Personalised Public Services for People in Vulnerable Situations in Lithuania

5. The perspective of service users and those who work with them in public service provision in Lithuania

Abstract

To ensure personalised services meet the needs of those who require them, it is important to take a person-centred approach to service design and delivery. This chapter complements the service mapping exercise described in Chapter 4 and provides a perspective of service users and those who work with them on what has or is working well as well as the challenges. Focus group discussions in three different locations in Lithuania revealed that people with disabilities, people leaving prison and young people leaving care all face significant challenges, some unique, many the same, in receiving the supports and services they need to live the lives they want to live. While many improvements have been made in recent years, there is more that can be done. Future improvements were suggested during the discussions, many of which align with the recommendations outlined in the other chapters of this report.

5.1. Introduction

This chapter describes how service users and those who work with them – non-governmental organisations (NGOs), social workers, and municipality representatives – experience public service provision in Lithuania. The information collected during workshop discussions with people with disabilities, people leaving prison and young people leaving care in three locations complements the service mapping exercise described in Chapter 4, which outlines the different types of public services available for these groups. After describing the challenges, successful experiences and elements of the current system that are working well, the chapter concludes with insights about how to improve the delivery and quality of services based on the views of those who participated in the focus groups.

5.1.1. Research methodology

A half-day focus group was held for each of the three groups on a separate date and in a different location: the focus group for people with disabilities was held in Marijampolė on 24 May, for ex-prisoners in the Kaunas region on 25 May, and for young care leavers in Švenčionys on 26 May.

Focus group participants included service users and relevant service providers, i.e. non-governmental organisations (NGOs), social workers, and municipality representatives who work with the three groups of service users. Participants were invited based on their relevant experience and knowledge; their views were not intended to be representative of the stakeholder group of which they are a part. Participant numbers for each focus group are set out in Table 5.1.

Table 5.1. Participants across focus group discussions

Stakeholder group	Marijampolė – People with disabilities	Kaunas region – Ex-prisoners	Švenčionys – Young care leavers
Service users	6 (5 from Marijampolė, 1 from Švenčionys)	6 (All from Kaunas region)	4 (All from Švenčionys)
NGOs	6 (All from Marijampolė)	7 (6 from Kaunas region, 1 from Marijampolė)	2 (1 from Švenčionys, 1 from Kaunas region)
Social workers	5 (All from Marijampolė)	6 (All from Kaunas region)	6 (All from Švenčionys)
Municipality representatives	8 (2 from Kaunas region, 2 from Švenčionys, 4 from Marijampolė)	4 (2 from Kaunas region, 1 from Marijampolė, 1 from Švenčionys)	8 (2 from Kaunas region, 6 from Švenčionys)

The focus groups were held in person and the discussions were moderated by a professional moderator in accordance with an OECD discussion guide (attached as Annex 5.A.). The structure of the three focus groups was the same. At separate tables, each stakeholder group first discussed challenges relating to the provision of services for the relevant group before identifying successful experiences and elements of the current system they believe work well. Suggestions for improvements were made throughout the discussions. This part of the session lasted two hours. Following the individual table discussions, participants gathered for a joint debrief (one hour) where they presented the conclusions of their table and commented on the views of other groups.

The discussions took place in Lithuanian and the transcripts were translated for this report.

5.2. People with disabilities

5.2.1. Challenges experienced with service delivery

This section discusses the challenges experienced by people with disabilities accessing appropriate services starting with general observations made by all four stakeholder groups before moving to specific challenges raised by each group. Supporting quotes from participants are included to help illustrate key points.

Mobility and adaptation of the environment for people with movement-related disabilities was widely discussed by all participants (which may reflect the specific backgrounds of the people in the room and their experiences of disability). There was general agreement that the situation is gradually improving with solutions benefiting not only people with disabilities but also parents with small children and older people with mobility issues. However, mobility remains problematic with participants pointing to existing challenges both in terms of the environment and service provision. For example, a service may exist but be very difficult to access or be implemented without paying attention to the real needs of service users (such as very steep slopes or curbs in parking lots for the disabled). Access to workplace and/or training institutions was also raised.

Participants observed there are many services provided by different institutions. For some disability groups there are so many services available that service users can choose a preferred provider. However, the information made available about services is not always adequate. Existing information channels are not always the most appropriate, the conditions to be met for accessing some services are not always clear, and there are a lot of formalities and paperwork required to access services. For example, in some cases part of the service cost may be covered nationally, another part covered by the municipality and the rest by the user. The distribution is not always clear and varies across services. In addition, issues are exacerbated because information cannot be shared across different institutions due to data protection regulations.

Lack of co‑operation across institutions was also highlighted as a key problem by all four stakeholder groups. There was a sense of duplication of services and functions and not enough sharing of information. All participants believe there is a real need to consolidate existing services, and tailor them to the service user, rather than designing them based on the views of the institutions providing the funding. Service consolidation and tailoring could simplify outreach, reduce duplication, and make service provision more transparent and effective to plan (i.e. it would become apparent which services do not work and which are needed more). Furthermore, it would make clearer to service users what services are available to them.

Appropriately qualified staff with the ability to identify what services someone needs (e.g. personal assistance, or psychological support) was identified as being crucial for providing better targeted support and for improving service provision. There was a view that services that simply assist rather than empower service users are still dominant, while support should be oriented to helping service users better integrate into society. Psychological services and other supports that help service users become as independent as possible should be promoted, however, people’s attitudes and behaviours toward people with disabilities continue to make fuller integration difficult.

Service users

Overall, service users viewed the provision of services positively, believing they should be content with the services they have access to rather than focusing on what they do not have. The main challenges service users identified related to socialisation, improving their quality of life, and being mobile, that is, those things that help them participate more fully in society and overcome exclusion rather than those things that focus them on their disability. It is important to note that most of the service users who participated in the focus group discussion had a mobility disability, one person had a physical disability, and one person had an oncological illness.

Accessibility

One of the most frequently mentioned issues during the discussion was the lack of disabled-friendly infrastructure, in cities but particularly in rural areas. Although participants said the situation is improving, they noted that in some cases the solutions are superficial.

Challenges regarding car parking were common. People with disabilities who drive themselves would like to see more parking spaces made available, particularly at public institutions, as well as improvements made to the car parking environment, for example, so that they can access a parking space when in a wheelchair. Service users also noted that parking spaces reserved for people with mobility issues are often occupied by other people.

Even if access to the municipality exists, reserved spaces in the car park are not always present. In addition, available spaces are not always suitable, as you do not only have to park your car, but you also need to be able to leave the car park with your wheelchair – people do not think about the need to adapt the environment as well. (Service user, Marijampolė)

Service users believe that while public and government institutions are making efforts to adapt the environment for people with limited mobility, they would like to see these efforts extended to private institutions and public areas; they want to be able to participate fully in society, visit cafes and bars and move around more safely in pedestrian areas.

We want to go to a concert or a bar in the evening, but the ride service used to be only available until 6 PM. They have now extended it until 8 PM, which is very convenient, although I would like it to be available later. (Service user, Marijampolė)

Even if you can sit on the terrace of a bar during summer because the door is too narrow to get in, you cannot go to the lavatory. Of course, you cannot force them to adapt but I wish they would think about us too. (Service user, Marijampolė)

There is a serious lack of signage for people with visual impairment. Even with a wheelchair, you cannot go anywhere. (Service user, Marijampolė)

It was very good to be able to study remotely, I hardly missed anything. I was able to participate like everyone else and I did not have to go anywhere or ask for a lift. It is a pity that when classroom teaching resumed, there was no opportunity to continue virtual participation, even if only partially. I could have been more involved. (Service user, Marijampolė)

The difficulty of accessing workplaces and/or training institutions was raised and said to inhibit the desire to seek any kind of work or training. Difficult access to health services was also mentioned; registration with doctors is particularly complicated (with in-person registration no longer available, it is very difficult to get through on the phone to health facilities to make an appointment with the right specialist). While it was acknowledged this is a general problem, it is particularly important for people with disabilities, as they visit doctors more often. Furthermore, participants highlighted that healthcare facilities tend to be poorly adapted for people with reduced mobility, for example, doctors needing to consult patients in rooms not necessarily intended for that purpose. In hospitals particularly, this situation introduces additional accessibility difficulties.

Service users also said they lack access to cultural and other social events that would help them to get out of the home, where they could socialise with other people and not be alone and isolated. Suggestions for improving opportunities for socialisation included possible educational trips around Lithuania, concerts, and events.

Lack of other opportunities

All service user participants viewed their needs as being perceived in a very physiological way. However, their disability can also prevent them from being financially independent and deprive them of other opportunities not directly related to their specific disability, which requires a more holistic approach to the supports and services they need.

Some service users pointed out that those who have not been disabled from birth often face a drastic change in their quality of life when their circumstances change. The time needed for dealing with, in some cases illness or accident and treatment, the incapacity to work (fully or partially) and related changes in income levels require some people to have to restructure their lives in a significant way.

Before the illness, we were just like everyone else – working and able to take care of ourselves, but then things change a lot, and you need to readjust. It is not easy, there is a lot of tension. We want to relax, to take a break from the diagnosis, but we are only entitled to treatment and rehabilitation services. And I want to have a massage or sit in the salt room, although I do not have enough money. (Service user, Švenčionys)

Some cultural services should be free for us, to compensate for the lost income and to avoid feeling left behind. (Service user, Marijampolė)

Poor institutional co‑operation and lack of adequate information

Poor co‑operation between institutions was not raised by service users at first and was only discussed when raised by the moderator (it was a much more important problem for NGOs and municipal representatives, see following sections). Service users observed that information about services is often disorganised. Different institutions sometimes do not know what services they offer to a particular service user and/or what services a service user may be missing out on. Different institutions often offer overlapping services, and service users are not aware of what services they are entitled to.

They offered me rehabilitation, which I accepted, but then another institution offers it again. I told the institution that I had been there before, but they cannot see it in their system. I am offered twice the same service, while there are other services that I would like to receive but they are not offered because there is not enough money. (Service user, Marijampolė)

NGO representatives

NGO representatives identified that the main problem in service provision for people with disabilities is the lack of co‑operation between institutions, which leads to difficulties in accessing and understanding information and obtaining or providing services. Secondly, NGO representatives viewed bureaucracy as a barrier to providing more services and reaching more service users. NGOs believe they are used to being flexible and adapting to changing situations. They would like to see other institutions be as flexible and take a less formal approach to service delivery, incorporate more creativity, avoid bureaucracy and provide a wider variety of services.

NGOs view stigma as a systemic problem that requires the long-term and consistent involvement of everyone, including service providers, service users and other organisations to address. NGO representatives were the only group to observe that service providers, as well as service users can experience stigma, making it difficult to attract service users to their services.

Poor institutional co‑operation and lack of adequate information

Lack of co‑operation across institutions was highlighted as a key problem by all service provider groups but particularly by NGOs. There is a sense that services and functions are duplicated, and that there is a lack of information provided about changes to service provision and legislation, for example. Everybody “reinvents their own wheel”.

Sometimes you cannot catch up – you hear about one problem from one institution, and about solutions from another. Moreover, our client does not find or understand that information at all. You end up drowning in that pile of information. You cannot even ask them to look it up themselves because you know they will not find it. If they do find it, not all professionals understand that bureaucratic language. (NGO, Marijampolė)

Lack of co‑operation between institutions also leads to poor information about services being available to service users. Since different institutions offer different services, service users do not know exactly which institution is providing which services on the one hand, and service providers do not know what services a person is already receiving or what services they need on the other hand. As a result, a service user could receive services they do not need, including situations where staff from different institutions offer the same services, or no services at all.

NGO representatives observed that it is difficult for them and their clients to understand what documentation is needed, for which authorities, or how requests must be addressed. Emphasis was placed on the misunderstanding between the Health and Social systems (e.g. what kind of illness code a doctor must use for a service user to be able to receive another service and/or what kind of prescription the doctor must issue to their patient to get to the right person and to receive the service needed). The fact that procedures constantly change and need to be re‑explained was also raised as a problem.

This situation is thought to lead to an inefficient use of resources, with staff spending a lot of time on paperwork rather than with the people they are meant to serve. NGO representatives believe that when service users (or their representatives) try to find their way around the system, they often get frustrated, lost, and end up not using a service at all.

Excessive bureaucracy

The information that is provided about services, its format and language, was described as bureaucratic and complicated by all NGO representatives. The legal language of some documents can be particularly difficult for older people or people with mental disabilities.

It seems like a paragraph has been taken out of the legal document and inserted directly. And make of it what you will – what you can do and who can or cannot use the service. We do not have a legal background, and not everybody can consult a lawyer. If you interpret freely, then it is your responsibility. We have enough responsibilities as it is. (NGO, Marijampolė)

NGO participants also identified excessive documentation as a problem, which they believe is created by too much bureaucracy and poor institutional co‑operation. Service users must fill in many different forms and collect various certificates from different institutions to be able to access public services. Most of these certificates exist in digital form, but unfortunately, it is often necessary to collect them physically.

There is a lot of travelling around the city from institution to institution to collect when everything could be in one system, or the information could be accessed by a responsible person who could collect it all from the archives. People get lost, they do not always get it right, and they do not always understand what they need. It is a shame to have such complicated processes nowadays when everything is computerised. (NGO, Marijampolė)

An excessive amount of documentation is also required to receive funding. NGOs feel they are constantly having to take part in competitions and write proposals to obtain funding, which can take a very long time to do, and services are often needed immediately.

We spend a lot of time filling in the paperwork, and then you receive the funding after 1.5 years. That would give us more time for the people and would allow us to have more time to use money in a targeted way. The state knows what we do, and sees our reports, it could be simpler. (NGO, Marijampolė)

It is not only the project application process that is complex, but also during the execution of projects, no matter how large or small, the documentation and bureaucracy is very complex, time consuming and demanding.

Stigma

Stigma was also raised as an important issue. While other groups talked about stigma as a problem faced by service users, NGO representatives also talked about stigmatisation in relation to their services, for example, there is a perception that care services are a “beggar’s bowl”. NGO representatives said it can be difficult to attract service users (e.g. potential service users choose not to take up a service because they do not want it to be noticed by their neighbours) or they find it difficult to promote their services (e.g. negative comments on Facebook about why they are posting pictures of people with disabilities etc.). The issue of stigma also came up in relation to the inclusion of people with disabilities in education or employment, with NGO representatives stating that negative attitudes from those around them make engagement in education or employment more difficult.

Other access barriers

In addition to the key issues outlined above, NGO representatives discussed a range of mobility problems faced by people with disabilities. A barrier to greater inclusion of children and young people with disabilities in schooling is a shortage of both specialists and additional help (special educators and teacher aids for example). In addition, there is a lack of clear methodological tools and common procedures for the integration of people with disabilities into the general education system. NGOs raised the issue of employment of people with severe mobility or other disabilities. For people who are physically unable to leave their homes there is a lack of so-called “mobile occupation” services, where service providers can deliver occupational activities in a service user’s home.

Social workers

Many social workers who participated in the focus group discussion work with people they described as having complex disabilities, that is people with a mental disability as well another disability such as mobility issues.

Lack of appropriate training

Social workers believe they often lack the professional skills and necessary knowledge to offer the best support to the people they work with. They identified the need for continuous professional development as a key factor in the effective delivery of services, as it directly affects the quality of the services they provide. Social workers feel they are often required to act as specialists because there are simply not enough specialists who are willing to work for low salaries.

Social workers view the content of the training available to them to be of a very poor standard, moreover it focuses too much on more formal events. There is a particular lack of training for social worker assistants.

