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Hard Edges: Mapping severe and multiple disadvantage

This study sought to provide a statistical profile of a key manifestation of ‘severe and multiple disadvantage’ (SMD) in England. In this report, SMD is a shorthand term used to signify the problems faced by adults involved in the homelessness, substance misuse and criminal justice systems in England, with poverty an almost universal, and mental ill-health a common, complicating factor. The study also included an initial qualitative scoping phase.

The main findings were as follows:

• each year, over a quarter of a million people in England have contact with at least two out of three of the homelessness, substance
misuse and/or criminal justice systems, and at least 58,000 people have contact with all three;

• SMD, as defined in this report, is distinguishable from other forms of social disadvantage because of the degree of stigma and dislocation from societal norms that these intersecting experiences represent;

• people affected by this form of SMD are predominantly white men, aged 25–44, with long-term histories of economic and social marginalisation and, in most cases, childhood trauma of various kinds;

• in addition to general background poverty, it seems to be in the realms of (very difficult) family relationships and (very poor) educational experience that we can find the most important early roots of SMD;

• the ‘average’ local authority might expect to have about 1,470 SMD cases over the course of a year (as defined by involvement in two out of the three relevant service systems);

• in practice the distribution of SMD cases varies widely across the country, and is heavily concentrated in Northern cities and some seaside towns and central London boroughs. However, all local authorities contain some people facing SMD;

• the quality of life reported by people facing SMD is much worse than that reported by many other low income and vulnerable people, especially with regard to their mental health and sense of social isolation;

• SMD creates a significant cost for the rest of society, particularly with respect to disproportionate use of certain public services;

• there are also significant social costs associated with SMD, not least the potentially negative impacts on the children with whom many people facing SMD live, have contact, or are estranged from;

• there are some encouraging short-term improvements reported by services working with people who face SMD, but progress is weaker amongst those with the most complex problems.