Are People Really "Hard to Reach" - or Are Our Systems Hard to Access?

Over the past seven years of doing community-based work, I've heard the phrase "hard to reach" more times than I can count.

It is often used to describe people experiencing homelessness, serious mental illness, substance use, housing instability, or other complex barriers. Someone doesn't answer the phone. They miss an appointment. They don't complete a referral. They disengage from a program.

Eventually, they become "hard to reach."

But I've started wondering whether we're describing the person- or the system.

Access is Not the Same as Engagement

Our health and social service systems have more resources than many people realize. There are housing programs, behavioral health services, benefit programs, food resources, care management programs, and increasingly sophisticated referral networks.

Yet having a resource available does not necessarily make it accessible.

A phone number is not access if someone's phone has been disconnected.

An online application is not access if someone doesn't have reliable internet.

A referral is not access if the person has already called five organizations and been redirected five times.

And handing someone a list of resources is not the same thing as helping them successfully connect to one.

People Are Showing Up Somewhere

One of the most important things I've learned through community-based work is that many people considered difficult to engage are, in fact, engaging.

They show up at food pantries.

They visit community centers.

They go to libraries.

They attend neighborhood resource fairs.

They return to places where someone remembers their name and where asking for help does not require navigating another complicated intake process.

That raises an important systems-level question:

If people are already showing up in trusted community spaces, why aren't we building more of our health and social-support infrastructure around those spaces?

The Gap Between Referral and Resolution

Housing has made this especially visable to me.

A person facing eviction may technically have multiple resources available to them. But knowing that a resource exists is only the beginning.

They may need help determining which program applies to their situation, gathering documentation, communicating with a landlord, navigating public benefits, understanding notices, making multiple phone calls, or figuring out what to do when the first option doesn't work.

The same is true for someone experiencing homelessness who needs behavioral health care, identification documents, benefits, transportation, food, or permanent housing.

The gap between “I gave someone a referral” and “this person successfully connected to support” can be enormous.

That gap is where relationships matter.

Maybe We Need to Rethink “Hard to Reach”

There will always be circumstances where someone does not want services, and respecting individual choice matters.

But I think we should be cautious about using “hard to reach” as an explanation for disengagement without also examining the systems doing the reaching.

Did we go where people already are?

Did we make it easy to come back?

Did someone follow up when the first connection failed?

Did we build trust before expecting disclosure?

Did we design the process around the realities of instability—or around the administrative needs of our organizations?

These aren’t questions with simple answers. They are questions I find myself asking more often as I continue this work.

Maybe the challenge isn’t figuring out how to make people better at navigating increasingly complicated systems.

Maybe part of the answer is building systems that are better at reaching people.

And perhaps instead of asking:

“How do we get hard-to-reach people into our systems?”

we should start asking:

“How do we bring our systems closer to the places where people already feel comfortable showing up?”

View the original article on Brittani Hall's LinkedIn.