Qualification improvement is necessary, but the training is very poor, repetitive, and more focused on formal certification when you get your diploma. It takes a lot of psychological knowledge, you cannot always send someone to a psychologist, sometimes you just must resolve situations – and not all of us know how to do that. We also need to improve. It is difficult to get quality training. Without it, we cannot provide a good service. (Social worker, Marijampolė)

Also highlighted was that training that is currently available is often generic or based on international examples or experiences, which is difficult to put into practice in the Lithuanian context. It is very important to get training for social workers that is implementable or dedicated to target audiences (e.g. specifically adapted methodologies or practices for people with intellectual disabilities).

Poor quality of services

The second major problem, according to social workers, is the lack of quality services (services for people with mental disabilities or complex disabilities were highlighted). Social workers believe there is a wide variety of services available, perhaps too many, with many different organisations providing services. Social workers feel a duty to advise the service users they work with, but do not always feel they can do this well because the system is confusing and there are so many services.

We see that not everything is used because a person does not know that they are entitled to it, and the social worker does not offer it because they have no idea the person does not know. The system is very confusing system – we are barely getting by. (Social worker, Marijampolė)

Multiple services can also lead to competition between service providers with the service user becoming an instrument in that competition. There is also a high degree of formalisation and control over the provision of services (e.g. monitoring how many clients attend, how many hours of sessions are held, etc.). As a result, service providers often focus less on the effectiveness of the service and more on its formal implementation.

Current public procurement processes and standards also impact negatively on the quality of services. Social workers believe service provision tenders are often won by unqualified suppliers, and services are being implemented for the sake of the award, rather than for the recipient’s benefit. Procurement procedures are not sufficiently regulated, and services are monitored from a bureaucratic process viewpoint, without assessing whether they are benefiting the service user.

Our clients cannot always stand up for themselves, so they receive services very formally. They will not complain. If parents or children stand up for themselves, then they have more finances. It is a shame when people do not get what they are entitled to and are thus disadvantaged. (Social worker, Marijampolė)

Social workers were more critical of the quality of services than other stakeholder groups. They observed that service users are less likely to be critical and officials are too distant from the reality of the situation. Social workers believe establishing common quality standards could help to improve quality.

There are all sorts of occupational therapies that are not in high demand – like beading for men. I do not want to sound sexist, but not many users want them. On the other hand, there are lack of interesting and necessary ones, dominating these created for the formality’s sake. (Social worker, Marijampolė)

Social workers offer a lot of services, but users do not come. And then they wonder why – some have no idea, but some are not interested. Disabled people are not a “waste bin” to be offered things that others do not need. It is a question of attitude – you must try to create a good service. Maybe it does not have to be aimed just at a disabled person, maybe it just has to be tailored to them, as well as other people from the city. (Social worker, Marijampolė)

Social workers like NGO representatives believe the services provided by different service providers often overlap with service users receiving services that are not always appropriate or necessary. A smaller number of service providers would be better, with specific services targeted and tailored to meet the needs of specific groups. In addition, too many providers and services can confuse clients, who feel obliged to be involved in everything, or who simply do not understand where to get what services from.

Stigma

The negative perception of service users was identified as the third problem to be addressed. As social workers often mediate or accompany people with disabilities to different institutions, they notice that stigma occurs across a wide range of institutions, ranging from medical facilities to banks. They observe that stigma is particularly prevalent when it comes to recruitment. The most common problem is the lack of job opportunities for people with disabilities, due in large part to employers often being afraid to employ people with disabilities because they do not know what to expect, what to ask for, and how to communicate with them (e.g. if they have a hearing impairment). To solve this problem, social workers consider it necessary to disseminate good practice information about the recruitment of people with disabilities and invest more effort in adapting environments where necessary, so people with disabilities are more integrated and visible in the labour market.

Municipality representatives

One of the greatest challenges identified by municipal representatives is documentation, i.e. the excessive number of documents, an unclear system for managing documents, and the application of different systems in different institutions. Related to this, municipal representatives observed there were missed opportunities for greater co‑operation between service providers to deliver services more efficiently. Sharing expertise and bureaucratic burden could reduce the duplication of administrative functions undertaken by different institutions.

The second major problem identified was persistent negative perceptions towards people with disabilities. Stigma and discrimination were linked to many other problems that arise in working with disabled people (e.g. the impact on service users’ own motivation, lack of qualified staff and the difficult integration of people with disabilities into the education system, labour market or social life in general).

The third problem that was raised is the lack of motivated and qualified staff to adequately assess service user needs, find the right combination of services, and motivate service users to be more active and autonomous where possible.

Poor institutional co‑operation and lack of adequate information

As with other stakeholder groups, municipal representatives raised poor co‑operation between institutions and a lack of adequate information as barriers to effective service delivery. Municipal representatives also provided the example of certificates having to be physically collected by service users from different institutions on the grounds of privacy. To speed up processes and not burden service users with unnecessary paperwork, municipal representatives believe service users should be able to provide their consent for a single bureaucrat to collect the certificates.

The system is still relatively complex, and I am not stating that everything must be done for them, I am simply in favour of autonomy. But a lot of formalities exist, a lot of inter-institutional complexities, which can certainly be done almost automatically by logging into the systems and just informing the person that these certificates will be collected, or these forms will be filled in. But this would require further integration of the systems of the different institutions, improving the user interface so that the person can see what they have already received and what they can still receive. (Municipal representative, Kaunas region)

Poor or burdensome processes are particularly difficult for people who have recently developed a disability and their family members (e.g. parents who are “overwhelmed” with instructions and paperwork to fill in when they have not yet recovered from the “shock” of their children’s disability.

The issue is that often, the paperwork and certificate need to be filled in at the start of the disability when the person is still in deep shock. They are vulnerable, do not remember what they are being told, and sometimes do not understand that they now need a book of certificates to be collected. It sounds like a punishment. They often do nothing. It would certainly be possible to help them here and make the process clearer, simpler, and more transparent. (Municipal representative, Marijampolė)

Municipal representatives echoed the views of both NGOs and social workers in that it is difficult for them to see the full range of services available making it difficult to offer targeted services to clients. Service users often receive services that are not specifically tailored to their needs (e.g. a parent caring for a disabled child needs a person to be with the child for a short period of time, but municipalities only have people with other specialisations). Another problem is that in the absence of common information about the services available, service users may be offered services that are not relevant or necessary to them, i.e. an over-supply of services.

Stigma

Negative public attitudes towards people with disabilities was highlighted as the second most important problem by municipality representatives. Stigma still exists towards people with disabilities, in particular people with mental disabilities which impacts on their employment and integration into education or community life. For example, signatures to stop the building of group homes where people with disabilities could live independently were collected following an announcement they would be built in a particular neighbourhood). This raised the question of how much publicity should be given to such projects. Municipality representatives suggested that publicity might increase stigma, presenting people with disabilities as being different to other members of the community. Another municipality representative said they had no problem with public reactions to setting up group homes in their communities, after refraining from publicity campaigns.

Stigma was also associated with difficulties in integrating children with disabilities into general education. Resistance to the integration of disabled children in general education comes not so much from other children, but from their parents, who often react negatively to the presence of children with disabilities in the same classroom as their own child. It was also observed that special educators can discriminate against children with disabilities, especially children with mental disabilities.

Workshop participants observed that people with disabilities experience stigma differently. While the stigma faced by people with mobility or visual impairments has reduced and is less emphasised in society, the stigmatisation of people with mental disabilities (both adults and children) is a pressing problem, which poses challenges for the implementation of programmes to integrate them into society.

Shortage of qualified professionals

Municipal representatives echoed the concern of social workers that there are not enough qualified professionals to work with people with disabilities. There is both a shortage of staff and insufficient funding for ongoing training. Particular attention was paid to the lack of special educators who are prepared to work with different groups of disabled people.

Motivation is all sorts of things, but when you cannot invest in qualifications, you have what you have. (Municipal representative, Marijampolė)

It is important that appropriate qualification already in educational establishments exists, so they understand the career they are choosing. Because they come out of education, work for a few months, and say, “this is not for me”. We need to make them understand more about what the job is when they are in training. More internships maybe? (Municipal representative, Kaunas region)

Lack of services for families

Municipal representatives raised the issue of families with children with disabilities. Support for families is not well developed and there is a lack of services such as counselling for families with disabled family members. Parents for example often need time and support to adjust and accept that their child is going to have different needs compared to other children and that they will need to adapt to meet those needs.

The parents are shocked. They cannot believe it, sometimes denying the diagnosis and trying to live as if it does not exist. The child suffers. Other children also suffer if they are in the family. What the social worker does is give one to fill in a bunch of forms to get benefits, services, and advantages. That is not what people need – they need to be given time to come to terms with it, they need to be presented with it bit by bit, to be introduced to it, and to be there for it. However, social workers either do not have the time or the expertise or sometimes either. Conflicts arise, and people feel that they have been told the wrong thing, the wrong way. The social worker is angry for not being heard and not receiving filled-in documents in time. Everybody is in chaos. (Municipal representative, Marijampolė)

Situations were cited where parents expect more from a social worker or other service provider than they can or should provide. A parent may not feel confident to provide the right support for their child or young person and therefore expect the “qualified” social worker to do everything for them.

They simply do not engage with the child. A specialist comes in and works with the child, but then the family must continue educating, and if they do nothing, the progress becomes very slow and insufficient. There is an attitude in families that it is safer to give the child to the worker and then do no work at all. (Municipal representative, Marijampolė)

Other issues

The challenge of accessibility for people with disabilities was also raised by municipality representatives. To date, not all public infrastructure or old Soviet-era public buildings, especially in smaller towns are accessible to people with disabilities (e.g. narrow doorways that do not accommodate wheelchairs). Charging for services was also mentioned as a problem. People with disabilities are reluctant to pay for services especially if the services were previously provided free of charge. Finally, municipal representatives pointed out that there is a shortage of jobs for people with disabilities, all the “attractive” jobs are filled by others.

5.2.2. Successful experiences and elements of the current system that are working well

This section discusses the positive experiences people with disabilities (and service providers) have had when accessing or providing services (the “successes”) and the elements of the current system stakeholders believe are working well. Again, the section starts with general comments made by all four stakeholder groups before moving to specific observations. Some of the examples provided were not of initiatives that have been implemented but rather of those that are keenly anticipated by participants.

Each of the four stakeholder groups highlighted different success stories, focusing on different aspects of service provision for people with disabilities, based on their specific roles in the system and their unique experiences as a result. However, all four stakeholder groups agreed there is a need to promote autonomy, for service users as well as for caregivers. There is a view that initiatives in which service users have played a role, be that in service design and/or in the promotion of a worthy idea, are more likely to be successful than those that have been imposed top-down.

Listening to service users was also viewed as important, to understand the challenges people with disabilities face so that their needs are clearly understood, and the right initiatives are implemented, in the right way. Regular meetings between municipalities, NGOs, service users and their representatives, for example, would help to ensure services are designed closer to the service user, and that the unique needs of people with disabilities are understood when designing universal services.

It is important to continue practices that may have been implemented in response to a specific event or have been aimed at a wider range of people but have proved to work particularly well for people with disabilities such as online learning during the COVID‑19 pandemic. It is also important to understand why these initiatives have worked.

Participants from the service provider stakeholder groups (NGO representatives, social workers and municipality representatives) raised increased collaboration and co‑operation as being particularly important to improving service provision for people with disabilities. For example, both NGO representatives and social workers highlighted the value of the support municipalities provide in creating employment opportunities. Publishing good news stories can also break down barriers and help provide better and correct information.

Service users

In general, while the service users group viewed everything to be working well, they struggled to identify specific success stories. They did express that a positive attitude is a critical requirement in anyone who works with them and service providers who have the necessary communication skills to work effectively with service users are more likely to be highly valued. However, service users recognised that a positive attitude is an intrinsic quality, not easily trained or selected for.

Educational programmes

Remote learning in response to the COVID‑19 pandemic was raised as being positive as it allowed more interaction with colleagues and more participation in the learning process for some groups, particularly those with mobility issues. Service users believe it would be desirable to keep educational programmes (as well as introducing cultural activities) online to allow people with reduced mobility to continue studying in this way, as they are often not able to attend lectures in person. This would not only improve access to education for people with disabilities but also improve socialisation and inclusion, which is sorely lacking for people with mobility issues.

When we connect via Zoom, we all become equal. We have a very big window to the world. I enjoy learning this way. Good intensity. (Service user, Marijampolė)

Accessibility and mobility

Participants pointed out that having lists of places that are accessible to people with disabilities could be valuable. The idea of displaying accessible places on online maps, or creating a common register of cafes, bars and clubs was raised. Another idea could be to create an award for easily accessible places.

We could make lists like Wikipedia that others could see. Or Google could allow us to bookmark cafes that are accessible [to people with disabilities] for free because there is a charge to be displayed otherwise. (Service user, Marijampolė)

Like with a Trip Advisor recommendation, there could be a recommendation for people with disabilities. (Service user, Marijampolė)

Currently, free ride services are available for people with mobility issues. In Marijampolė, these services have been extended to 8 PM, a move that has been positively received by service users as it allows them to be more social. It was noted however that while these services are free of charge, people who drive their own, adapted car do not receive any compensation for fuel.

If a person does not have a car, they can get a lift, and if they have a car, they do not get any support, even though they are also limited in means, and for them, driving is a form of integration that is not encouraged by the policy. (Service user, Švenčionys)

People with visual disabilities raised as a good practice the regular meetings they organise, where everyone gets together to talk and solve problems. During those meetings, social workers will help to fill in any paperwork and/or find out who needs what services (e.g. registering with a doctor or other assistance like buying food). As well as meeting immediate needs there are opportunities for socialising and sharing information.

NGO representatives

Success stories discussed by NGO representatives related mainly to positive co‑operation and the exchange of information between institutions, networks and colleagues.

Informal groups

The importance of informal groups, networks and connections was raised. For example, people with a hearing impairment have developed social connections with interpreters. They feel they can communicate more through interpreters, receiving more and different information than what they can receive on their own. Together they have formed a social network, with various social interactions occurring.

Peer organisations can also play a support, communication, and advocacy role. It is important to have a place where service users can meet and talk from time to time.

Regular meetings with local government representatives

NGO representatives believe it is important to co‑operate with the municipality regarding employment opportunities. In the Kaunas region, thanks to the municipality, an employment initiative where people with disabilities have been employed in the production of notebooks has been implemented, and it is considered very effective. Both NGO representatives and social workers believe the municipality’s support in creating employment opportunities is very important. They are the first to know about new jobs being created and can promote the creation of more jobs that are suitable for people with disabilities; real, meaningful jobs, not symbolic ones.

In Marijampolė an example of bringing representatives of the municipality, suppliers (clinics, hospitals, other companies) and NGOs, as well as patients’ organisations together twice a year to discuss what has been achieved, what is planned, and what is getting in the way of progress was described as very useful.

Meeting together can help you design a more effective, customer-centric service. Now the government is on its own and we feel side‑lined. Service users and service providers, through discussion, could find ways to spend money more efficiently, because users would give feedback. This is now being performed at the NGO level, with less formal gatherings to exchange ideas. (NGO, Marijampolė)

A user-friendly information system

NGO representatives observed how hard it is to find useful information about services; if they can barely find it themselves, it must be very difficult for a service user to do so. Establishing a user-friendly information system was provided as an example of a highly anticipated initiative – making information simpler so that service users can find out what services a municipality provides at the click of a button.

