NADRA 2022: Q&A with keynote speaker Bagga Bjerge

Bagga Bjerge, your theme is Welfare state recalibration. In your presentation, you will talk about drug users who have complex problems, which create challenges for the welfare system. What are these complex problems?

A person who uses drugs can have additional problems besides and related to substance use. I have studied drug users, and thus potential clients of drug treatment programs, who at the same time are unemployed and suffer from mental health issues. This makes them clients of the job centers and the psychiatric hospitals as well.

The drug treatment programs, job centers, and psychiatric hospitals are very different types of organizations, operating at different levels in society. The research aimed to look at how professionals in each organization manage the people with complex problems, and if the organizations are compatible with each other when it comes to legislation and guidelines.

Unfortunately, we found that the organizations are not working together well enough. Instead, they tend to have barriers between them that are hard to cross.

Could you give an example of these barriers?

Psychiatric hospitals, for example, tend to view their clients as patients that need to be treated until they are well. Drug treatment programs might take a more humanistic and forgiving approach. The job centers focus mainly on turning their clients into productive citizens.

How does the insufficient cooperation between the organizations affect the individual seeking treatment?

People with complex problems usually find themselves in a Catch-22 situation, since rules within one organization might contradict policies in another.

Job centers, for instance, demand that their clients meet certain criteria to be eligible for benefits. This might lead to stress, which in the case of a drug user might lead to an increase in drug use, which in turn might lead to a failure of a drug treatment program.

A drug user seeking help for a mental health disorder at a psychiatric hospital might be referred to a drug treatment program instead, where the staff might not have the proper training for dealing with mental illness.

Sometimes people with complex problems do get help, but it is often not because of how the system works, but rather despite how it works. The quality of help is very dependent on the individual social worker, what contacts they have and how willing they are to be flexible. This makes the system vulnerable.

What is the solution?

More cooperation between different organizations is needed, and a certain willingness to bend the rules when necessary. If a social worker sticks too much to their own professional identity and blindly follows the protocol, the clients’ situation might not improve. In the worst case, it might cause more problems. Every social worker wants to help, but few look at the problem broadly enough.

I think it would be very useful for professionals in different fields to spend time together and learn from each other. This has been suggested many times before, but it rarely happens. Despite pressed work schedules, I think it would be worthwhile.

We need highly skilled social workers who can take a helicopter view of the client, and understand that there is no singular solution for all cases. When it comes to persons with complex problems, unorthodox solutions work best.

Text: Sebastian Dahlström