Trust Development in Street-Based Outreach: Building Engagement with Vulnerable Populations in Helsinki

Abstract

This article describes the everyday operating practices of a team of municipal outreach workers in Helsinki and analyzes their strategies for building trusting relationships with clients on the street. Drawing on participant observations and ethnographic interviews, the analysis focuses on key processes involved in engaging hard-to-reach populations. Trust development from the perspective of outreach workers emerges as the result of three primary outreach strategies: (1) gradual engagement, (2) authentic interaction, and (3) team reputation management. Engaging in these strategies enables outreach workers to create contact and support individuals who are otherwise not reached by the welfare services. Trust is an essential prerequisite for connecting vulnerable populations with appropriate services, and therefore understanding the processes involved in nurturing trusting relationships is paramount for developing effective outreach programs.

Introduction

“We once had this project with a woman who was rough sleeping, and it took us a very long time to build trust with her. But she was part of a circle of local people and those other people already knew us and trusted us. So, we had a lot easier time establishing contact with her than any other worker from the social and health services. It took us a long time, but slowly we were able to make progress. At first, she refused to accept really anything else except maybe a coffee or something. But then she started to really enjoy talking with us, and so that’s what we did. She seemed to get a lot out of those conversations. And then finally one day, when it was pouring rain and cold outside, she agreed to hitch a ride with us to the emergency shelter. She hasn’t been sleeping outdoors since then and she’s still on the same path we started her on that day.” (Jesse, an outreach worker in Helsinki).

Trust is an essential component of social work practice and is particularly important in street-based outreach work with marginalized populations. Outreach workers operate outside institutional spaces of care and engage people in the everyday milieus of public urban spaces. The people they target are often described as “hidden populations” because of the way that existing services fail to reach them (Szeintuch 2015). Outreach is designed as a method for creating contact with these socially excluded groups and for making social and healthcare services more accessible for people in need (Mikkonen et al. 2007). Research has shown that trust is a key factor in the effectiveness of outreach interventions and in promoting positive outcomes for clients (Kryda and Compton 2009; Olivet et al. 2010). However, building trust can be challenging in these contexts, due to the complex and difficult circumstances often faced by individuals who are left outside services. Distrust of service providers and care avoidance is prevalent, especially among people experiencing long-term homelessness. Previous studies have found that this is due to exclusionary practices in welfare services, a lack of appropriate services for those with complex needs, and social stigma (Cortis 2012; Klop et al. 2018; Maeseele, Bouverne-De Bie, and Roose 2013). Respecting client autonomy and offering services aligned with individual preferences are found to be important characteristics of successful outreach programs (Bond, Wusinich, and Padgett 2022; Mikkonen et al. 2007). Consequently, outreach work requires professionals to build highly personalized relationships with clients and to nurture trust through informal interaction and affective rapport. Within the context of the diminishing welfare services in Finland, this exemplifies how “intimate governance” has become an important tool for the welfare system to address its problems of access and to engineer trust through locally embedded and physically present professionals (Vollebergh, De Koning, and Marchesi 2021).

While there is a growing research interest in how outreach methods are used to overcome problems of access to services, the specific strategies outreach workers employ to develop trust with their clients remain largely uninvestigated, apart from a few notable exceptions in which trust is discussed as a key issue (e.g., Kryda and Compton 2009). In this article, I describe the everyday operating practices of a team of municipal outreach workers in Helsinki and analyze their strategies for building trusting relationships with clients on the street. The analysis draws on 7 months of ethnographic fieldwork that I carried out while embedded with the team. As the quote at the beginning of this article illustrates, trust development from the perspective of outreach workers emerges as the result of three primary outreach strategies: (1) gradual engagement, (2) authentic interaction, and (3) team reputation management. Engaging in these strategies enables outreach workers to establish contact with individuals who are otherwise not reached by the welfare services. Trust is an essential prerequisite for connecting vulnerable clients with appropriate services, and therefore understanding the processes involved in nurturing trusting relationships is paramount for developing effective outreach programs.

Street-Based Outreach Work

In street-based outreach work, social and healthcare workers collaborate to provide support to vulnerable individuals outside institutional spaces of care. Also known as “street work” (Szeintuch 2015) and “detached outreach” (Rhodes 1996), its main principle is that services are delivered to the target population’s own environment (Mikkonen et al. 2007). This is done to counteract the barriers to access that outreach clients typically experience in welfare services. Broad target groups include people experiencing homelessness, substance abuse problems and/or mental illness (e.g., Hall 2017; Rowe 1999). Outreach work on the street may also specifically target, for instance, youth at risk (Gibson 2011) or sex workers (Graça, Gonçalves, and Martins 2018). While the specific target populations may vary depending on the context, the aim of outreach is to create contact with groups and individuals that existing welfare services fail to reach. Outreach is often conceptualized as a bridge between the client and the system (Grymonprez, Roose, and De Corte 2022) as outreach workers aim to directly facilitate their clients’ access to welfare services.