The size of the information is overwhelming. People get lost. It needs to be structured, linking the services of several institutions so that the user chooses by need rather than by institution, or by a group of services. (NGO, Marijampolė)

Training and educational programmes

NGOs believe they could valuably contribute to the training of professionals. At present, there is a shortage of professionals especially social workers, and they are often trained in a more formal way, far from the reality of frontline practice. NGOs could provide a training ground, for example, to help enhance skills in providing specific assistance.

NGOs could also perform educational activities, such as providing counselling for parents with children with diabetes – informal education, in simpler forms, including group meetings. Some municipality representatives agreed with this idea.

As many children with diabetes attend mainstream schools, and not all teachers and other parents understand how to live with the disease, we go to schools and give formal talks. And at the same time, we bring the parents of these children together, they support each other. It’s so much easier for NGOs to get to those parents because we have different skills than the medical staff, there is less formal communication. (Municipality representative, Marijampolė)

One NGO provided an example where they had organised training for public transport drivers on how to transport people with disabilities (particularly those with visual or mobility disabilities) including how to stop at bus stops, how far from the pavement to stop, and how to help people get off the bus.

The value of bottom-up services

One factor that NGOs believe contributes to successful service delivery is when a service need is identified in the community and/or by the target group, and the service is co-designed and co‑implemented by the people who need it. One success story was the establishment of a day centre for children with disabilities in Marijampolė by mothers caring fulltime for children with disabilities. They decided that they needed a day-care centre where they could take care of their children. They wrote a project application and received funding. At the beginning there were minimal applications for the day centre but now they have 20 accredited places, for children with mental and intellectual disabilities. A similar example was raised by an NGO representative who had started their own NGO for people with speech and hearing disabilities resulting from having a hearing disability themselves.

Social workers

Social workers focused on examples of collaboration and opportunities to work as part of a team to support services users. For example, teams of social workers working together is proving successful, a practice that requires the right theoretical foundations and skills. Resilient teams that can build strong bonds can create quality services.

Shared living homes

Social workers believe they should not focus on doing the work for people with disabilities but teach them how to do the work themselves and that more facilities and programmes that help people with disabilities live independently are needed. Nowadays, social workers will often rush in and do everything for people, but service users need to be given the time, space, and support to learn how to perform tasks for themselves. The opportunity to live in a shared house for example, even if only part-time, where an individual can make more decisions and choices on their own, which currently are often made by others including relatives, would be valuable in many cases.

It requires them to choose their furniture, what they want to eat, whether they want to have a pet, etc., which develops independence and requires fewer services, while at the same time, makes the person feel more self-confident and more courageous in interacting with the external environment. (Social worker, Marijampolė)

Encouraging independent living is not easy, it is not a mechanical process, and it is not necessarily smooth – it requires professionals, and well-thought-out methodologies. Nowadays it is done more intuitively, with fewer positive successes than there could be. (Social worker, Marijampolė)

Social workers viewed the introduction of group homes as a good practice. The co‑operation of professionals, particularly those in health institutions, is important. One social worker working in a group home said they have a contract with a health institution so that different specialists (e.g. psychologists, physiotherapists, general practitioners) come and provide on-site services in a group home when required. Group homes not only help people with disabilities but also the staff who work in them, by strengthening their relationships and developing co‑operation (e.g. informal meetings, common trips, supervision of workers).

Participation and representation

Social workers observed the value of people with disabilities being able to directly participate in municipality decision-making processes, so that their needs can be heard, and they can influence decisions. Involving people with disabilities in municipal bodies such as commissions and committees is worth exploring to allow them to express their needs and monitor the implementation of services.

Practical representation and advice on implementation are needed on an ongoing basis. Similar co‑operation could also take place with healthcare institutions to improve the tailoring and diversity of services. (Social worker, Marijampolė)

Stigmas exist and often lead to ineffective services because of a lack of consultation with direct service users. There are many requirements to meet or prove to be eligible. Life gets frozen and one can only return to it once the requirements are met. We need an easier route to services. (Social worker, Marijampolė)

It is important that people with disabilities are not only involved in the decision-making process as members of certain commissions, but also have a real voice and influence (e.g. in the renovation of the city’s infrastructure). Every year all the associations of people with disabilities are invited to submit proposals for the development of the municipality’s social services plan for the following year. In this way, people with disabilities feel that they belong to society and that their needs are being heard and acted on.

Municipality representatives

Municipal representatives highlighted the employment of people with disabilities and the overall involvement of people with disabilities in more activities as their biggest success and ambition. Integration of people with disabilities into the labour market can help realise ambitions for self-fulfilment. Municipality representatives acknowledge that it is not possible to reach the same degree of integration for everyone, but it is still seen as something that should be continuously pursued. Currently, successes are rare, as employers tend to be uncertain about employing people with disabilities and are unwilling to take on potentially unknown and additional responsibilities. It is also important to seek funding actively and regularly for projects, including from European Union Funds for relevant projects.

Labour market integration

Municipal representatives provided an example where advocacy has helped improve employment prospects for people with a hearing impairment. In Marijampolė, people with a hearing impairment do not have a problem getting a job, however, this has not always been the case. Representatives of an advocacy organisation advocated strongly to employers, clarifying the possible challenges and highlighting what are often groundless fears, for example, employers had thought that communication would be a problem.

You try out one, then the other and it becomes normal. Now they hire without issues. (Municipal representative, Marijampolė)

Deaf people make souvenirs that we can buy and use as representative merchandise. The important thing here is that the person whose work has been bought is the one who receives the award for selling the item. It is not only about employment but also about value – that they learn money. They are not just making these dolls, they are studying what the national costumes of the region are, and what the colours are. They match everything and are involved enough in those activities. (Municipal representative, Marijampolė)

Municipal representatives believe publishing positive examples and practices is worthwhile, particularly the testimonies of employers, including what they expected and what happened when they took a risk and employed someone with a disability. Breaking down barriers requires the ongoing dissemination of good and positive information.

To help people with disabilities integrate into the labour market it was suggested that opportunities to engage in productive activities could be created, the results of which would be valued and sold (e.g. producing notebooks or making and selling bracelets to raise funds for Ukrainians, i.e. activities that create a sense of purpose as well as a financial return). Alternatively, people could sell the work they create (e.g. handicrafts, woodwork, knitting, etc.) on a dedicated website.

Co‑operation between institutions

Municipality representatives also raised the value of identifying, encouraging, and supporting bottom-up initiatives such as in the establishment of the day-care centre discussed above recognising the particularly important role they can play. It was noted that in small municipalities like Marijampolė, this kind of co‑operation is easier because municipal staff, applicants and organisations know what services are available, what is needed and how to help.

Fundraising

Municipal representatives believe their involvement in writing proposals for European Union-funded projects is essential. Projects are more likely to be sustainable if the municipality has been involved from the beginning.

Families of children with Down’s syndrome have joined together in an association and we started a project to set up a day centre. They know what they need better, and how to organise everything, and we [the municipality] helped with the project and the funding. It is important to support initiatives that come from the bottom of the problem. They are now accepting children on the autistic spectrum because they have extra places. (Municipal representative, Marijampolė)

A social workshop where people come together and work together. A European Union project has made it possible to fund such activities. There was a project to knit socks for premature babies. We just ordered them and then brought them to the hospital. But the people were very happy to participate in such a project. (Municipal representative, Marijampolė)

The municipality’s role in these cases is to facilitate. This could involve gathering information about needs from the public, assisting with fundraising, helping fill in applications, collecting documents, or contributing with some of the funding.

5.3. People leaving prison

5.3.1. Challenges experienced with service delivery

Focus group participants articulated the significant barriers people leaving prison face when re‑integrating into society following release from prison. They struggle to find housing and employment and to establish or re‑establish positive social connections, and as a result, are at higher risk of reoffending.

The four stakeholder groups raised similar issues during the workshop discussions; municipal representatives however had less to say about service provision for this group, most likely explained by municipalities only having been involved in prisoner re‑integration processes for hardly more than a year.1 Municipal representatives acknowledged their lack of experience in this area and consider training for their staff to be important.

The stigma faced by people leaving prison and the negative impact this has on re‑integration was perhaps the issue that came up most in the discussions. Most service users reported having experienced stigma at some stage including from the service providers and other professionals that are supposed to help them.

A variety of accommodation and employment issues were touched on by the stakeholder groups. Participants’ opinions were divided on employment opportunities for people leaving prison. Service users and NGO representatives thought that finding a job is not difficult for many people leaving prison but cited cases of service users struggling to stay in a job longer-term due to poor overall reintegration. Meanwhile, social workers and municipal representatives thought that employers were not willing to employ people leaving prison at all. Inadequate sharing of success stories and good practices means the opportunity to change the attitudes of employers and others is missed.

Accommodation options, particularly immediately on release are limited and/or unsuitable. In some cases, service providers can meet people leaving prison on release and take them to pre‑arranged accommodation, in other cases however, service users are provided with an address and must find the accommodation themselves or may refuse the assistance of a service provider. In these cases, people leaving prison often simply disappear, and it can be very difficult to find them again and establish a relationship. Use of night shelters is common in some municipalities which participants viewed as unsuitable because of the environment and minimal support associated with them. Some service users reported not having anywhere at all to go.

A lack of co‑ordination and/or co‑operation between institutions resulting in duplication of processes and effort, or conversely in some cases, competition between institutions, overly formal and time‑consuming bureaucracy with service users being sent from one institution to another can result in them losing their motivation to engage with the institutions meant to help them. These issues can be exacerbated by insufficient sharing of information which means service providers do not always have the information they need to support a successful reintegration.

Service users

People leaving prison identified three main problems, all of which relate to the immediate period after release and the process of reintegrating into society: implementation of probation services, difficulties with bailiffs and finding housing. Experiences of stigma were also discussed.

Implementation of probation services

Probation itself is generally considered necessary and effective, with a significant number of service users reporting that it helped them. However, its implementation is highly formalised, and not always aligned with service users’ individual needs and experiences of integrating into society, resulting in probation often slowing or hindering their re‑integration.

It is the same for everyone, whether you go out on the street, into the community for rehabilitation or into the family. The same template applies. This is often a hindrance when a person goes out into the community. There he has a home and a safe environment, and he does not go out alone. But probation is still done on a signed basis, where every trip must be co‑ordinated. Probation considers whether he can go. It does not matter that you are in the community and under supervision. (Service user, Kaunas region)

Service users stressed that probation services are applied to everyone equally, regardless of how psychologically ready a person is to adapt to society, what kind of environment they live in (e.g. in a rehabilitation home or elsewhere), or whether they have an addiction (alcohol or drug use or “long term clean”). Treating everyone the same results in issues such as some psychological assessments being seen as unnecessary (e.g. “There is no real assessment of the persons or, their readiness to leave”) or “over-care” of those living in a rehabilitation centre, as they are already sufficiently cared for. For people without addictions, having to provide constant “proof” that they are “clean” feels excessive, creating a sense of mistrust and presenting a threat of “relapsing”. More differentiation between service users (i.e. a more tailored approach based on need and circumstances) would be desirable.

Service users also reported duplication of processes, a lack of co‑ordination between institutions, or conversely, competition between institutions, and sometimes an apparent lack of the necessary mandate(s). For example, a service user may be receiving all the help they need, say from a psychologist and/or social worker in a rehabilitation facility, however the probation service may also require them to attend a similar course(s) with them.

One has to go through the same programmes one goes through in the rehabilitation centre and repeat the same ones on probation. There is a difference between a person from the street and a person from the community – their living conditions are different; they could count those activities in the community. (Service user, Kaunas region)

Service users noted that the requirement to report to the probation service once a week when they are working can create problems, as they must excuse themselves from work and their employer may not always be happy with this. The alternative is to wear an electronic monitor, but because of the strong stigma attached to this, people leaving prison report avoiding it.

Service users viewed the tendency of institutions to take responsibility for providing comprehensive assistance as excessive control which does not help with re‑integration, but rather encourages service users to search for ways to circumvent this perceived control. Service users agreed that probation services and other rehabilitation institutions could support people leaving prison to take more responsibility for themselves for example by maintaining a map of activities they can access on their own.

Problems with bailiffs

Dealing with bailiffs is a major problem for some people leaving prison. It is not possible to repay debts while in prison or immediately after release because paid activities which would enable the repayment of financial obligations (e.g. consumer loans, etc.) are not available. Furthermore, there is no grace period once out of prison, which would enable a person to find a job and secure an income which would enable them to repay their debts with some service users saying an employer is less likely to employ someone they know to have a problem with a bailiff. Furthermore, payments to bailiffs can even be deducted from benefits. “The person becomes a hostage of the situation”.

If you have financial obligations in prison, a year, a year and a half can go past and bailiffs show up; if you are in prison, there is nothing you can do. If you have financial obligations, you are financially burdened in prison. When a person is released, he or she becomes a hostage. (Service user, Kaunas region)

While the problems with bailiffs were not discussed in detail, service users identified them as one of the most pressing issues hindering their integration into society.

Accommodation

Some service users raised the issue of accommodation and having a safe place to live as one of the most pressing issues in the first few days after leaving prison. Sometimes people released from prison have nowhere to go back to, in other cases, the environment they left is unsafe. People can end up on the “street”, where they are not only faced with meeting their daily needs such as food, clothing, hygiene, etc., but also the psychological shock of not having the social skills to live in society (a lack of social skills, how to communicate or interact), often aggravated by the negative attitudes of others towards them.

Every time I leave, I say – it will be different now, 2‑3 months, I am committing a crime. I want to go back in society, but I don’t know how to go back, and there is a painful despair. Now I am in a community where there are psychologists, there are social workers and everything is free, they don’t ask for anything, they support us, there is an adaptation centre. And I started to think that there is no other way but this. It’s like salvation. (Service user, Kaunas)

Accommodation, in a rehabilitation centre for example allows people to meet their basic needs, to receive the help they need from specialists (psychologists, social workers, etc.), to acquire social skills, and to feel accepted, acknowledged and psychologically safe.

Stigma

Although stigma was not identified as one of the most critical issues people leaving prison face, being constantly confronted by the negative attitudes of others was raised throughout the discussion. Service users described feeling unnecessary, rejected, like “lepers” which reinforce existing feelings of self-depreciation and personal contempt during their time in prison; as one participant put it, “you are not a human being, you are an animal”. Facing the indifference or contempt of society makes it extremely difficult to even try to re‑integrate, to “cling” to life.

There must be a high level of resistance. Most people break down in society, if I am not needed, I am rejected. The person goes back [to prison], it’s easier for him. (Service user, Kaunas)

Service users sense a lack of empathy and positive attitudes towards them, not only at the individual level but also at the institutional level. Discrimination is not only experienced in the direct interaction between the service user and the service provider, but also from professionals involved in the service user’s re‑socialisation and re‑adaptation processes. Service users feel they are often still seen as dangerous and unworthy of help, an attitude reported to be prevalent in public institutions like the police and medical institutions, as well as private institutions such as banks. The success of the re‑integration process depends to a large extent on the quality of the contacts service users have with institutions and individuals and how positively professionals engage in the process.

Returning from prison, ex-prisoners feel like out-casts. Others look down on us. At the very beginning, most of the encounter with society is a request for help, and during that, we are often looked down. (Service user, Kaunas region)

Other issues

Developing the necessary adaptation skills such as basic communication and social skills or simple computer literacy skills can be a challenge particularly for those who have been in prison a long time. The adaptation process should start earlier during imprisonment, and not at or near the end. Problems with employment were also raised, employers do not want to take on people who have been in prison and/or do not take account of a person’s abilities. Service users also indicated that opportunities to learn specific skills or trades “a speciality” while in prison are limited. One service user also raised the lack of educational services in prison as a barrier to better preparation for employment once released.

