Scottish Government Prevention Unit: Areas of Shared Interest

Area of Shared Interest 2 – Person-centred Services

Introduction

This area of shared interest invites focusses on person-centred prevention, in particular how services can be designed around people’s needs, strengths and circumstances to ensure they receive the right support at the right time.

It explores also how interventions and systems can better support individuals experiencing multiple disadvantage, where overlapping challenges can compound and lead to poorer outcomes. This includes consideration of how to support Scotland’s “hard edges” population - a relatively small group of individuals who experience multiple and interconnected disadvantages, often resulting in significant and persistent impacts on their wellbeing and life chances.

Why we are interested in the topic

Prevention works best when it is well targeted at those who need it most. “Person centred” services focus on getting the right support around the individual, recognising each individual’s differences or circumstances. In some cases, prevention will be population-wide action, such as a vaccine, that impacts all groups. In other cases, it will be targeting groups are particular risk of harm, such as targeted tenancy sustainment support for someone at risk of homelessness. Designing preventative interventions and services to better support individuals needs will increase the impact we have on reducing negative outcomes and future demand for public services.

A particular area of interest is understanding how services can better support individuals who experience multiple and interconnected harms. These individuals may face a combination of challenges, such as substance use, poor mental health, homelessness, involvement with the justice system, poverty, or trauma, which interact to create significant barriers to wellbeing and opportunity. The concept of Scotland’s “Hard Edges” population, drawing on research by the Robertson Trust, highlights how a relatively small number of individuals can experience multiple disadvantages simultaneously, often resulting in intensive interaction with acute public services and poorer long-term outcomes.

Understanding how services can be designed around the needs of these individuals offers an important opportunity to improve outcomes, prevent crises from escalating, and reduce demand for reactive public services over the longer term.

Existing work in this area

There is a large body of research and data development in the Scottish public sector looking at the needs of individuals, and how to enact person-centred approaches. This includes recognising that people rarely fit neatly into single policy categories and that outcomes are often shaped by the interaction of multiple characteristics, experiences and circumstances. Understanding these intersectional inequalities is important to ensuring services respond to the whole person and their needs, rather than addressing issues in isolation.

In Scottish Government, there is a number of strategies that are looking at particular groups, such as the Child Poverty Delivery Plans, Alcohol and Drugs Mission, Mental Health and Wellbeing, Coming Home Action Plan, Disability Equality Action Plan and Violence Prevention approaches. In health there are a number of policies, such as screening, that are targeting key at-risk groups of the population and intervening at the right point.

In the wider Scotland landscape, there are a range of reports that focus on key cohorts and how services can be developed to provide the right support to these groups. Examples include:

• The Lankelly Chase 2019 report Hard Edges Scotland provided the first Scotland-wide estimate of the scale and nature of severe and multiple disadvantage.
• The Homelessness Network Scotland plan to launch “the Level” in October. This builds on the Hard Edges report, and provides a shared framework and protocol for applying a “No Wrong Door approach” to those facing severe and multiple disadvantage, helping partners identify needs earlier, coordinate support and prevent people becoming trapped in cycles of crisis and poor outcomes.
• The Promise Follow the Money report (2020) examines the financial and human costs of Scotland’s current care system, highlighting that poor outcomes for care-experienced children and adults create significant long-term social and economic costs. It argues that investing earlier in families, relationships and preventative support would deliver better outcomes while reducing demand for crisis services and the costs associated with system failure.
• The Scottish Health Equity Research Unit Inequality Landscape report highlights that men aged 18–44 are often overlooked by preventative policy despite facing elevated risks of drug deaths, alcohol deaths, suicide and other "deaths of despair".
• The Scottish Parliament Information Centre (SPICe) has developed briefing on specific issues and cohorts, including a 2025 report developed examining men’s mental health in Scotland.
• Drug Research Network Scotland have developed research on preventing substance use-related harms among young people in Scotland, focussed on young people under age 25.
• The Scottish Government's Inequalities and challenges experienced by disabled people in Scotland evidence review synthesises evidence on inequalities experienced by disabled people across areas including health, education, housing, employment and poverty, highlighting the importance of understanding how disability intersects with other aspects of identity and circumstance.

Areas for future exploration

While there is a strong evidence base on specific disadvantaged groups, there are opportunities to build a better understanding of how multiple risks interact across an individual’s life and across different public services. Much of the current evidence remains focused on individual policy areas, rather than the whole-person experience.

There is also scope to improve how we identify and understand cohorts that may benefit most from preventative intervention. This includes exploring how administrative data, service intelligence and lived experience can be used to identify emerging risks earlier and target support before poor outcomes become entrenched. Alongside this, there is a need to better understand the role of community capacity building in prevention, including how resilient, inclusive and connected communities can strengthen protective factors, support wellbeing and help prevent negative outcomes from arising in the first place.

Further research is needed on what works in delivering person-centred prevention in practice. This includes understanding which approaches are most effective for different groups, how interventions can be tailored to individual needs, and how outcomes should be measured over time.

Addressing these gaps will help strengthen the effectiveness and impact of preventative action across Scotland.

Shared research and policy questions

To support the development of thinking in the area of person-centred services, we have established a set of shared research and policy questions set out in Figure 3.

Connecting on this area of shared interest

This area of interest is shared by a number of key policy areas in Scottish Government, such as public protection team and Whole Family Support, who focus on person-centred approaches to prevention and wider service provision. The Scottish Government Prevention Unit is coordinating contributions to support these policy areas.

Contributions will be considered as part of future service design for key programmes such as Whole Family Support to improve how these services are offered and delivered.

Person-centred services is a planned component of the Prevention Investment Framework and will provide a lens, alongside other factors, to ensure prevention activity is focussed around people and their unique needs.

Contact

The Prevention Unit PreventionUnit@gov.scot can support with coordination of contributions to ensure they reach the right teams.