As a social worker, I was trained to look for underlying causes behind behaviors that could ultimately harm my clients. If Thomas was missing school day after day, I would swing into action: Was he depressed? Abusing drugs? Did he have unmet special education needs? Were his parents not providing adequate supervision and enforcing rules?
Thankfully, some truancy programs have embraced a basic needs-informed approach. That is to say: They are asking if the problem is really a lack of resources. Does Thomas have a winter jacket? Is he embarrassed about his hygiene because his family cannot afford cleaning products and toiletries? I know of one program that buys kids alarm clocks because many of the parents are out of the house at 5 a.m. for early shift jobs and there’s no one home to wake the children for school. In other words, these programs support the family rather than find fault with it.
It seems so obvious. I developed a curriculum to help health care providers, educators and social workers ask questions about the role that resources play in the health and success of their clients. Even people who have worked with families in poverty for decades find it a revelation that they should ask about poverty itself. That’s the system we’ve created. It is far easier to get an adolescent into counseling than to secure his family a monthly supply of detergent and laundromat money so that all the kids have clean clothes to wear to school.
There are many reasons for that – which I’ll go into in a bit. But there are even more reasons to change. Basic needs-informed care supports a strength-based approach to youth. Yes, Thomas’ lack of laundry detergent is not a strength. But Thomas really wants to go to school and cares about his hygiene. The trap of resource deprivation is that it hides such strengths. Thomas missed three counseling sessions. It is easy to assume that he is unmotivated or engaging in some negative activity. Maybe Thomas takes care of his younger siblings on days that his father can find work, because the family cannot afford childcare. So Thomas is responsible, caring and contributing to his family support.
We will never know these things about Thomas unless we ask. So why don’t we?
Because we assume our clients will tell us what they need.
Often those of us in the helping professions make that assumption. But this ignores the tremendous power imbalance between us. Perhaps Thomas is embarrassed about the laundry situation. (He probably got teased about his clothing before he stopped going to school.) Why would he want to talk to you of all people about it? Besides, he may not see you as the appropriate person to ask for help in this area. And that is the crux of the problem. Often there is no appropriate person to ask for help with basic needs.
Because we are embarrassed to talk about money.
Money is a taboo subject. Think about it. We’ve all witnessed – or maybe participated in – conversations where one casual acquaintance asks another how many children she plans on having and when. But even dear friends do not disclose their annual incomes to each other, and we’d think it extremely rude to ask. Though your relationship with your client/patient/student is different, you’ve both been raised in the same society. Questions about money are considered private.
Because we assume they do have resources.
Let me start with a confession: I work in diaper banking. These are non-profits that operate much like food banks, only instead of groceries they distribute free diapers to families in need. This all started for me when I was working with a chronically homeless woman. I saw her dump the solids out of a soiled diaper and put it back on her baby. I talked with her about how important it was for the child’s health and hygiene to always use a clean diaper. I was doing exactly what I was trained to do – educating the client. She told me that she could not afford diapers. I reminded her that she had access to WIC and Food Stamps. She said neither could be used to obtain diapers. I assumed she was wrong, and investigated it myself. After a lot of phone calls and paperwork, I found that she was right. My client, as often happens, was educating me.
Neither public assistance to families in poverty nor wages from low-income jobs have kept pace with inflation. As we all know, Temporary Assistance for Needy Families is not enough to cover the median rental on a two-bedroom apartment in most communities.
There is no safety net. So the people we serve are making choices between shampoo or bus fare, paying the electric bill or buying a child new jeans after a growth spurt. Our clients have multiple resource needs that affect them in myriad ways.
Because we don’t believe we can help.
This is a major difficulty – and there are no easy fixes. But if you were interested in easy fixes, you’d probably be in a different profession anyway.
As I said, it’s easier to get a young person into counseling than to get him access to a washing machine. Most organizations are not set up to deliver basic needs. That will never change until people in direct contact educate their funders, policymakers and the general public about the importance of basic needs.
We see this happening on a small scale. Many non-profits do things like hold sock and underwear drives. And believe me, small scale is not a criticism. Small scale can make a big difference in the short run by helping clients, and in the long run by educating people about the need.
The publicity for that sock drive lets the public know that people are sleeping out on the streets on cold rainy nights without a change of clothes, and that this puts them at risk of infections that are damaging to them and require expensive emergency treatment.
We have a role to play in the policy arena. We can go to upper management and say: Half the people I serve are missing important programs because they don’t have transportation. Can we budget for bus passes?
A number of my colleagues have succeeded in getting public funding for diapers, and in getting states to abolish sales tax for diapers and feminine hygiene products. That’s a model that could be adopted by people serving older youth as well.
Every movement begins with information. Talk with your clients/patients/students. Really talk with them. Find out how the want of some small thing – a backpack, shampoo, an alarm clock – is causing big problems. That is step one of working toward a solution, a step that only people in direct service to low-income families can take.
Joanne Samuel Goldblum is executive director of the National Diaper Bank Network and developer of a basic needs-informed curriculum approved by the National Association of Social Workers. Goldblum was chosen as a 2007 Robert Wood Johnson Community Health Leader for her work.