In prison, a person can get a computer for two hours a week and play computer games that are not connected to the internet. Windows is banned, and downloads of programmes that allow you to learn something are also not available. (Service user, Kaunas region)

NGO representatives

NGO representatives highlighted a variety of challenges to providing services that ensure effective and sustainable integration. Three challenges were identified as being the most important: accommodation, stigma and a lack of co‑operation between institutions with the view that if there was stronger co‑operation between institutions all other problems could be solved more easily. Participants talked about stigma as a wide‑reaching problem that impacts all aspects of service provision (e.g. employment and accommodation), even when trying to attract professionals to work with this particularly vulnerable group of service users.”.

Society sees him/her as a threat – you want to receive help and they are afraid of you. (NGO, Kaunas region)

Poor institutional co‑operation and lack of adequate information

NGO representatives view the long and formal communications between institutions including municipalities and the prison department as a means of shirking responsibility and not addressing problems. More frequent contact, greater flexibility and better alignment of responsibilities would allow for more effective action, particularly between the municipalities.

Furthermore, clients can be sent from one institution to another, their documents can move around in circles between institutions due to bureaucratic attitudes, all of which takes time and service users can lose their motivation to seek further help with reintegration.

The current policy settings slow down the reintegration process and waste time when the user is not yet involved in disruptive activities. Apart from their personal tragedy, it is also an inefficient use of public funds. (NGO, Kaunas region)

NGOs also want better sharing of information, as it can be very difficult for service providers to find the right information for the ex-prisoner. Service users do not always have the skills to ask for what they really need and better co‑operation between institutions would allow NGOs and social workers to target their efforts more effectively.

On the way to this meeting, I tried to find the information on the municipality’s website, and I could not find it, so I called and found out everything quickly. And how an ex-prisoner, who is not used to work with computers, should find anything there. Moreover, it is hard for him to make a call because he expects not to be listened to. (NGO, Kaunas region)

The probation period drew particular attention with NGO representatives, especially those working in rehabilitation centres, noting that probation procedures are often very formalised and overlap with what service users receive from them. Rehabilitation centres employ professionals (psychologists, clergy, social workers) to provide specialist services, but Probation can also require service users to attend courses they organise. Since attendance is compulsory, it duplicates what the service user is already receiving and complicates the work of rehabilitation workers, who must escort and wait for the service, which requires time and resources (e.g. transport).

The excessive requirements of probation were also noted, for example, when a person is in a rehabilitation centre, officers can come to check on them (even at night). This formal, “blind” compliance with procedures is a distraction for rehabilitation centre staff, for other residents and for the service themselves.

NGO representatives also noted that other institutions (e.g. law enforcement officials, municipal employees) look down on NGOs treating them as hierarchically “inferior”, less valuable rather than as co‑operating institutions or as partners.

Law enforcement officials feel superior to NGO representatives, and there is only formal, inflexible enforcement of legal laws. All services are available here [in rehabilitation centre], they must take that into account. We have a man, we have 24‑hour surveillance, if something happens, we call them immediately, we inform them, we do their job, and they put conditions on it. Then we won’t take those people. By interfering, they prevent such people and us from doing our job. (NGO Kaunas region)

The lack of co‑operation between social workers and NGOs was also raised. This results in NGOs not always knowing what services are provided in their region and by what organisations. It was also noted there should be more co‑operation between municipalities, for example, it should be easier for a person leaving prison to change the municipality in which they live (this is discussed in more detail below).

Accommodation

NGOs observed they need to contact a person leaving prison from the very first hours of release. Representatives from Caritas (Kaunas region) reported they can meet service users when they are first released and immediately accommodate them at a pre‑arranged address while representatives from Marijampolė and Švenčionys indicated that they do not always have this opportunity. Sometimes they meet the service user and escort them to their future place of residence, which they check in advance to assess for safety. Sometimes they just provide the address, and the service user must find it themselves. It was observed that in such cases, people often disappear, and it can be very difficult to find them again and establish a relationship.

There is a general shortage of suitable accommodation for example it is inconvenient (far from district centres, difficult to secure a vacancy in advance). In Kaunas district there are no hostels, so there is an agreement with a night shelter in Alytus. Although normally there is no shortage of beds there, its location means it takes a long time for a person to travel to find work or for other activities. In other municipalities, Marijampolė in particular, people leaving prison are often accommodated in night shelters which are only available for overnight stays. Most night shelters do not allow people to keep their belongings there if they stay longer. People are forced to carry their belongings with them wherever they go.

A person needs a place to live, not just a place to sleep. He needs to be in a safe environment in which he can begin to learn skills and develop the necessary social skills. (NGO, Kaunas region)

It was also noted that the current system of registration of residence and the provision of assistance linked to that is not helpful. Currently, people leaving prison are required to return to the municipality in which they lived before they were imprisoned. If a person leaves prison in a place other than their original place of residence, they are often unable to get accommodation in night shelters.

A particularly critical issue that was raised is people leaving prison not being able to live in a different municipality from that which they lived in before being imprisoned. Re‑registration is difficult which forces someone leaving prison to return to the same environment from which they left. This can be a particular issue in small communities where people know each other and there is a greater likelihood of negative attitudes towards the person returning from prison. One NGO representative said:

It is very important, if we are talking about successful integration, that I really want change and that he does not do the same. So why are we practically leading to a place where he did it [crime]? (NGOs, Kaunas region)

NGOs believe that suitable and safe accommodation alone will not help a person integrate into society. For integration to be successful, a person must also be provided with a range of services such as specialist support, employment, community support, etc. as soon as they leave prison.

Stigma

Stigma can slow or hinder a service user’s re‑integration into society. NGO representatives noted there is a negative attitude in society towards people who have been in prison. This is particularly the case in small communities, where people who have just returned from prison are exposed to negative attitudes in everyday situations (e.g. in shops), they are feared, labelled as “criminals”, and are expected to steal, commit crimes and be a threat to others. Participants believe that being able to change a previous place of residence would help with this.

The issue of negative attitudes from the people who are supposed to help people leaving prison re‑integrate into society, namely municipal employees, law enforcement officials, etc was also raised. Discrimination makes it difficult to obtain information and get co‑operation from representatives of the different institutions.

The representative of the municipality has a certain power, so if his attitude towards the ex-prisoner is negative, then you know in advance that a conflict will be coded. You immediately know that the person will not be satisfied, maybe he will open and close the door too loudly, if he does not know something, then the person will be sent on his way. (NGO, Kaunas region)

NGO representatives believe the systems and procedures to facilitate re‑integration exist and can be applied, but that negative attitudes become a barrier to the implementation of those systems and procedures.

The attitude of service providers toward service‑users, which seem to be different, remains unchanged. It seems that if we had an attitude of acceptance [of ex-prisoners], if we were able not to exclude them, then everything else would work out. In many places, we find ourselves in an attitude that stops us from doing. (NGO, Kaunas region).

NGO representatives said that the community itself can be a great resource for integration. If the community is accepting, open and helps people to adapt, it would solve many problems. At present, the attitude of communities remains negative towards initiatives related to people leaving prison.

When the plans to set up the community centres for ex-prisoners came to light, there was a great deal of resistance from the community (e.g. fear of falling real-estate property prices, children being frightened, etc.). (NGO, Kaunas region)

Reintegration process

On integration issues, NGO representatives noted that integration is still too late. The very process of deprivation of liberty, of being in an institution, deprives people of social skills, especially in terms of work skills or motivation to work. It was noted that when one is dealing with those who have left, one is already facing the consequences. In the opinion of the NGO representatives, high expectations are placed on people leaving prison, they are expected to be motivated to work, to want to integrate into the wider community, but in prison expectations are very low and motivation to work is not developed at all. As a result, when they are released, they face not only objective problems but also subjective psychological and value‑based problems. As one NGO representative said:

Prison deprives people of the skills to work because it does not give them a job. And therefore, to expect a person who has spent so much time not working (going out to eat, exercising and all that) to be able to integrate into the community after living in a “sanatorium” regime and to work from 8 to 5 is not possible, because the person is simply losing the skills to work in prison. (NGO, Kaunas region)

In the opinion of the NGO respondents, integration should start as soon as they enter prison. This view was also expressed in the group of social workers.

Other problems

In addition to adaptation problems or a lack of motivation to enter the labour market, it was noted that people in prison are required to show a work certificate while still in prison, which guarantees them a job upon release. However, NGO representatives consider this practice to be unfair, as prisoners cannot reach or contact employers while in prison. It was acknowledged during the discussion that employers are now quite positive about employing people who have been in prison, and no negative attitudes had been observed by the workshop participants, it is the requirement to have a job before leaving prison that is perceived as the barrier.

When a person is awaiting parole from the Commission and is required to have a work certificate to guarantee his release to work. It is absurd when he cannot actually reach, contact employers. (NGO, Kaunas region).

While there are many opportunities for people who have left prison to attend various training courses and to acquire a specialised vocation, it was stressed that such training should take place in a safe environment (e.g. in rehabilitation centres or night shelters). NGO representatives noted that if a person goes to general training, there is a chance that they will end up in a “negative” environment, “meet others like them”, and reoffend.

NGO representatives raised the issue of a lack of some services, such as legal services (especially when people leave prison with former obligations – “bailiffs”) and /or logistical problems accessing services (especially if clients must be transported to medical facilities or their place of residence is far from the service location). There was also a discussion about the lack of social workers working with this group. Many social workers are women and given many of the people leaving prison are men that can lead to problems such as security, communication, etc.).

Finally, NGOs representatives mentioned that it is still not clear what happens to a person who “drops out”, for example, starts drinking or using drugs. Rehabilitation centres are not allowed to accommodate people who are drinking or taking drugs and night shelters are for overnight stays only. This problem does not seem to have been solved, nor is the solution entirely clear.

People start working or going out, they start drinking, so you can’t take them in (to a rehab centre). He must decide. If he decides that he will continue to drink, then you have to say goodbye to him and then it is a question of where he goes from there. He goes back to his environment again. Perhaps you should look at what you can do with this person, how you can continue to help him. (NGO, Kaunas region)

Social workers

Social workers observed that they work with a variety of service users, all with different needs. This means they can lack the specific knowledge, acquired through practical training and experience to work with some service user groups. They also feel their ability to help the service users they work with is hindered due to the services available not necessarily being the services a service user wants or needs. Stigma was not widely discussed by social workers. It was noted however that people who have been in prison do experience different attitudes from the public or from the staff of some institutions (e.g. doctors) and there is more discrimination in the provision of services to people leaving prison (e.g. reluctance to provide health services).

Lack of cross-institutional co‑operation

Social workers raised the lack of cross-institutional co‑operation as one of the main problems. Firstly, it is very unclear which institution or worker provides which service(s). This includes municipal and district workers, social workers, NGOs, as well as the police, health workers (doctors) and financial services providers. This can cause difficulties when dealing with a specific situation and it is not clear which institution is responsible for providing the necessary service (e.g. in the case of a drunken client the police might take them to a temporary night shelter to see a social worker because the hospital does not accept them). It is not clear what services are provided by the staff of the municipalities (e.g. “some documentations are supposed to be made by the municipality, but the municipality worker herself comes with the client and says “I don’t know what to do, it’s not my job”).

Secondly, there is a lack of information about the services that are available, both for people leaving prison and for social workers who are supporting them, who are the intermediaries between service users and society. For example, what services are available to people leaving prison such as free ID. Moreover, poor co‑operation between institutions leads to complicated and long-lasting procedures when accessing services, such as payment of benefits, finding accommodation services, etc.

They send the person to me, I send them to the municipality, they check, then they send them back to me, and it takes a long time. The information about the person leaving is “long-walking” through different institutions: social worker-municipality worker-social worker. (Social worker, Kaunas region)

The third aspect mentioned by the social workers relating to poor co‑operation is the lack of feedback about how a client is doing, have they found a place to live or a job, how are they re‑integrating into society more generally. Social workers do not always receive feedback from the intermediaries who communicate directly with people who leave prison. Social workers arrange benefits but do not do much else, they do not know how any problems are resolved.

Shortage of qualified professionals

Because social workers work with a variety of service users, not just people leaving prison, they must multitask and are not specialised in helping any one group. Social workers feel they must limit themselves to providing more transactional services such as securing accommodation, clothing and food certificates, and (albeit less often) escorting service users to institutions (e.g. the bank). However, service users often need other services, such as psychological counselling or help acquiring employment skills or basic computer literacy courses and social workers do not feel as qualified to help with or advise on these types of supports or services.

This issue is exacerbated by a lack of skilled professionals willing to work with people who have been in prison. Social workers are aware of their lack of specialised knowledge and believe that it would be useful to have professionals in the field who specialise in meeting the needs of this group and in public education, without which successful reintegration is unlikely. However, there is a reported lack of professionals willing to work with these service users.

The lack of training programmes for social workers was highlighted, specifically programmes to help with changing behavioural mindsets.

Insufficient resources

Social workers noted they are used to making do with the resources they have. However, they, together with NGO representatives, raised a question about the total amount of resources made available to the sector. Even knowing this they believe would allow for a more effective planning of activities.

It is not clear how many resources are available; how many can be claimed and how to plan activities. (Social worker, Kaunas region)

Social workers also raised the issue of a lack of resources to access training and courses that would help them support service users to improve their motivation and change behaviours. Some people leaving prison are reintegrating into a completely changed world and social workers do not feel they always have the skills and/or experience to help with this transition and to truly empathise with their client’s situation.

There is a serious lack of courses on behaviour change and re‑motivation. (Social worker, Kaunas region)

The ability to empathise with the situation is also helpful in overcoming a lack of resources when you have a clear understanding of the client’s life and can apply your knowledge to how the situation can be handled – when you need material support and when you need psychological support. Without trust and a good relationship with the client, especially in this target group where defensiveness is quite high, it is not possible to identify the problem and thus help solve it. (Social worker, Kaunas region)

One of the bigger problems highlighted by social workers about the lack of resources is the lack of accommodation services, or rather the problem of declaring one’s place of residence. While NGO representatives also mentioned the problem of declaring a place, social workers highlighted a slightly different aspect of this problem. It becomes complicated when a person leaves prison and does not have a declared place of residence, in which case he/she cannot receive any services (not even benefits). The social worker is then forced to look for or check the place of declaration to be able to provide services to the client, which takes additional effort and time.

Reintegration process

Social workers consider that it is insufficient to start the reintegration process only six months before someone leaves prison. The process should start from the time of imprisonment and continue throughout the term of imprisonment to ensure that people leaving prison have at least the basic skills (including computer literacy) to live independently.

No party, society or the person leaving prison is prepared for re‑integration. Starting to prepare people for their return to society only six months before release does not help because, particularly in cases of long-term imprisonment, people lose many social skills. When they are released, they behave defensively, avoid new challenges, or even ignore the opportunities offered, because of a lack of confidence in themselves and a high level of distrust in society.

Society isolates the ex-prisoner and lives on, but the ex-prisoner lives a different life, moving away from society and once freed, no longer knows how to find his place. (Social worker, Kaunas region)

What you fail to learn in 15 years, you will not learn in six months. (Social worker, Kaunas region)

A lack of confidence can also contribute to a lack the motivation or the will to engage in social or employment activities and to integrate fully into society. As one social worker put it, “The client seems to think that the most important thing is to get the benefit. He gets it and disappears. You don’t even know what the person needs. There is a lack of willingness to adapt, employment, change of activities, etc.”

