minutes. This isn’t unusual and I had pre-warned Sally this may be the case, so she had some form of preparation. A full assessment was completed, Sally engaged and answered the questions. We returned to the waiting room.
We were called through again. Another professional arrived (in training) with a colleague and completed the assessment again with Sally. I appreciate everyone needs to gain experience, but attending at the first time the questions were asked probably would’ve been better here. Back to the waiting room. Called through again to see another professional – the same questions are asked. There is the addition of other questions, but the core assessment seems to be on every piece of paperwork. Back to the waiting room. Sally’s really getting fed up now and I can understand why – can you yet?
We were called through a fourth time, the same questions are asked again. At this point Sally’s really getting annoyed and is on the edge of losing her temper. We’ve been here a while now, well over an hour and a half and Sally’s truly fed up. Back to the waiting room. Sally is on the edge of leaving, she doesn’t want to wait anymore and she doesn’t want to answer any more questions. I manage to encourage her to remain, as we were at the last stage of the appointment and when completed Sally would be provided with the support that she needs.
Finally we are called through again – the same questions are reviewed once more. This time, I answered these questions. I’d heard them five times now, I knew how to answer all of them. Sally would not have remained to answer these again, she didn’t want to be there anymore. I believe if I hadn’t take control of the situation and gained consent from Sally for me to answer the questions on her behalf, she would have left without completing the assessment, and the whole process would’ve been null and void. To re-engage, we would have to go through the entire assessment process again, from the beginning.
As a professional I was exhausted with the repeat questioning, so it’s no wonder Sally did not want to answer personal and sensitive questions over and over again, for the same service.
If we think about all the other assessments Sally has completed as well as the fact she had already been accepted into the service in question previously, it’s understandable she did not want to continue with the process. Quite simply, repeated questioning of sensitive (and sometimes irrelevant) topics is not in line with Trauma Informed Care nor does it promote a strengths-based approach. I think we all may have been in a situation where we do not want to answer the same questions over and over, never mind if they trigger emotional or traumatic memories.
As part of the VOICES legacy plan we have been working on various projects, one of which is ‘Telling our Story Once’. The purpose of this project is to think creatively to develop an idea that would prevent a service user (any service user) having to continuously repeat themselves. To do this VOICES contacted, and are working alongside, Jellymould – a user-centred design agency who develop digital applications. A ‘mockup’ of a smartphone app (DITTO) is currently in development having completed consultations with various stakeholders: CEO’s, managers, support workers, volunteers and those with lived experience, in order to gain a holistic and well-rounded view of what the app should look like and what would be required for the app to be fit for purpose. Once the mockup is ready we will, once again, consult with stakeholders to gain their feedback to ensure the application is in line with the purpose of the project.
The final point I want to make, is that as services we should support those with multiple and complex needs to engage with us and not make this process any more difficult than it needs to be. If something like DITTO has the potential to reduce this issue, whilst improving engagement and confidence for those who require assessment to access the services they are entitled to, without the re-triggering of trauma, this can only be a positive thing, for both service users and services alike.
As development of DITTO continues we will provide regular updates as to its progress via the VOICES website and social media channels, stay tuned…
(Note: Sally is a made up name to protect the identity of our customer)