The aim of this integrative review is to investigate research of social work practices for adolescents and young adults with complex needs. The research questions are: What are the major themes in studies of practices for young people with complex needs? How do studies suggest that complex needs can be met in ways that are beneficial for young people? A young person with complex needs is in this review defined as an adolescent or young adult who, due to mental ill-health in combination with different types of social vulnerabilities, is receiving assistance from multiple welfare services. Searches were conducted in seven databases. These searches resulted in a sample of 1677 records, published 2007-2016, which in the screening process were reduced to 24 publications, all peer-reviewed articles. The participants in the studies in the articles consisted of young people, parents and professionals from mainly Anglo-Saxon countries. The articles were analyzed with qualitative summative content analysis. Three empirically generated themes were found in studies of work practices targeting young people with complex needs: collaboration-, relationship-and empowerment-oriented practices. In conclusion, the practices contain a wide variety of features, but with the joint aim of acknowledging young people's needs. The results can be used by practitioners and policymakers to further the development of services for youth with mental ill-health and social vulnerabilities, who use multiple welfare services.
This paper concerns preconditions for the well-being of young people with mental ill-health combined with social vulnerabilities, also referred to as youth with complex needs. Research questions are: What barriers to sustainable work practices for young people labelled as having complex needs do professionals encounter? What do professionals identify as possible ways to overcome these barriers? Sustainable work practices are reflected in three themes: empowerment, relationships and collaboration. The findings are based on semi-structured interviews with 24 professionals, 3 men and 21 women, working in psychiatric care and the social services in two Swedish municipalities in 2016 and 2017. Major barriers are lack of continuity and co-ordination in staff and support, and fragmentation of work practices. As a consequence of the increased specialization of human service organizations, young people have to interact with many different professionals which could cause disparate interventions. Possible ways mentioned to overcome these barriers are supported through good interactional skills, using keyworkers as well therapeutic alliances, wrap-around services and case management. Complexity is linked to organizations and work practices rather than to young people. An often dysfunctional service delivery system in organizations with rigid boundaries may also affect professionals' aim for sustainable support. RÉSUMÉCet article concerne les conditions préalables au bien-être des jeunes souffrant de maladies mentales associées à des vulnérabilités sociales, également appelées jeunes ayant des besoins complexes. Les questions de recherche sont les suivantes: Quels sont les obstacles aux pratiques de travail durable pour les jeunes considérés comme ayant des besoins complexes? Qu'est-ce que les professionnels identifient comme moyens possibles de surmonter ces obstacles? Les pratiques de travail durable se reflètent dans trois thèmes: l'autonomisation, les relations et la collaboration. Les résultats sont basés sur des entretiens semistructuré avec vingt-quatre professionnels, trois hommes et vingt ARTICLE HISTORY
The paper uses the concept of recognition to investigate how young people labelled as having 'complex needs' experience their encounters with welfare state actors. Semi-structured interviews were held in 2018 with 14 young people, aged 15-22 years, in two Swedish municipalities. The participants have received multiple, long-term interventions from social services and psychiatric care. Research questions are: What aspects in the encounters between welfare state actors and young people may contribute to complexity in their life situations? How can Honneth's concept of recognition illuminate this complexity? Aspects that have contributed to complexity in young people's life situations are related to acts of dismissal. These dismissals by welfare state actors are interpreted as forms of disrespect as regards affection, rights or solidarity. Barriers to recognition are also related to the participants' young age and position as children, and what this implies in a particular society. Our findings show that the difficulties young people face in their encounters with welfare state actors are partly due to the high level of specialization which contributes to an increased organizational complexity. Implications include that, when encountering young people in complex life situations, welfare state actors need to consider the importance of recognition as regards affection, rights, and solidarity. Recognition is central to achieving a positive outcome in working with young people in complex life situations and is expressed in social interactions. Therefore, building relationships needs to be more highly prioritized in welfare state organizations.
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