Municipality representatives

Municipality representatives from all three municipalities struggled to identify the challenges faced by people leaving prison in accessing services, viewing just over a year (the amount of time they have been involved in re‑integration processes) as too short a time to fully understand the sector and its challenges.

Participants instead focused on the challenges they are experiencing in coming to grips with their relatively new role such as not having a common understanding of how the re‑integration system works and what role NGOs and social workers play, and what assistance they need from the municipalities to better support service users. Municipality employees see their role as more mediator-administrator, with only minimal contact with service users.

We receive information from the prison that such and such a person is going to be released, then we pass this information on to Caritas, and the person there takes care of it, contacts the client, finds out the client’s needs, and then continues to interact with him/her. (Municipal representative, Kaunas region)

It was identified during the discussion that the procedure for the re‑integration of people leaving prison is still very new, and that municipality staff lack the knowledge and skills to handle it. There are still no clear procedures. Different municipalities have different approaches to how to deal with re‑integration problems, an issue exacerbated by a lack of sharing of information and good practices between municipalities. Stronger co‑operation not only between institutions but also between the staff of different municipalities would be valuable for improving knowledge and practices.

Reintegration process

One of the most important problems identified by municipal staff in the re‑integration of people leaving prison is when the re‑integration or adaptation process begins, which echoes what social workers and NGOs said. In the opinion of the workshop participants, being in prison does not give people the motivation to change when they leave and as a result, in many cases, people leaving prison do not know or specify what services they need, nor are they willing to approach municipal staff at all, even for cash benefits.

There was a case where a woman was released, the social worker assigned to her was very active, and we agreed with her that she should be contacted after she left, but she was not. I did not get in touch until a week later. She is back in her life and does not want to remember the institution. (Municipality representative, Kaunas region)

Municipality staff believe that the re‑integration process should not start when they leave or six months before they leave, but much earlier.

Accommodation

Not only is there a general lack of accommodation, but according to municipal staff, there should be specific places that are safe for service users once they have left prison. A place where they can feel safe and receive necessary services (e.g. psychologists, social workers) and/or be helped to find a job, to change their lifestyle. People leaving prison do not receive enough help from others when they return to their own environment (friends, relatives, etc.) and are not sufficiently self-motivated to change their lifestyle and integrate successfully into society, which is why rehabilitation centres and half-way houses are so important. This view was echoed by service users and NGO representatives.

The introduction of a programme where social workers (from NGOs or the municipality) visit a person in prison six months before their release and ask them what help they need, can enable a partial arrangement of accommodation. Some prisoners refuse this help however, not because they do not need it, but because they do not fully understand the situation they are returning to. Some people plan to return to their own or friends’ families, which are not necessarily safe environments, and they agree this can make reintegration more difficult. Service users themselves acknowledge it is difficult for them to make a realistic and adequate assessment of their prospects at the time of release, and that assistance to accompany them when they leave prison can therefore be very valuable if provided.

Furthermore, returning to live in a place where the person leaving prison has committed their crime(s) and where their victim(s) may still live, can make it difficult to find a job and settle back into society. One possible solution to this would be to help service users settle somewhere different where they are not known and constantly reminded of their background. Currently this is hampered by the loss of state benefits when people leaving prison change their place of registration.

Stigma

A further concern raised was the stigmatisation of people leaving prison. Some municipal workers noted that often people leaving prison are unwanted in society, shunned, and find it more difficult to find work, as it is expected they will cause problems. Although stigmatisation was not the key issue raised, the overall discussion suggested that stigmatisation was the challenge that has changed the least. People leaving prison suffer negative attitudes not only from the public, but also from the staff of different organisations (e.g. municipality workers, social workers), Even the number of NGOs that focus on the re‑integration of people leaving prison is very limited.

Municipality representatives also raised the issue of a lack of professionals willing to work with people leaving prison.

5.3.2. Successful experiences and elements of the current system that are working well

Unlike the discussion about challenges where the stakeholder groups had a lot to say, the four stakeholder groups struggled to identify examples of positive service delivery experiences that have improved people leaving prison’s reintegration into society. Only NGO participants, who have been working with people leaving prison for a long time were able to provide any concrete examples, such as the introduction of a law that allows them to meet with and take prisoners out of prison on a temporary basis six months before their release. As a result, while there are some good practices identified this section focuses more on the potential solutions identified by participants. Municipality representatives commented that while it was difficult for them to identify good practices, the fact that an integration programme has been launched is a positive thing.

Like the focus group discussion with people with disabilities, the four stakeholder groups each highlighted potential solutions to issues, based on their specific roles in the system. One solution raised by all four groups (in response to the issue of stigma) was the potential value of publicising success stories. There is a view that currently success stories are known only within the provider organisations themselves and while organisations alone could improve dissemination of these stories and good practices. The impact may be greater if there is a joint approach to improving public awareness and education and disseminating good practices and experiences within and across different municipalities and other institutions.

The need for more accommodation options both short and long-term, for male prisoners just leaving prison in particular was raised by most groups. Service users themselves said they would value an intermediate environment where they have the space and time to adjust to living outside prison. NGO representatives advocated for halfway houses in which people leaving prison can live for a short time until they are more financially independent and have found their own housing while social workers suggested that housing could be provided by NGOs or non-commercial institutions into which case management and other services are incorporated. Rehabilitation centres were raised by all four groups as a success story.

Service users

People leaving prison focused on the value of having access to an “intermediate” environment following release from prison, provided in a community setting, where they have the time and space to transition safely to independent life.

An intermediate step between prison and independent life (rehabilitation centres)

Service users believe an intermediate step between prison and independent life, in a non-prison environment, is necessary. A place where they can realistically understand their potential outside prison, acquire practical skills and gradually increase personal responsibility. They do not believe they are ready for independence immediately upon release and need an environment in which they can “relearn” how society works and discover what opportunities are available to them.

It is important to feel safe in your environment. Then there is a willingness to change rather than defend and resist. There are few safe environments at the moment. When returning home, there are many temptations. Employment is also essential. There may be chess, pool, and music as this allows you to interact within the rehabilitation community itself, discuss similar experiences and learn to be together. (Service user, Kaunas region)

The exit process is facilitated by a social worker who visits a person leaving prison before they are released. The social worker helps with things like finding accommodation and starts to bring the service user into closer contact with life outside prison. It is important that they, the social worker is not from the prison itself, but from the outside, which provides service users with a greater sense of security.

The Caritas organisation and its day centres where service users have access to food, clean clothes, and where Caritas staff can help them find somewhere to live was viewed as a success story. Service users also highlighted rehabilitation centres (e.g. “Tėvo namai” in Kaunas) as good experiences, where they can acquire the necessary skills (they get a place to live, food, clean clothes, and a place to shower). In such places they are also provided with employment, help from psychologists and social workers, and the necessary skills for integration. Moreover, as already mentioned, service users feel valued, accepted, and cared for. Rehabilitation centres create a safe environment where there is less chance of “backsliding”.

Service users consider support to be most effective when it is delivered in a community-based setting. Many rehabilitation centres are run by people who have been in prison themselves, they have been through rehabilitation and are now providing services to others. Service users feel more information about these types of services should be available.

You come from an unsafe environment to a safe environment where you are given everything at the start – accommodation, food, supplies, rehabilitation. In that safe environment, you learn to live. If you want to change your life, then it is easy to do so. In the rehabilitation centre, you even get to know things like what the phones are like now and how the banks and e‑banking work. They teach you how to work. When I left the prison, I had not worked, and I did not want to work. But there was occupational therapy, you learn how to make food, how to take care of others because you make food for everybody. (Service user, Kaunas region)

Although most participants considered probation to be one of the most problematic periods, one participant mentioned it was during probation that it was suggested to him to contact Caritas because they were looking for staff. He got a job with Caritas, started to socialise with other people and eventually was offered the opportunity to volunteer with refugees. Working with Caritas restored a sense of self-esteem as well as providing employment and new activities and experiences.

The second time I came to the probation office to sign off, a woman said there was a possibility to go to Caritas, and she offered me to take part in a project. There you discover something new; the communication is good. There you don’t feel that you have come back from prison. (Service user, Kaunas region)

Another success story that was shared was applying to the employment service for a subsidy to create a job. For example, one service user applied for and received funding to set up a “šakočių” (Lithuanian sweet cake) factory. Another participant recounted a similar experience where he was offered the opportunity to buy premises to produce children’s toys.

NGO representatives

NGO representatives have been working with people leaving prison for a long time and were able to provide specific examples of successful experiences and/or good practices.

Good co‑operation/trust between institutions

Despite one of the main problems being the lack of co‑operation between institutions, better co‑operation is what NGOs believe will help to solve many of the other problems. One success that was mentioned was the change in attitude of staff in institutions toward people leaving prison; the positive attitude of the staff of the Department of Prisons was particularly highlighted. The NGO representatives believe the change in attitude has created increased opportunities for communication and joint problem solving.

Young people are coming, and it is clear that they really care about change. The central team (of the Prison Department) is already strong. There may still be a “they“ vs „we“ attitude towards NGOs, but it is definitely changing for the better. (NGO, Kaunas region)

NGOs thought that attitudes towards them are also changing, and they are starting to be seen more as valued partners; there is a greater willingness to share experiences and to consider the needs of NGOs. An NGO worker from Marijapolė said:

The change took place when the escort service came into being and the tender was launched. We [NGOs] ourselves made a list of the things that might be needed, because we knew from experience what might be needed for both clients and staff, because we had worked on it a lot before. And the success story is that for the first time we didn’t have to cut the funds, but all the “lines” we needed (e.g. transport) were met. (NGO, Marijampolė)

NGO representatives value the trust prison employees put in them and social workers, which has resulted in prisons issuing them with permanent passes and allowing them to take in food when they visit prisoners, so that communication with the prisoner is as informal as possible which helps to build trust. NGOs also invite prison staff to visit their premises to see how they operate, to get to know the other staff and to build a relationship of trust. This promotes a common approach to service provision and more effective communication. Organised meetings (specifically FGDs) have brought at least some NGOs closer together, they have learned about each other and what services they each provide.

Implementation of new integration law

NGO representatives viewed the introduction of a law that allows them to meet people in prison six months before their release date and take them out of prison on a temporary basis positively. It helps them to build a relationship with the service user, understand their needs and to integrate them into society one step at a time. While the law is already in place, it is how it is implemented that matters. It is very important to understand and clarify the individual needs of the service user and target supports accordingly.

We make contact, find out about their social needs and, if necessary, contact their relatives. When the person returns, he already knows what he will get when he returns and where he will need to go. (NGO, Kaunas region)

NGOs are the bridge between prisons and society. And it is indeed a breakthrough that all the ministries have come together and worked together to build the system. (NGO, Marijampolė)

NGO representatives see this law change as a real breakthrough, and it is important that it is not only implemented to the letter of the law but is used to really help people successfully and confidently transition from prison to life outside prison.

Addressing multiple and complex needs

A holistic approach needs to be taken to a person’s situation. NGO representatives believe it is important to provide comprehensive support (psychological support, help finding employment and integration into the community). This requires the co‑operation and support of more than one institution. By way of example, when there was a threat that a service user might reoffend, a worker from that service user’s former prison got involved and talked to him, persuading him to stay in the rehabilitation centre. He was then given the opportunity to get a vocational training and a job in the rehabilitation centre and eventually managed to integrate successfully.

Now this man has been working for 12 years, has a home, a wife, a family, drives a car and has sober habits. He is still sober, but it was a very good situation that helped him. (NGO, Kaunas region)

Family involvement

Although NGO representatives did not have any success stories related to family involvement in the reintegration process, they view working with and coaching families, for example on how to react and accept people who have been in prison coming home, to be important. This can make re‑integration easier not only for the service user but also for their family. The importance of creating a safe environment was mentioned many times. The situation is new for everyone.

The approach of relatives needs to be more complex – no one includes them. The relatives are motivated, but they don’t know how to guide the person. (NGO, Kaunas region)

Social workers

Social workers focused on solutions they believed would help them to deliver better services and better understand where they and the services they provide fit in the system.

Information sharing and co‑operation between different institutions

A feedback channel across service providers is needed – to exchange information on what works and what services are effective. In the absence of such information, social workers believe service providers can operate ineffectively, failing to understand how the services they provide work in the context of other services available. This sharing of information should also include information about relevant private and public institutions such as the police, banks and healthcare institutions. Service providers should be aware of the general services that are available for people leaving prison, including what forms of mediation and representation are available. This information would help service providers to better tailor services.

It is important to involve psychologists and NGOs that specialise in the provision of services specifically for ex-prisoners. They could more adequately assess the services planned or provided, give practical advice on how to communicate more effectively with this group, and how to navigate unusual emotional reactions. (Social worker, Kaunas region)

A positive experience that was shared was the example of Caritas workers, who act as intermediaries between a service user and society, acting as the service user’s representative; they also provide information to the social worker about the service user and their needs. Intermediaries not only help to maintain the link between the social worker and their client, but also facilitate access to other institutions and their services.

Several social workers said it was often their calls to prisons, bailiffs, employment services and other institutions that helped to solve their clients’ problems. Clients are often afraid to go directly to the services they need because they have a prior experience of being treated with disrespect, and social workers can often speed up the delivery of services because they have the relationships and understand the system.

Responsibilities

It is not always clear to social workers what responsibilities NGOs have and they do not feel there is a clear division of responsibilities and activities. Periodic meetings where responsibilities are reviewed and possibly redistributed according to current circumstances and the needs of service users would help (e.g. available funding or the expertise of professionals). Social workers believe the problem could easily be addressed by more frequent roundtables, where professionals working in the field share their experiences. Social workers were not the only stakeholder group who did not understand the responsibilities of NGOs, municipality representatives were also unable to clearly define the functions of NGOs and what services they provide.

NGOs are not as committed as social workers because they do not have permanent funding and can easily change the nature of their activities depending on the people working there at the time. Social workers feel some competition and duplication of services. It would be better if we would not compete but co‑operate. However, this requires an agreement on resources – money, people and competencies. (Social worker, Kaunas region)

A lack of inter-agency co‑operation could be improved if the community was able to take on more functions or co‑ordinate them better between themselves which would contribute to more on-the‑ground solutions and a smoother re‑integration experience for service users.

Up-to-date information

Proactively looking for who can provide the services required works, however proactivity often depends on a social worker’s personal initiative and qualities. It is important to be able to link services to needs and opportunities so that the right services are delivered at the right time. Social workers viewed NGOs as more skilled in proactive inter-agency networking, which then allows them to react in a quick and timely manner. Social workers would like to acquire these networking skills.

Often there is a lack of information about the services provided. A “directory” of partners could be compiled and kept up-to-date by municipal representatives, who could then extend their activities to co‑ordinating services and initiating the provision of missing services through projects or other forms of promotion.

Accommodation options

Social workers also raised the need for more accommodation options, housing and shelters, particularly for single males. Crisis centres for women are available and female service users are easier to find accommodation for but there is lack of accommodation for men.

Housing could be provided by either the public sector or NGOs. Accommodation could be bought from NGOs or non-commercial institutions which is provided together with case management and professional services.

Municipality representatives

Municipality representatives emphasised the value of publicising success stories as a stigma-reducing measure. They believe it is possible by highlighting success stories to start to change public attitudes, including a perception that people leaving prison are “dangerous and irredeemable”.

Municipality representatives also raised the issue of greater representation for people leaving prison. They noted that while they often encounter organisations representing children with disabilities or care leavers and see their activities publicised, they are not as familiar with organisations representing people leaving prison. This may reflect how few organisations there are working with people leaving prison. To illustrate their point municipality representatives said that two years ago, when tenders were launched for the provision of services for people leaving prison, only one tender was received.

