We cannot afford to keep providing ‘bad help’, too much is at stake

The ‘bad help’ that dominates our services has huge social and financial costs. There is an alternative.



Ryan* had been on and off the streets for 12 years. He was dealing with addiction after being in prison. It wasn’t until he met Aisha from Mayday Trust that his life started to change.

“[Aisha] was the first person in a long time who stopped, listened and didn’t judge” explained Ryan.

In fact, how Aisha helped Ryan was key to the success of that help. Some help, what we call ‘good help’ supports people to feel hopeful, purposeful and confidently take action. Other help, what we call ‘bad help’ does the opposite, undermining people’s confidence, sense of purpose and independence. This matters because individual actions are essential for addressing everything from health conditions like heart disease and diabetes, to finding work, living independently or finding a job.

Today we face a paradox: many of the services designed to help people actually undermine their ability to take action

This can exacerbate acute and obvious issues, such as homelessness or addiction, but also have chronic and subtle effects which erode confidence and mental health, making everyday activities, such as parenting and healthy eating, much harder, and sometimes impossible.

In addition to the personal and social costs of ‘bad help’, there appear to be significant financial benefits of ‘good help’.

Liverpool Waves of Hope project, that works with people with complex needs, found a reduction in both A&E attendances and arrests in over 90 per cent of people they support. Groundswell, which specialises in improving the health of homeless people, reported a 68 per cent reduction in missed outpatient appointments, and a 42 per cent reduction in unplanned care activity, saving £2.43 for every £1 spent. Other organisations, such as AgeUK, Mayday Trust and Community Catalysts report similar savings.

Unfortunately, however, activities such as these remain on the margins and our mainstream services usually inhibit ‘good help’. This partly explains why so many professionals such as nurses, social workers and teachers are so frustrated. Many have been trained in ‘good help’, it’s been a pillar of health, social work and primary education for decades. Now though, with increasing workloads and highly restrictive, target-driven working environments, they can’t offer the ‘good help’ they know is needed.

You might think that under the current cash-strapped conditions, integrating ‘good help’ into mainstream services is impossible, but that’s not true. Across the board, there are professionals applying ‘good help’ despite the current system: GPs like Doug Hing, who use ‘good help’ in their 11 minute consultations to great effect; organisations like Grapevine and User Voice, who creatively navigate mainstream services to improve the lives of people with disabilities and ex-offenders respectively.

Yes, these examples are the exception, but they prove what can be done in spite of the prevailing conditions. Imagine what would be possible if our services were designed to encourage ‘good help’.

The simple truth is that we cannot afford to keep providing ‘bad help’. Too much is at stake. When ‘bad help’ affects millions of people, as we believe it does, the social and financial costs are huge. We must make ‘good help’ a central plank of mainstream services.


Rich Wilson