Lived Experience and the Multi Agency Resolution Group (MaRG)

Author: Lee Dale, Recovery Community Coordinator, Expert Citizens

I’m writing this as someone with experience of being stuck in the cycle of re-occurring homelessness, addiction and poor mental health. I’d probably frustrated many professionals across multiple disciplines with my challenging behaviors and ability to just disappear from services and return to the streets and old acquaintances, only to reappear again and having to start with treatment and housing plans from scratch. I’m not proud of this one bit and it was never something I set out to do, wasting ten years of my life now gives me great pain to reflect on. I think providing this context is really important and will help you as the reader to develop an understanding of where my viewpoints and observations are coming from.

As part of my role as Recovery Community Coordinator with Expert Citizens and the Changing Futures Programme we will be promoting and encouraging the voice of those who are active ‘cases’ of the MaRG or Multi agency Resolution Group, to be heard and listened to in the meeting. We know this will be challenging and it would be easy for me to be just another spectator within this forum, but equally we know that this works to improve outcomes, and nobody said it was going to be easy.

During my experiences of being a person that utilized a service with a perceived ‘chaotic lifestyle’ I would be hyper aware that conversations would take place about my situation without me being present or represented, and later learning in my professional capacity that these took place in my ‘best interests’. I suppose on signing a contract to a service without reading the small print made this possible, but hindsight is a privilege that only now I am afforded. The Changing Futures Programme is an opportunity to ensure lived experience is at the heart of everything we do in Stoke-on-Trent in relation to some of the most difficult situations people find themselves in.

So how are we going to bring the voice and wishes of a ‘case’ into the MaRG group?

We feel by being explicit with people about what the MaRG is for, is the foundations of a good start, we have to be honest, transparency is our friend. In an ideal world the person who’s situation is being discussed would attend the MaRG themselves, however we understand that this is not always going to be possible, and so we have to offer people different methods of communicating their message and future desires to us. This could be a short video, audio recording or written word as a few examples. We recognize that for some this would be extremely difficult and maybe support to do this would be sought. Another avenue is a delegated representative, which could be the professional who introduced the case, if the person wishes, but we should also be exploring other options like peer mentors that are trained in motivational interviewing and active listening techniques for example, or even family members. There is an opportunity here for more strengths-based information to be relayed to the group to address the balance of risk heavy information sharing.

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Another very important ingredient of an effective MaRG group is positive inter-professional relationships, this isn’t us picking on anybody at all. This is recognizing that we are all on ‘the team’ of the person we are seeking resolutions for. Sometimes due to the high-pressured nature of caseloads and work commitments its easy to take the pedal off the accelerator and assume someone from another organization can pick up the actions. Networking here is important, developing an understanding of each other’s limitations and capabilities is key to forming positive working relationships, a Community of Practice could be a good way of achieving this and help us to prevent silo working when looking at solutions for ‘stuck’ cases. Lived expertise will be a crucial ingredient to forge and strengthen this.

Capturing the learning from every MaRG meeting will be vital to identifying themes and common barriers, that can then be explored within the Community of Practice.

More importantly we have to ensure that we communicate the outcomes of any meetings we have with the person being discussed and give them the opportunity to voice any concerns or grievances they have. We have to listen carefully and use this feedback positively to inform what we do in the future.

Sounds simple, yet I’m not naïve to the extent of the mission we are trying to achieve. I am confident, in fact I know, that everyone involved across the city is well intentioned, and yet we can be very overwhelmed at times and burn out is a recognised thing. I’m proud of the involvement of lived expertise that has supported workforce development over the years in my previous role at VOICES and I am confident that bringing that same lived expertise to the MaRG will help us to achieve the best outcomes possible for the people we are here to support.  

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