Municipality representatives believe there are lessons to be learned from other groups, such as people with disabilities, patients’ organisations, or people with addictions, who have established organisations to represent their interests.

Other groups are somehow audible, but I do not know much about this group unless it is how they overcame addiction. However, this is only part of it, not all are addicts. (Municipal representative, Marijampolė)

NGO involvement in the re‑integration process

The success of Caritas and having NGOs involved in the re‑integration process was highlighted. These organisations, according to the municipality representatives, have the necessary staff, specialists, experience to provide quality services to service users.

Information about services

Municipal representatives mentioned that leaflets are now being prepared and distributed in a targeted way that provide information on what services are available to help people identify the specific services they need.

The leaflets are a plus. The good thing is that more information is being gathered and information is being exchanged. Prisoners get more information on where to address. The leaflets are given to representatives of NGOs working with prisoners, so now there is a more targeted distribution of information. (Municipal representative, Kaunas region)

One participant mentioned that in her municipality the services accessed by service users are captured in one database. They know the characteristics of person applying, what services they need, and what services they received and what outcomes are changing as a result.

5.4. Young care leavers

5.4.1. Challenges experienced with service delivery

As with the two previous sections, this section begins with a discussion of the challenges faced by care leavers transitioning out of state care to independent living. Common issues raised by the four stakeholder groups included insufficient preparation for living independently, the stigma experienced by care leavers, and inadequate resources to better support young people to transition successfully.

Service users talked about the fear they felt leaving the known for the unknown, feeling quite unprepared for “suddenly” having to look after themselves. The three service provider groups all stressed the importance of the transition process, with care leavers needing access to tangible and intangible supports like having a significant adult involved in their lives. NGO representatives viewed the transition process as too spontaneous and informal, and when they got involved, service users were often not ready to start an independent life. Social workers said the transition process was the main problem from which all other problems arose, and municipal representatives said that while they have been working to improve the support, they provide to young people transitioning from care, more action is required.

Many examples of care leavers facing discrimination were provided, for example when looking for housing or a job, being paid less for unskilled work, or being employed without a contract. NGO and municipal representatives talked about the stigma they believe exists in educational institutions; care leavers are not encouraged to continue their education or to have professional ambitions. Some of the service users in the workshop viewed work and/or education as unnecessary, a view some other stakeholders believed resulted from the discrimination care leavers were subjected to.

Inadequate resources to help prepare care leavers live independently was expressed in a variety of ways, for example, service users said that a lot of the people involved in their lives e.g. teachers did not have the necessary characteristics to really help them, while service providers advised there is a shortage of qualified psychologists, not enough cross-sectoral services, and a lack of appropriate activities for young people in smaller communities.

Service users

Service users had difficulties describing their expectations for the future, they were more focused on the present and were reluctant to look or plan ahead. Participants told their stories without necessarily identifying them as successes or failures. It appeared too difficult for these young people to open up to a stranger (the moderator) in front of other young care leavers. Having said this, the participants did highlight several barriers to a successful or smooth transition from care.

The fear of exiting care

Service users observed it is very difficult to prepare for something you do not know anything about. All the young participants mentioned a strong sense of fear of facing the unknown, often reinforced by those in their immediate environment who work with them.

We live with having everything and the thought of having to go out and start something when you just do not know yet where to study, how to live, and you have to make decisions quickly. It is scary. I do not even want to think about it at the time. You do not think about it until the last minute. You have your room, it is all there, they give you everything, there is a kitchen, you have your own cup. And then you go out and there is nothing, and there is somebody else living in your room. You cannot even go back there, sit on the chair. There is nothing left. I was scared. (Service user, Švenčionys)

When it was time for me to leave, I was so angry, so hostile, that even if someone tried to talk to me, I would not listen. It is not too scary about housing or a job at first, because you think you are going to get some kind of monetary support. But you are left with nothing, with no home of your own, where you used to live. (Service user, Švenčionys)

We hear it all the time. For example, you go to the canteen and there is what they made today. And you do not always like everything. But if you say you do not want that dish, you are immediately told: “Oh, how it will be when you leave, you will be glad just getting one. You will not have anything.” (Service user, Švenčionys)

A successful exit from care relies not only on the right material supports being in place, but also on less tangible supports such as psychological support or better trained teachers (at common education institutions like secondary or professional schools). Currently, service users do not believe teachers are well qualified to support them during the transition period and that the characteristics they want in a teacher they find to be the exception rather than the norm.

Stigma

Care leavers noted that experiencing stigma is common after leaving care, for example when looking for a job or housing. Many examples of discrimination were cited, such as being denied housing or having their rent increased, being paid less for unskilled jobs, or being employed without a contract. Care leavers believe it is helpful to have a significant adult involved who can take the time to help with the challenges faced and to perhaps even accompany or represent them when looking for a job or a home.

When you work, you are offered less than others, only to find out that others get more. Sometimes they try to turn you down, or not pay at all. We are gullible, we do not always get it right. It is good when a carer intercedes. (Service user, Švenčionys)

We are currently preparing to leave care and are already living in apartments. For example, when someone in the neighbourhood plays loud music, the police are called directly for us. Even if we are not at home at all. We do not expect anything else. (Service user, Švenčionys)

Lack of information

Care leavers observed that they do not always have the information they need and do not always know where to turn with specific questions. There are likely to be several reasons for this, there is a lot of information to absorb when leaving a care home and until practically confronted with a situation such as paying a utility bill or applying for a health service the young person does not know where to find the information they need or remember having received it, if at all, because it was irrelevant at the time.

NGO representatives

NGO representatives focused on the challenges that arise from a lack of clear regulations and allocation of responsibilities. Given how important the transitional phase is, NGOs feel it is too spontaneous or informal; the Ministry’s forthcoming regulation was highly anticipated as it should provide for better co‑operation between different institutions and service providers including NGOs.

Poor institutional co‑operation and lack of adequate information

NGO representatives observed that service procedures are currently interpreted and enforced differently by officials in different municipalities, making it difficult for volunteer support people to be effective with actions based more on personal initiative. For example, there is a lack of clarity about the procedures when a young person is transitioning out of care, which institution is responsible for what and who does what. This may be because the legal framework has only recently been adopted and the services available are still very new and so rules about what should happen have not yet been established. It was also suggested that there is competition between different institutions, e.g. between different NGOs and social workers which contributes to a lack of clarity.

These services are new in Kaunas municipality. So far, they are only listed in the Catalogue of Services, but there is no regulation for them yet, the ministry is still in the process of drafting it with those who carry out the work, it is not yet legal. For the system to work, be clear, there is a lack of common knowledge between institutions, and it is not clear who has to do what and when they do it. In a word, there is a lack of order as a lot of chaos and a certain amount of competition perhaps between NGOs and social workers exists. It is not clear what some do and what others do. There is no kind of co‑operation and clarity in that co‑operation. (NGO, Kaunas region)

The experience in Švenčionys shows that it is very easy to get along with people. But it is just difficult for me to understand, from the services offered, what is going on, what is not, who is doing what, etc. Really, it is such a complexity. (NGO, Švenčionys)

Lack of autonomy

NGO representatives believe too much is decided for children who are living in a shared house to ensure their maximum comfort. Lack of autonomy means that young people can lack basic life skills, from doing simple household decisions (what or where to buy), to financial literacy or education questions (where to enrol, what to study) etc. This means the skills to make decisions and choices and be responsible for those choices are not being sufficiently developed and so when NGOs step in, they find service users are not ready to start an independent life.

In the short term, residing in an institution may work, but in the longer term, it may prove unhelpful for both the person in care and the carer (the system). It is important to start developing a young people’s autonomy skills earlier, i.e. before they reach adulthood, to allow them to carry out activities that will be important (e.g. filing documents, paying taxes, getting help from health professionals etc.).

Everything in the household is decided for them because it is easier that way. But then they lack basic domestic or financial literacy. They are told straight away: “You cannot do this”, “You will not study there”, and “You will be this or that”. Children get used to it. Then we expect them to make up their own minds when they are 18. But they do not learn. (NGO, Švenčionys)

Children from ordinary families are sometimes not very independent, but it is easier for them. While care leavers often even face such devaluation: “You cannot do it”, “I will do it for you”, “I will decide”, “I will tell you”. We need more education for social workers so that they do not stifle the desire to act, make mistakes, and learn from mistakes. They [social workers] may not always know how to do it themselves. But it is very important. (NGO, Kaunas region)

NGO representatives believe a lack of independence is a problem that all stakeholders have a role in addressing. Teachers for example were identified as important agents in this area, as there appears to be a view that children in care or who have been in care are less able or capable, and teachers therefore make life easier by making verbal agreements: “I will give you the minimum score because you will not be studying further anyway”.

Stigma

NGO representatives also raised the issue of stigma, believing it to exist in educational institutions and in society more generally. Care leavers are often encouraged not to continue their education or to have professional ambitions.

At school, there are a lot of stories like that. For example: “Do not go to 11^th grade because you are struggling”, or “Will not study here with us, we will give you fours here”. They often say then that they do not need an education, they do not need to do anything because their uncle, their parents get benefits and they survive, they go to construction and they earn money, they do not need an education. They often say: “Why do you want me to finish ninth grade when my aunt did six grades, and everything is fine”. There is this continuity, and there is no incentive to go higher. It is such a systemic problem. (NGO, Švenčionys)

Social workers

Lack of adaption skills

An important issue social workers raised, which was also raised by other service providers is about the adaptation skills of children when leaving a shared home. Social workers pointed out while children in shared homes learn skills for daily living (e.g. how to cook, wash clothes, etc.) they lack adaptive skills for adult life such as financial literacy, how to access health or other services (e.g. how to renew a disability certificate to get benefits or what is the procedure for changing your passport, which documents are needed etc.).

It was also observed that young people find it difficult to adapt due to the adoption of certain behavioural “scripts” that are present in their environment which they consider sufficient or even exemplary (e.g. they do not think it is worth going to school because their father has dropped out of school, works in construction, and survives or their parents are on benefits and live off them). Young people do not always have access to good role models or the opportunity to see a wider range of possible scenarios making it even more difficult to transition out of care into society and which can lead to antisocial or violent behaviour, and eventually into the criminal justice system.

They go from one system to another. Children are taken from their parents – they have seen the pattern in their family and for them this pattern is normal, and they return to the system. (Social worker, Švenčionys)

Shortage of qualified professionals

Social workers talked about a lack of qualified staff in several ways. First, they feel there is a need for more qualified staff who have the experience to support care leavers and work with them more generally. Secondly, there is simply a need for more staff, so that more and better attention can be paid to each child. It was stressed for example that there should someone to accompany the young person when they leave a care home, to help them to deal with the problems they face and to answer any questions they have. There is also a role for volunteers who could help care leavers for example navigate relationships with authorities, choose a place to live or settle into a new home once they have left a shared home.

We sometimes feel like single mothers of many children without a husband. The little ones need one thing, the big ones another. Then there is food and illness. Sometimes we do not know how to prioritise, how to keep up and how to involve them in activities. (Social worker, Švenčionys)

Social workers from Švenčionys also highlighted that they need a wider network of case workers as part of the recently introduced “leaving care” service. This service was added to the Catalogue of Social Services in 2021 by the Ministry of Social Security and Labour, with the aim of providing a set of inter-connected and cross-sectoral services and measures for young people leaving care to facilitate their integration into the community and their transition to an autonomous life.

Other municipalities have more case workers as part of the “leaving care” service, but here in Švenčionys, there is a severe shortage. We do it ourselves as much as possible, but I would prefer it to be official, not between jobs. When it comes to accompanying and being together, we do not always have time together. In the families where they live, it is possible to continue it, not to say goodbye to them when they become adults. (Social worker, Švenčionys)

They want what they call a free life. Everybody wants that at that age. But they are more vulnerable because they often have relatives who live a life of disruption and often take advantage of them. And others have seen it, if a child is from foster care, he/she gets a more expensive flat to rent. All sorts of stories happen. They need to have adults they can talk to and consult, who will represent them if there is a problem. (Social worker, Švenčionys)

Insufficient resources

The unique challenges small communities face was highlighted in a discussion about resources. Švenčionys for example is not a big town and social workers often face the problem of encouraging young people to become interested in something, whether that be a hobby or sports where the number of available activities is limited.

They get bored of everything quickly. You do not know what to suggest. Everybody has been everywhere, and everything is known. It takes imagination to come up with something, but it also requires methodological tools to stimulate our imagination. (Social worker, Švenčionys)

We lack methodological tools to make our work more effective and interesting, to involve them, because children are specific – they are sensitive, they have been hurt – and sometimes we just lack the knowledge. (Social worker, Švenčionys)

Material resources are provided by various local employers, but social workers believe that fundraising skills are lacking on how to, for example, attract more potential donors and secure long-term sponsorship. Social workers also believe that involving employers and the general public more in activities with care leavers could help mitigate the problem of stigma.

Stigma

While not the most significant challenge raised by social workers, the issue of stigma was raised with a view that it is clearly present in society and eliminating it was seen as “fighting windmills”. In general, there was a pessimistic attitude towards the possible elimination of stigma in society. Social workers observed that young people from shared homes are not always accepted by their peers and are more likely than others to be accused of various anti-social behaviours.

Our children are labelled that if they are from a care home, they are immediately accused of being the one who broke something, stole something, beat someone up or something like that. (Social worker, Švenčionys)

Municipal representatives

Municipality representatives cited similar barriers to those raised by NGO representatives and social workers, that is, inadequate planning and preparation for independent living (e.g. financial, and legal literacy skills).

Sudden exit from care

A key issue raised by municipality representatives was the sudden exit from care which can cause considerably frustration and stress for care leavers. Young people not only lose their “home” where they have been relatively well cared for but also their friends and wider social circle (teachers and care home staff for example who have been part of their close environment).

All three municipalities involved in the focus group discussion indicated that they are improving the supports they provide to care leavers following the introduction of the new “leaving care” service. The municipalities believe supporting independent living is necessary and that it can take one of two forms: either the young person lives independently and is in regular contact with a counsellor or other professional support person, or they live next to a shared home and run their own household, visited periodically by a social worker, perhaps for counselling and other support when needed. There are some early results from the new service, but it is not yet widespread nor fully regulated.

It depends very much on their age. By law, they can be independent at the age of 18 years, but some of them are still at school at that age. What independence is there? They do not have a supportive network to fall back on. There are their families and relatives, but children have been taken into care, so it is clear what influence there is. They are better off away from them because they are also deprived of benefit money and their habits are damaging there. We try to keep in touch with them so that they know that they can go to us and can at least get some advice. (Municipal representative, Švenčionys)

Shortage of qualified professionals

Representatives from the three municipalities echoed the views of social workers about the lack of skilled professionals. They believe there is a particular shortage of qualified psychologists who can work with the increasing number of children displaying experiences of deep trauma.

We need good psychologists. And I stress – good psychologists, not just any psychologists. We have a higher proportion of children who have been taken into care from full families. They were not orphaned or abandoned in infancy. They were taken from those families. They are going through a lot of difficult emotions, but there is no practical work on that. There is a desire to promote adoption so that, in the long term, there will be no such thing as a shared home, but we need to realise that no one takes these children in. Not only because of the stigma but also because they are very difficult. There is a need of qualified help, both for the child, in the first place, and for the professionals and foster carers who work with them. (Municipal representative)

Stigma

Municipality representatives raised the issue of stigma in the context of schools, believing it to be commonplace. It was observed that in mainstream schools, there are problems with teachers or parents of other pupils who, because of prejudice or the behaviours of children in care, want to restrict their children’s participation in common activities and contact with children in care. These experiences can contribute to confusion, fear and a resulting detachment for young people when preparing to leave care.

