Transformación de la práctica

However, the case managers were also faced with the challenge of understanding various funding sources, responsibilities and work patterns of each service. Therefore, case managers identified that in order to establish collaborative partnerships, there was a need to work towards a common goal.

Traditionally, organisations involved with providing services for the homeless have different goals to those of the HSP as a service provider’s objectives may be focused towards managing a particular issue whereas the HSP’s objectives focus was on prevention and ongoing management. The result was that there were many opinions regarding the type of goals for the client. Two case managers highlighted the necessity to focus on the welfare of the client when working collaboratively with other service providers: One case manager suggested that it was:

... extremely difficult to actually draw people in... Difference of opinion, I think... trying to make the issue that the main point of all of this is the welfare of the person... we need to all collectively work together for the common good of this person rather than everybody going, well, they’re not doing this, or I’m going to do this. (CM3) In order to keep relationships active and moving forward case managers needed to remain positive. This attribute was especially important when

138 clients failed to attain their goals. Case managers also needed to have other attributes such as being able to be encouraging and accepting when hoarding issues continued, appointments were missed, activities of daily living were neglected and social activities were shunned. Further positive attributes required by case managers included the ability to acknowledge disappointments, knowing when to be patient and when it was time to start over again. In addition, attributes such as the ability to take one day at a time, to be optimistic and to be resilient were also required

While the rhetoric was that service providers tried to work towards a common goal for the client, case managers found that government departments lacked the necessary communication channels or flexible work patterns to meet the challenges of providing services for this client group.

... Department of Health doesn’t talk to Housing NSW really; even though there’s a joint guarantee of service... they are all in segments, and no other segment talks to the other segment. (CM2)

It’s very difficult to get people to see outside of their own little square that they work in to see... the greater good, the other opportunity that we could have if we all just put the person in the middle, of their best welfare, and let’s see if we can all just be a little bit flexible about what we need to do. (CM3)

When compared with other service providers, especially government organisations, case managers found that the HSP offered the required flexibility to accommodate conflicting priorities. This flexibility provided

139 case managers with time to work out common goals for the client and to be persistent to ensure goals were met. Two case managers explain:

... it [the workers in the HSP] has the flexibility to continually persist with people and have the time to persist with people in a way that other types of models don’t. (CM3)

The joy of this service, and this project it is quite flexible and you can really work out where the client is at as opposed to what is your agenda… Not all services have that luxury, when you’re working with services it can be frustrating. (CM2)

The state of being without any form of a home is in itself one of the most traumatic events in an individual’s life. The effects especially the physical and psychological consequences cannot be underestimated. The transition from being homeless to being fully housed has enabled clients to begin to rebuild a life that is valuable and meaningful for them. To understand and appreciate how an individual’s identity is affected by these experiences - is to listen to stories of what it was like to live a dichotomous life between homelessness and regaining a sense of home. In order to explain the difference between these two worlds, clients in this study used a variety of storytelling and figures of speech which incorporated memories, vignettes, similes and metaphors to shape and present visual images for the listener. The client’s story begins with the reasons why some of them became homeless. For one client having a disability and being taken advantage of by a loved one was the trigger:

140 A lot of my partners took advantage of me because they knew I had a disability. (C7)

For another client it was a series of losses that were the instigating factor. For example, loss of success related to work, loss of health, loss of his wife and finally loss of material processions:

It was very devastating because I was out of control. All my life I was successful... I had various posts of responsibility… that was the five years when I had a breakdown and diagnosed with bipolar and that was the beginning of all this and, of course, my wife divorced me... She got everything, even the family car and, of course, I was displaced. (C2)

Another client suggests it could be just as simple as losing control over particular events:

People don’t understand how difficult it is when you had control of your life and suddenly it goes out of control and it goes out of control because other people can’t be told. (C3)

Knowing where they have evolved from and their particular history provided clients with a sense of discovery. In this instance, a striking image is created to explain and clarify what it was like to lose control and as a way of expressing the unpredictable nature of control. One client uses water as a concept to illustrate the unpleasant feelings associated with being homeless. Here water in the form of rain produces negative feelings of being cold, shivering or being uncertain. Whereas when water can be

141 controlled feelings become positive such as being dry and being able to have some control over actions and events.

I’m so pleased that I’m not – ‘where am I going to sleep tonight? Is it going to rain?’ Particularly when it rains - the only time I like water when it’s in a glass and I can control where it goes, down me and not on me. Not when I’m homeless and shivering. (C7)

The client’s story now changes from the past to the present. The concept of sickness and health becomes the comparison to imply a new beginning. Sickness was the past and health is the future. Health is about hearing messages about change, it is about being ready to change and it is having support while you undergo change.

I was sick of being sick. I was primed; I was so ready to be helped. I wanted it and I grabbed it. I was so grateful there was someone to help me. (C3)