The evolution of problem definitions and solutions for multiproblem families on the interface of care and security

Even though a lot of public money and well-intended effort is invested to help multi-problem families (MPFs), success seems to be limited. The help that is offered to these families by a diverse set of organisations and professionals is fragmented. This is one of the obstacles for effectiveness (JoosseBil et al., 2019). Collaborative networks of the involved professionals and organisations are promoted as solutions for overcoming the obstacle of fragmentation (Levi-Faur, 2012). However, research has shown that collaboration between actors around wicked problems, such as the MPF-issue, does not happen naturally. This is due to the existence of different perspectives on what the problem actually is and how it should be solved (Klijn & Koppenjan, 2016). This study analyses the development of problem solution definitions (PSDs) for MPFs within a Dutch collaborative integrated approach called Zorg- & Veiligheidshuis (ZVH). ZVH are initiatives where professionals from care and security organisations collaborate to address complex issues, such as MPFs. This study answers the following research question: How do problem definitions and possible solutions for MPFs evolve in the working processes of the ZVH (aimed to increase collaboration and integrated approaches)? A qualitative research method is adopted to conduct a multiple case study of several ZVH. We assume that PSDs evolve through interpretations by professionals. The interpretive process in which meaning is attributed to ‘the problem’ and ‘the solution’ of MPFs is studied by conducting semi-structured interviews with sixteen process managers of several ZVH-locations. The focus is on process managers because of their connecting role between the professional actors of the ZVH–network. One additional MPF-case study is conducted by interviewing three family members, one district agent and the involved process manager in order to test the results of the aforementioned multiple case study. From the interviews with the process-managers it can be concluded that the professionals of the ZVH-network develop their PSDs from individual points of reference. As a result, multiple diverging and sometimes conflicting PSDs evolve around one family in which each PSD emphasises a different element of the issue. This study argues (in line with Joosse-Bil et al., 2019) that such a separate approach does not suit the emergent and wicked nature of an MPF. Furthermore, the diverging and conflicting relationship between PSDs challenges the formulation of an integrated approach to MPFs. This study also gives insight in how, according to the process-manager, the individual professionals’ PSDs unfold into more integrated approaches. The family case analysis gives insight into which conditions do or do not contribute to the formulation of a collaborative integrated approach that suits the complex nature of an MPF. This single case study supported earlier insights that effectiveness is clearly related to the variable ‘do family member feel that they are taken seriously’. The study reveals that the following factors contribute to a better fit between the PSDs of the professionals involved, the family members on which the involvement is targeted, and the complex nature of the issues at stake: 1. Tap into the self-organising capacity of the family members, 2. Acknowledge the emergence of the system elements, 3. Stimulate symbiotic co-evolution, 4. Use boundary spanning activities. This study argues that when these four principles, in line with the complex system theory, are taken into account, the MPF-issue will be defined and addressed in a less fragmented way. This opens up the opportunity to more effectively deal with MPF-issues. In this way, this study aims to contribute to the realisation of long-term solutions for MPFs. Further research has to focus on the question whether or not a really applied integrated approach is the answer to more effectiveness. This is a hypothesis still open for testing