Municipality representatives observed that often, even when creating a shared house, some local communities and neighbours have a negative view and can try to prevent their establishment. There is a perception that children living in foster care are irresponsible and do not know how to protect property and will damage it and others’ property. When young people leaving care try to rent a home and apply through advertisements, they are often confronted with a similar attitude.

As soon as they find out [young people] are from care, they immediately say they are not renting, or they raise the price so much [care leavers] cannot rent. And even if we go and try to talk, they often do not agree. In small towns, everyone knows everyone, it is hard not to hide that you are from care. (Municipal representative, Švenčionys)

Big cities are no better. They sometimes try to make a profit by renting for twice the amount and then paying half of it back to the child. The child cannot get the money in cash, so they cash it in. And children are naive, they do not understand what they are doing sometimes. Sometimes landlords just say: “They will destroy the flat, then I will have to repair it”. (Municipal representative, Kaunas region)

5.4.2. Successful experiences and elements of the current system that are working well

Like the discussions with people with disabilities and people leaving prison, participants struggled more to identify and articulate successful experiences and things that are working well for care leavers than they did with the challenges. Of the positive examples provided, most appear to result from inter-agency and interpersonal co‑operation, the creativity and commitment of staff working in the field, and personal initiative including utilising informal networks of people who are willing to help young people with their transition from care.

All four stakeholder groups talked about what is required to successfully transition a young person out of care. Creating a new home, a space of one’s own was noted by all the service provider participants as a cornerstone for building an independent life, together with education and the ability to plan one’s own resources. Ensuring adequate supports are in place was emphasised as particularly important for young people who may not have the same employment prospects as others.

Ensuring appropriate accommodation options for care leavers was a strong theme. The introduction of shared and “independent living” homes was viewed as a positive step forward, where a young person transitions gradually out of care to a life where they can take care of themselves. Renting in the private market appears more difficult, with some participants reporting that as soon as landlords discover that a potential tenant has been in care, their application is declined, or the rent is increased so much that the young person cannot afford it. Participants discussed state housing insurance as a possible solution to this problem. In this case, the landlord would know that any damage to the property or civil damage to neighbours would be covered by the state through an insurance company.

As in other focus group discussions, the value of publicising “success stories” to help reduce stigma, make employers and landlords less likely to exploit young people, and instil a sense of pride and self-confidence in young people themselves was raised. Participants also talked about encouraging communities to become more involved in the transition process for care leavers. The stakeholder groups felt that the potential for volunteering in this area is likely underutilised, particularly in activities aimed at reducing stigma.

Service users

Care leaver participants attributed the successes they have experienced to the opportunities they have had to access different types of support during the “preparing to leave” phase as well as after leaving care. Employment was not seen as an issue with service users saying they manage to find a job in one way or another. Financial literacy was also not seen as an issue because from the young people’s point of view, the money they receive is quite tightly controlled by law, with very clear regulations on when they can spend how much and on what.

Familiarisation with public authorities

In Švenčionys, care leavers were taken on a field trip to the social assistance office before leaving care, not only to find out what services were available, but also to physically visit, get used to, and overcome any fear of the institution. This experience was viewed very positively.

They took us on that tour, and I may have listened carefully at the time, but then, when I needed to, it was only from that tour that I remembered where to apply for benefits. (Service user, Švenčionys)

A support person

Care leavers talked about how valuable it would be to have a confidant they could talk to as an “adult”, this could be the person organising their transition process or another significant adult who is involved in their lives; someone who has the time to help them with the challenges they face including helping them with activities such as renewing a disability certificate or applying for a passport. As discussed earlier, the person should be someone the young person knows and can trust, from a close environment, rather than a stranger (this could be a relative, a friend’s parents or the like). This relationship should start early, while the young person is still in care, so that they can get to know them and establish a close relationship.

There is no one appointed now, so you find someone through friendships. For example, foster parents, parents of friends or classmates, who know, can give advice. It would be good that the carer from the shared home could, but she does not work with you anymore, so it does not always work out. (Service user, Švenčionys)

Financial independence

Young care leavers said they are sincerely grateful for the financial support provided to them for independent living. It relieves fears about the immediate future, although it can become a target for unscrupulous individuals who try to take advantage of their ignorance. The first money earned on one’s own is crucial to strengthening self-esteem and to becoming less dependent on others.

When we are already living on our personal earnings, it is very good, because we are already independent, whereas those who live on their parents’ income are less independent. (Service user, Švenčionys)

NGO representatives

Success stories shared by NGO representatives related to the personal involvement of staff, where one person passionate about solving a problem, has found a like‑minded person in another institution and together and because of their personal networks and efforts, they have achieved positive change. This may indicate that on the one hand, the system is open to innovation and local initiatives, but on the other hand, that there is not a systematic approach to supporting effective co‑operation.

Inter-institutional co‑operation

Effective co‑operation between NGOs and municipality service companies is often based on personal relationships and informal communication. Trust is essential, but if there is staff turnover and practices are not at least partially formalised, initiatives can fall over. A more formal system of co‑operation would prevent this, so when employees change, effective communication channels based on inter-institutional trust remain in place.

Clear rules for independent living homes

Independent living homes for young care leavers are viewed positively, however there is currently no clear framework or rules for how these should be managed. NGO representatives believe it is important to have rules that apply to everyone equally and are understood by everyone, i.e. what services are available, who needs them, and who is receiving them. By way of example, it is important that young people understand why escort services are needed, that they are not “guards” but intermediaries between the community and the care home, that they can provide a close, trustworthy link and are available to help in any situation.

They have a fear of moving from one care home to another. But they do not realise that they do not know how to be independent yet. That these “companions” can be just a close person, a counsellor who can advise and comfort if necessary. (NGO, Kaunas region).

They are seeking independence, so it is important to agree on when and how that accompaniment helps them. To form a business-like relationship, so that they make their own decisions, but after consultation and thinking through the alternatives. (NGO, Švenčionys)

It is important that information about available services is provided to the full range of professionals who work with care leavers and their companions. Companions require their own circle of advisors to advise them on the possible problems their foster children may face – financial, legal, psychological, etc. In addition to the general services of the companion, the young care leaver should also be provided with some direct advice on legal, financial, or other issues and psychological services.

Labour market inclusion

NGO representatives believe employment is crucial to a successful transition from care, particularly for those who do not progress to higher education. Employment is not just about financial independence or gaining social status, but also about creating and developing social ties. Internships and mentoring schemes can work well, where young people can try out different activities and get a feel for what works best for them. This can help care leavers and employers move past any misconceptions they have about each other. Several examples were provided of young people choosing careers or going on to work as employees after a summer internship.

Work is important, of course, but it is also important for them to gain new contacts and new relationships. They get involved in normal life. Feel more stable. (NGO, Švenčionys)

NGO representatives did note however that care leavers must have the opportunity to consult with a trusted support person such as their carer or companion before signing an employment contract, to ensure the conditions are what the law says they should be.

Increased resources

NGOs also suggested that more resources would contribute to the more successful integration of care leavers. Services should be charged at a normal rate because working with young people, especially in the case of “leading person” services, is not only time‑consuming, but also requires a lot of emotional effort. There is also a shortage of professionals. Expanding the range of professionals and services that are accessible (e.g. lawyers, psychologists, financial consultants) is not only necessary for the young people but also for the staff of the NGOs, who do not always know how to deal with some situations.

Social workers

Social workers struggled to identify existing good practices and tended to reference their personal experiences of working with care leavers. Social workers referenced practices in other municipalities, but their knowledge was limited, which suggests there is limited sharing of best practices between municipalities.

Involvement of local communities, NGOs and the public

Social workers believe that many of the challenges that have been identified could be solved by the greater involvement of local communities, NGOs or the general public. People such as assistants or “leaving persons” who are available to assist young people develop their adaptions skills, not just once or for a short period of time but for at least a year.

Financial literacy training

All participants from the social worker stakeholder group pointed out that financial literacy is a big problem for care leavers, and it should be taught at school. In that setting, all children and young people could learn about budgeting in a non-stigmatising way i.e. situations not necessarily related to living at home, for example, budgeting to attend a camp or a study trip etc.

There are no good practices at the moment, but maybe they could be something that they would all do together in schools as challenges. I do not know if my children are very literate, but at least they can ask me, but for those children, there is not much help. They are very absorbed in such things. I have advised one girl when she came out of foster care: “When you get your salary, pay the utilities first, then the food money, and only then look at what is left and plan what you want to buy”. So, I met her the other day, with a baby and she says: “I remember what you told me, I still do that”. (Social worker, Švenčionys)

Publication of good practices

As well as working with care leavers, service providers could work with the communities within which shared homes are located for example encouraging communities to become involved in a care leavers’ transition process. Publicising good practices in neighbourhoods, to create a sense of ownership is very effective so that those “rare” success stories of children adapting, and succeeding are recognised as a success for the system, and there is recognition and pride in having succeeded to get a young person on a better path. This is particularly important for professionals, and potentially it would help them to attract volunteers for activities that are traditionally understaffed.

Municipality representatives

Municipality representatives focused on the importance of accommodation and getting it right. They talked very positively about being able to provide transitional accommodation closer to the institution a care leaver lived in so that contact can be maintained after they leave and reduced gradually rather than suddenly. Municipality representatives believe when this transition is successful, other processes are less fragmented, such as financial counselling and representation with landlords, employers and other organisations.

Independent living homes

Municipality representatives believe that the introduction of “independent living” homes, thereby moving away from large children’s homes (residential institutions) can improve care conditions and the transition from care. This accommodation arrangement is considered very effective in creating a gradual transition, where the young person gradually moves from full care to a life where they must take care of themselves. This would be similar to the experience of children who leave their parents’ home to study and/or rent their first home, but who can return home if necessary. Young people leaving care also need such a buffer where they can feel supported by significant adults.

Municipality representatives in Kaunas region shared a success story where part of an “independent living” house was separated off and had a separate entrance. Three girls, aged 16, who were continuing their vocational training in Kaunas and wanting to live on their own, moved in. The social workers of the “independent living” home helped them to plan their finances and with shopping, to deal with shortages, and maintain their home. Both the staff and the three girls acknowledged that the experience was very positive.

We helped them settle in. We bought some non-perishable food – oil, flour, something else. We sat down together and planned how they would distribute their EUR 300 a month. How much per week, how much to put in. Their tickets to go to Kaunas on Monday and come back on Friday have been bought, so they do not have to worry. They live in a dormitory there. If they want to go back earlier, they have to pay for it. One day I got a call from a girl saying: “I do not have money for the week, what to do?” So, I say: “Wait for Friday, you have to survive those two days somehow”. We will of course lend her money, but she has to understand and ask for it. It is not for us to offer her. If you need help, ask. Sometimes they even do not know how to do that. Everything is very much done for them, thought out, planned. Now they are saying: “I had no idea how many things you have to think about when you live alone.” And they do not live alone, we pay the utility bills and so on. There needs to be a transitional period so that they learn those lessons safely so that there are adults around who want to help, not take advantage. (Municipal representative, Kaunas region)

We set up a separate housing next to the shared independent living house, just by separating part of the house. There are three girls living almost independently, learning a profession, and planning a budget. We visit them, they turn to us if they need us – we are all there. But that is the way it worked out for us, however, there is not always a possibility for that. But it is really effective. (Municipal representative, Kaunas region)

Municipality representatives also observed that where possible, if a minor owns a property when they enter care, that property should be preserved for them, either by renting it out or otherwise refinancing the costs. The possibility of returning to their home when the child reaches adulthood, or selling it to buy another one, can be a significant and positive step towards independent living.

We had a boy of 14 years of age, his mother died suddenly and then his grandmother, and he was left alone. But there was an apartment. We rented it while he was with us, and when he was about to leave, we all renovated it together, he bought furniture with the money he had from his move‑in, and now he lives there nicely. He has a home and some kind of connection with his family, they need those memories, their roots. (Municipal representative, Kaunas region)

We had a case where the father killed the mother in the flat, leaving twins, a girl and a boy, who came to us. That flat was still there. Nobody wanted to live there, you know, such a tragedy. In small towns, people are superstitious. But when it was time for them to leave, we consulted them and they did not mind – they fixed it up, and the sister is living there now with her husband and child. I do not know how she and her brother split up, but the house stayed for them to start a life. (Municipal representative, Švenčionys)

Publication of good practices

Municipality representatives believe that publicising good practices of young people successfully transitioning from care to independence not only reduces stigma in society, makes employers and landlords more vigilant and less likely to exploit young people, but also instils in the young people themselves self-confidence and the courage to pursue their own goals.

Municipalities currently manage publicity campaigns themselves, but municipality representatives believe that campaigns should be centralised, and creative work done by professionals in Vilnius (by the Ministry of Social Security and Labour, or a creative agency hired by the ministry). They agree that while information is known locally, they lack both the expertise and the time to write quality articles and, in the end, the desired impact is not being achieved i.e. public engagement, reduction of stigma and increased patronage. The Karas Keliuose (War on Roads) campaign which aimed to reduce the consequences of unsafe driving was provided as an example of a campaign that was carried out centrally, using both national and local media channels, achieving good results.

5.5. Conclusion

The objective of this chapter has been to describe how people with disabilities, people leaving prison and care leavers experience the delivery of public services in Lithuania based on their feedback. The views of service users themselves have been complemented with those of people who work with them – NGOs, social workers, and municipality representatives. This section draws together the focus group discussions about the challenges, the successes, the good ideas and the aspirations into a small number of key conclusions.

5.5.1. The challenges

A surprising number of challenges were common across all three groups. A lack of appropriately qualified staff was raised time and time again in the workshops. This ranged from a shortage of professionals such as psychologists to simply a need for more staff and volunteers with the right experience and qualities. All three service user groups talked about how important it is that the people who work with them have the right characteristics, for example, a positive attitude. They want people to encourage and empower them, not merely do everything for them. People with disabilities said that service providers with the right communication skills were more likely to be highly valued; people leaving prison said they sensed a lack of empathy and positive attitude from both the individuals and institutions that work with them; and care leavers in talking about teachers commented that the characteristics they want in a teacher (e.g. a sense of ambition for them) are often found to be the exception rather than the norm.

Stigma is a major issue for service users, particularly for people leaving prison and care leavers. People leaving prison believe they are often seen as dangerous and unworthy of help, even by the people whose job it is to help them. As well as citing examples of discrimination such as being denied housing or paid less for unskilled work, care leavers said that often less is expected of them i.e. they are not encouraged to continue their education or to have professional ambitions. Only one service user in the disabilities workshop said they had experienced negative attention from others, with most participants saying the situation has changed for the better in the last ten years. Now, people around them are willing to help if needed and they do not often feel any negativity. When discrimination was talked about, it was in terms of a lack of access to the same opportunities as able‑bodied people, for example, fewer jobs being available because employers lack an understanding of what people with disabilities can do and what it would cost to modify the workplace for them if required.

Finally, a lack of co‑operation and co‑ordination between institutions is a common problem which workshop participants believe leads to issues such as institutions not always knowing what services they or other providers are offering to a particular service user, overlapping or duplication of services and service users not being aware of what other services they might be entitled to. Poor or inadequate information can exacerbate the problem. Despite a view that many services are available, participants observed that the information about those services can be difficult to find and/or overly bureaucratic and complicated. Service providers observed that better co‑operation between institutions would allow them to better target their efforts.

