Identifying the Missing Hero: Service User Participation in Housing First

Social traps and identifying the Missing Hero

The idea of social trap is relevant for social science research on trust (Rothstein, 2005). Social trap refers to a situation where everyone would benefit from cooperation, but no one cooperates, because no one trusts that others will. Rothstein (2005, page 12) states that this results in the social trap recurring and creating: "... a situation that is worse for everyone, even though everyone knows that they would gain by choosing to cooperate.” To avoid and overcome social traps, there needs to be people who are willing to start cooperating. The problem is that this is rare. Platt (1973) calls this "the missing-hero" problem. He argues that there is often a lack of heroes who break the social traps. When they do appear, Platt (1973) says, it is very important that they get support and encouragement. In our efforts to improve social homelessness work in Sweden, the notion of the missing hero has become important to us because it reminds us of the importance of building trust and relationships with the people we encounter in our work, many of whom want to participate in change work (Knutagård, Heule & Kristiansen 2021).

Homelessness and Service User Involvement in Sweden

Homelessness is a rising problem in Sweden, like in many other countries, and it impacts more and more segments of society (Kristiansen 2021). Nowadays, homelessness is one of the most evident signs that economic and social inequalities are growing under the influence of neoliberalism. The rising homelessness does not only affect people with substance abuse or other types of social problems, but it also includes several other groups who are left out of the housing market because they are poor. Single parents and those born abroad are two groups where homelessness has grown in recent years.

Homelessness is a serious social problem because it leads to social exclusion for the people who experience it. Being homeless means facing a higher risk of having social problems, mental and physical health problems (Knutagård et al. 2020). Despite the existing knowledge that homelessness causes social exclusion, the social work with homeless people in Sweden does not follow a housing led approach (Knutagård, Heule & Kristiansen 2021), which means providing homeless people with their own homes as soon as possible. Instead, they are offered temporary housing in socially disadvantaged areas without the rights that regular tenants have on the housing market. The homeless people who struggle with substance abuse or mental illness are subject to the so-called housing ladder (or staircase model), which is based on the idea that homeless people need treatment and supervision to gradually earn their own housing. The housing ladder is therefore linked to drug-free conditions and other requirements that the homeless must meet to get support. However, the research shows that the housing ladder has poor outcomes. Those who are subject to the housing ladder tend to remain homeless (Knutagård et al. 2020).

Service user involvement is a democratic and rights-based issue, which rests on the idea that everyone in society should have equal rights to influence and be heard in their interactions with various social institutions. Service user involvement has origins in the social movements that arose in the 1960s and that demanded rights and impact for people with disabilities, substance abuse issues or who were psychiatric patients (Kristiansen 2023). The research also indicates that social work practices are more effective if the people who are the targets of social interventions are given power and control over these interventions (see e.g. Hasenfeld 1992). That is one reason why The National Board of Health and Welfare has for several years tried to encourage social services to develop service user involvement. Although many projects have been carried out to develop service user involvement in Sweden, there are few examples of municipal activities with working user involvement, but in many cases, it has rather been a case of tokenism (see e.g. Eriksson 2015; Knutagård & Kristiansen 2018).

Housing is a Human Right

Housing First is an approach to address homelessness for people who have been homeless for a long time and who have substance abuse issues and/or mental health problems. Housing First views having one's own home as a basic human right and a necessary condition for people to be able to participate in society. This also means that Housing First is based on a social justice perspective and a service user perspective. But Housing First is not only about providing people with their own home, but the service users also receive social support from social workers, who use a relationship-oriented approach based on meeting the tenants with "respect, warmth and compassion" (Tsemberis 2015, p. 18) and that they have "... a choice in the housing and services they receive and that services should be geared toward supporting their recovery." (Tsemberis 2015, p. 18). The support given within Housing First is not time-limited, but the residents are helped as long as they want it (Tsemberis 2010). The housing offered must be integrated and dispersed in regular residential areas. Moreover, the housing and the service and social support offered to the service users must be separate. This means that the housing must not be conditional on anything, such as requirements for social support or treatment (ibid.). The support regarding alcohol and drug use is aimed at harm reduction and there is no pressure on the residents to abstain from alcohol or other drugs. Recovery is an important principle for the social support, which means that there is a belief that change is possible, but that it may take time and that the residents must be allowed to make their own decisions (ibid.). Research findings from several countries show that Housing First is much more effective in reducing homelessness compared to the so-called staircase model. Various studies also show that Housing First is a cost-effective method (Pleace 2012).

Building Trust in Social work

To build trust and relationships with people who are economically and socially marginalized and to involve them in emancipatory change work, they need to encounter social workers who demonstrate that they stand up for them and for social justice. This demands a professional approach that is based on commitment and that fosters community, participation and mutual relations. This approach is closely related to Housing First and has several similarities with strength-based social work, which highlights the users' strengths and resources and where the social workers and the users jointly make these resources visible (Knutagård, Heule & Kristiansen 2021).

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