Several challenges relating to the specific target groups are worth highlighting. People with disabilities noted that their needs are often perceived in a very physiological way which can result in receiving services that focus them on their disability when what they want is a more holistic approach to the support they receive i.e. supports and services that help them to overcome exclusion and participate more fully in society. The lack of appropriate services for families of service users was raised in both people with disabilities and the people leaving prison workshops.

For people leaving prison, lack of (safe) accommodation options, particularly for male prisoners immediately upon release, is a pressing issue. Some service users reported not having anywhere to go while service providers reported that the use of night shelters, which are not viewed as suitable, is common in some municipalities. Service users said they would value an intermediate environment between prison and full independence where they have the time and space to adjust to living outside prison and where they can learn or re‑learn basic living skills. A much earlier start to the reintegration process (i.e. well before people leave prison) would also be valuable.

Greater preparation and planning for living independently was also discussed in the care leavers’ workshop. Care leavers talked about feeling quite unprepared for “suddenly” having to look after themselves. Care leavers need access to both tangible and intangible supports such as having a significant adult involved in their lives to transition successfully to independent living. Municipality representatives believe supporting independent living could take one of two forms: either the young person lives independently and is in regular contact with an appropriate support person, or they could live next to a shared home and run their own household, supported by a social worker.

5.5.2. The successes and opportunities for improvements

Across the board, workshop participants struggled to identify and articulate successful experiences and things that are working well. While participants provided a small number of concrete “success stories” they focused more on potential solutions to specific problems and what they believe is required to better support service users. This does not mean there have not been positive improvements to the services delivered or how they are delivered, but the stakeholders all agreed there is a lot more that can be done for all three groups.

Each stakeholder group focused on different aspects of service provision, based on their specific roles in the system. One solution (in response to the issues of stigma and discrimination) that was raised by all four stakeholder groups across the three workshops was the potential value of publicising good news stories. There was a strong view that a joint and systematic approach to disseminating successful experiences and practices within and across different institutions and municipalities to improve public awareness and education would be highly valuable. For example, service providers suggested that disseminating stories of people with disabilities successfully engaging in the labour market may encourage more employers to hire people with a disability.

Increased co‑operation and collaboration between institutions was described as critically important for improving service provision for all service users. NGO representatives went as far as saying better co‑operation is what will help to solve many of the other problems. Several examples of successful co‑operation were provided, for example NGO representatives and social workers stressed how valuable they have found the support of municipalities in creating employment opportunities for people with disabilities.

Some service providers believe that co‑operation is currently based more on personal relationships and informal communication and while this may be working initiatives can fall over for example if staff change. Formal systems and practices would help to prevent this, so that if employees do change, communication channels remain in place. Social workers believe that more frequent roundtables would be valuable, so that respective responsibilities are better understood, and people can share their experiences, including practices that are proving to work.

Promoting autonomy was a consistent theme, and while it may have been expressed differently for each group, the idea was the same – service users being supported and encouraged to progressively make more decisions and choices for themselves. The value of living arrangements that help service users increase personal responsibility such as shared housing with associated programmes and services that support independent living were discussed in all three workshops. In the care leavers workshop for example, service providers talked about young people living in an environment where they can gain independence gradually, within a support system of a professional support person(s), parents, other family members, and friends.

Finally, stakeholders raised representation and advocacy as important factors in improving service provision, for example, service users and their representatives having the opportunity to participate directly in service design and decision-making processes (“client voice”) so their needs are fully understood and accommodated. Municipality representatives noted that while they often encounter organisations representing children with disabilities or care leavers for example, they are not as familiar with organisations representing people leaving prison and that there are lessons that could be learned from groups who have established organisations to represent their interests.

Note‑worthy solutions specific to each of the three groups included, starting with people with disabilities, the importance of understanding the unique challenges people with disabilities face so their needs are not only met through targeted services but are also taken account when designing universal services. Remote learning during the COVID‑19 pandemic enabled more participation in the learning process, particularly for those with mobility issues, and service users would like to see more educational programmes and cultural activities offered online.

Accessibility is a major issue and participants want more effort put into addressing the challenges associated with limited mobility, including private as well as public institutions being required to adapt their environment for people with mobility issues and making lists of places that are accessible to people with disabilities readily available or creating an award for easily accessible places. Access to workplaces and/or training institutions, services such as health services, as well as cultural events was also raised as a challenge. Service users would like better access to cultural and other social events that would help them to get out of the home, where they could socialise with other people and not be so isolated.

The issue of institutional discrimination is particularly acute for people leaving prison, with most service users reporting they have experienced it, not only from private institutions such as banks but also from service providers and other professionals involved in their reintegration process. The success of an ex-prisoner’s re‑integration into society depends in large part on the quality of the contact they have with institutions and individuals. People leaving prison believe support is most effective when it is delivered in a community-based setting, for example in a rehabilitation centre or through organisations like Caritas. Many of these rehabilitation centres are run by people who have been in prison themselves, and so not only can people leave prison learn or re‑learn basic skills in a safe environment, but they can do so without feeling “looked down upon”.

Care leavers talked about the value of supports, for example, workshop participants said they are sincerely grateful for the financial support provided to them for independent living. It relieves fears about the immediate future. Care leavers also talked about wanting a confidant they could talk to as an “adult”, this could be the person organising their transition process or another significant adult who is involved in their lives; someone who has the time to help them with the challenges they face. Trusted relationships are built over time and so whoever the support person(s) is, they should be a constant in the young person’s life, while they are building their own adult life.

There is no doubt from the information workshop participants shared that people with disabilities, people leaving prison and care leavers face significant challenges, some unique, many the same, in receiving the supports and services they need to help them live the lives they want to live, the lives most people take for granted. While concrete examples of “success stories” were limited they do exist and were provided in the workshops. Furthermore, workshop participants spoke enthusiastically about potential solutions and improvements that could be made to improve social services for all three groups of service users.

Suggestions for improving service delivery

The suggestions in this box build on the experiences of users and key stakeholders involved in the delivery of public services and complement the recommendations provided in the other chapters of this report.

To identify and address the gaps, overlaps and complexity in service provision, Lithuania could consider:

• Consolidating some existing services and tailoring them more to the service user to simplify service promotion, to reduce duplication and to make service provision more transparent and effective.

• Ensuring consistent coverage of service provision across all municipalities and improving resources for smaller communities where necessary.

• Shifting the service focus from assisting service users to empowering them, promoting autonomy among service users, and encouraging them to progressively make more decisions and choices for themselves.

• Introducing case management for people with disabilities to help them identify the right mix of services (building on the experience with the recently introduced preparation and planning support for people leaving prison and care leavers).

• Providing more opportunities for service users and their representatives (including NGOs) to participate directly in service design and decision-making processes (“client voice”), so their needs are fully understood and accommodated in the design and delivery of services.

• Reviewing and where necessary improving the supports available to the families of service users.

To ensure service users are sufficiently prepared and supported to live independently, Lithuania could consider:

• Offering a range of services to inmates while they are still in prison to prepare them for their return to society (e.g. education, training, psychological support, etc.).

• Ensuring consistent implementation of the preparation and planning process for independent living for care leavers and people leaving prison across municipalities.

• Guaranteeing the development of an individual action plan for each care leaver and inmate to guide their transition process, so their individual reintegration needs are understood, and relevant service providers are identified to ensure that services are available upon release.

• Involving service users in the development of their individual action plan.

• Ensuring all inmates are met by a service provider on their release date at the prison gate to be accompanied to their accommodation.

• Increasing the availability of safe housing options, either through “independent living” homes where care leavers/ people leaving prison /people with disabilities can receive support for independent living, social housing, or through collaboration with private housing market (e.g. state housing insurance).

• Supporting target groups to build an adequate social network, e.g. through volunteers, who can help them in the transition to independent living.

To ensure adequate human resources and skills to deliver for these service user groups, Lithuania could consider:

• Undertaking a workforce planning exercise for social service provision, with the aim of developing future‑focused workforce strategies and plans.

• Exploring how to attract more volunteers, e.g. through campaigns aimed at attracting volunteers such as retired people to help run activities for and with young people.

• Making the personal attributes and characteristics necessary to work effectively with service users a core competency required of employees and considering how to build this into the recruitment process.

• Reviewing the training provided for staff working with service users (social workers in particular).

• In the case of people leaving prison, considering more community-based services provided by staff who were once prisoners themselves.

To increase and improve co‑operation and co‑ordination between institutions, Lithuania could consider:

• Reviewing and strengthening institutional co‑ordination mechanisms within and between all governmental and non-governmental stakeholders through stronger public governance arrangements.

• Improving greater sharing of information between institutions by identifying and addressing the barriers to information sharing.

• Introducing more regular meetings and networking forums, e.g. between municipalities, NGOs, service users and their representatives, to better understand the needs of service users, as well as “roundtables” for officials where information about respective responsibilities, changes to policy or legislation, best practices and successful innovations can be shared.

To improve the quality and flow of information to service users and service providers and between and within institutions and municipalities, Lithuania could consider:

• Rationalising the information available to service users and making it more “user-friendly”, including making more information available on-line.

• Introducing a directory of services and partners that can be accessed by service users as well as those work with them and support them (e.g. family members).

• Making more information available about the effectiveness of services, e.g. a research “clearinghouse”.

• Asking service users what information they would find useful and how they would like to receive it, e.g. lists of places that are accessible to people with disabilities.

• Reducing the bureaucracy and documentation required to access services, including through digitalising documentation.

To eliminate or at least significantly reduce the stigma and discrimination experienced by service users, Lithuania could consider:

• Establishing a joint and systematic approach to disseminating “good news” stories, i.e. stories of successful experiences and good practices, within and across different institutions and municipalities as well as for the general public to improve public awareness and education.

• Assigning service users with a “trusted adviser”, someone who can provide advice and represent or advocate for them (e.g. in the case of care leavers this role was described as a significant adult who has the time to help them with challenges).

• Introducing education campaign(s) within institutions who work with vulnerable groups to combat (public) institutional discrimination.

• Increasing/improving integration into the labour market through close collaboration between the public employment service and employers.

• Encouraging/supporting better organisation of advocacy groups for some service user groups who can help represent their interests.

• Providing opportunities for peer-to-peer networking.

Annex 5.A. Focus Group Discussions guide

IMPORTANT: At the beginning of the meeting, the researchers:

• Distribute at each table a sheet where the participants can note their full name, municipality and institution. This information will help the researchers to note “who says what” for the report.

• Name a representative per the table who will present the conclusions to the rest of the group after the table discussions.

1st discussion: Main issues and challenges around public service delivery (45 minutes)

• In your own opinion, what are the main issues/challenges surrounding public service delivery in your municipality?

• Could you please provide some concrete examples of those issues/challenges?

• What do you think are the main reasons/factors that trigger these challenges?

• [Only for Users] Have you faced any difficulties in trying to access the following services due to (your disability/your condition of young care leaver/ex-prisoner)?

  • Employment services

  • Education services

  • Healthcare services [Please probe for mental health care services]

  • Social services [See below the complete list of social services for your reference]

 

General services	Special services
	Social assistance services	Care services
Information	Home assistance	Day social care
Counselling	Support to develop or restore social skills	Short-term social care
Mediation and representation	Support for independent living	Long-term social care
Provision of food	Accommodation in night shelters	Temporary respite (care)
Provision of clothing and footwear	Accommodation in hostels
Transport	Accommodation in other forms of temporary accommodation
Socio-cultural activities	Intensive‑crisis resolution assistance
Personal hygiene	Psychosocial assistance
Open youth work	Temporary respite (assistance)
Youth work on the street	Support for carers, adoptive parents and guardians
Mobile youth work	Day-care services for children

• [For all groups except for Users] In your opinion, do people with disabilities/young care leavers/ex-prisoners face any difficulties in trying to access the following services due to (your disability/your condition of young care leaver/ex-prisoner)?

  • Employment services

  • Education services

  • Accessing healthcare services [Please probe for mental health care services]

  • Accessing social services [See below the complete list of social services for your reference]

 

General services	Special services
	Social assistance services	Care services
Information	Home assistance	Day social care
Counselling	Support to develop or restore social skills	Short-term social care
Mediation and representation	Support for independent living	Long-term social care
Provision of food	Accommodation in night shelters	Temporary respite (care)
Provision of clothing and footwear	Accommodation in hostels
Transport	Accommodation in other forms of temporary accommodation
Socio-cultural activities	Intensive‑crisis resolution assistance
Personal hygiene	Psychosocial assistance
Open youth work	Temporary respite (assistance)
Youth work on the street	Support for carers, adoptive parents and guardians
Mobile youth work	Day-care services for children

• Which of those were the most problematic/difficult to access?

• In your opinion which of the following challenges are most urgent to tackle regarding the provision of public services in your municipality? [Ask the participants to rank the challenges in terms or urgency. Please add other challenges to the list if they have been mentioned during the first part of the discussion. Ask participants to explain their decisions if the challenge has not yet been discussed in one of the previous questions.]

  • Limited resources

  • Lack of co‑operation between services

  • Unawareness of existing services among users

  • Limited availability of services

  • Low quality of services

  • Services are not easily accessible (possible reasons: distance, price, stringent conditions…)

  • Stigma

  • Other (please, specify)

2nd discussion: What is needed to improve service delivery (45 minutes)

1. [Only for Users and Family/friends] Could you please share a pleasant/successful experience you had with public service providers in your municipality?

[Probe:

• What type of service were you trying to access?

• Who provided the service?)

2. [Only for Social Workers/NGO representatives] Could you please share a pleasant/successful experience you had when providing public service to people with disabilities/ex-prisoners/ young care leavers?

[Probe:

• What type of service were you providing?

• What was the profile of the person trying to access the service?]

3. What elements in particular made that experience a pleasant/successful one?

4. What do you think we can learn from each of those examples?

5. Based on those examples, or other experiences/knowledge, what would be your recommendations to improve public service delivery in your municipality?

6. In your opinion, which of the following solutions would be most welcome to improve public service delivery in your municipality? [Ask participants to rank options. Please add other recommendations to the list if they have been mentioned during the first part of the discussion. Ask participants to explain their decisions if the topic has not yet been discussed in one of the previous questions.]

• Increase resources

• Improve co‑operation/co‑ordination between services

• Locate services in one place

• Raise awareness among users of existing services

• Introduce new services

• Improve the quality of services

• Improve the accessibility of services (distance, price, conditions…)

• Address stigma

• Other (please, specify)

3rd discussion: Common challenges and recommendations (50 minutes)

Table debrief (10 minutes).

Each group should identify the three main issues/challenges surrounding public service delivery in Lithuania and the three main recommendations to improve such delivery. The representative of the table will present their conclusions to the rest of the group.

Open debrief (40 minutes).

1. What are the three main challenges surrounding public service delivery for vulnerable groups in your municipality? Each table has selected three challenges and explains to the whole group why they chose them.

2. Any reactions from the other tables? How does this list compare to their own list? Are there any issues that surprise them? What can you learn from the other lists?

3. What are the key recommendations to improve public service delivery for vulnerable groups in your municipality? Each table has selected three recommendations and explains to the whole group why they chose them.

4. Any reactions from the other tables? How does this list compare to their own list? Are there any issues that surprise them? What can you learn from the other lists?

Note

← 1. Note

In 2020, the Ministry of Justice and the Ministry of Social Security and Labour (MSSL) enacted an order on the social reintegration of people released from correctional institutions (“ex-prisoners”). The order entered into force on 1 January 2021 and serves as a co‑operation instrument among municipalities, NGOs, correctional institutions and probation offices for the provision of integrated and personalised services to people leaving prison.