From the perspective of mainstream welfare providers, outreach workers engage people on the street who don’t make “good clients” (Hall 2017, 79). In welfare services these types of clients are variably labeled as “care avoiders” (Maeseele et al. 2013), “difficult patients” (Koekkoek, Van Meijel, and Hutschemaekers 2006), “service refusers” (Beresford 2005), and “hard-to-reach” (Andersson 2013; Cortis 2012; Saario, Hall, and Lydahl 2021). Explanations for the low service uptake abound, but in most cases, they are based on the perspective of service providers and policy makers instead of the people themselves who are marginalized from welfare services (Cortis 2012). Furthermore, welfare bureaucracies have a tendency to focus their efforts on those clients who are the easiest to assist and avoid those who are the most challenging (Lipsky 2010). In outreach literature, it is consequently a crucial point of discussion of how clients on the street often have good reason for distrusting service providers and how outreach workers should counteract these processes when engaging target populations (Bond et al. 2022; Kryda and Compton 2009). Assisting people on the street requires outreach workers to repair a lack of confidence in the system and convince their clients that despite their negative past experiences the system remains a viable option (Smith and Hall 2018). The need to win over trust is consequently paramount for successful outreach intervention (Olivet et al. 2010). Previous research has highlighted that outreach does not simply involve providing tangible resources; it is also about developing caring and sincere relationships with clients that are based on trust, dignity, respect of autonomy, and a recognition of individual needs (Bond et al. 2022; Rowe 1999).

While previous research on street-based outreach work has highlighted these critical ingredients for engaging vulnerable populations on the street, an analysis of how trust between outreach workers and their clients develops in everyday encounters remains largely uninvestigated. In fact, a few years ago Curtis Smith and Leon Anderson suggested in this journal (2018) that future analysis of outreach practices should examine outreach workers’ strategies for building trusting relationships with their clients. This article takes their suggestion as a starting point for an analysis of how outreach workers in Helsinki develop and maintain trust while engaging hard-to-reach populations. In this article, I use the phrase “hard-to-reach” in a practical sense to describe and denote a target population, who from the perspective of outreach workers, is virtually impossible to reach by other working approaches.

Trust Development in Client–Professional Relationships

Trust is a complex and multifaceted concept that has been studied extensively across academic disciplines and has produced a wide range of definitional debates (e.g., Misztal 1996; Möllering 2006; Rousseau et al. 1998). Although a definitive consensus has unsurprisingly not been reached, there is considerable overlap in terms of what scholars propose are the general characteristics of trust (Rousseau et al. 1998). Scholars generally define trust as an individual’s willingness to accept vulnerability, based on the expectation that other people will act in a favorable and reliable manner (see Gambetta 1988a; Lewicki, Tomlinson, and Gillespie 2006; Mayer, Davis, and Schoorman 1995; Möllering 2001; Rousseau et al. 1998). Trust, therefore, involves an inherent lack of certainty whether or not the one who is trusted will bring harm to the one who trusts (Möllering 2006). The trustor forms a future-oriented expectation that this vulnerability will not be exploited (Behnia 2008). According to Niklas Luhmann (1979), this willingness to accept vulnerability implies that trust is a device for coping with the freedom of others. One cannot monitor or control the agency of another, nor have knowledge of all potential contingencies (Giddens 1990; Mayer et al. 1995). Trust, accordingly, reduces the social complexity of engaging with others and facilitates cooperation between people and organizations (Gambetta 1988b; Luhmann 1979; Mayer et al. 1995).

For the purposes of understanding trust development in client–professional relationships, it is important to distinguish between some of the different scales and types of trust, and how these are interrelated. At the macro scale, social trust (or, generalized trust) refers to the belief in the integrity of people whom one does not know personally and the extent to which individuals can depend on others for help (Putnam 2000). This form of trust is distinguished from institutional trust, such as trust in democratic institutions (Misztal 2001; Norris 1999). Institutional trust is also referred to as trust in systems. Giddens (1990) distinguishes within system-based trust a further component, which is trust in expert systems; such as trust in doctors and lawyers. Trust in expert systems is crucial to the functioning of public institutions because lay individuals interact with institutions predominantly through representatives of institutions in what Giddens calls “access points” (Giddens 1990, 83). The experiences that individuals have at access points shape their perceptions of the abstract system. Finally, at the everyday, micro scale is interpersonal trust, which refers to trust between individuals. Interpersonal trust—which requires a degree of familiarity—is highly context-specific: it is shaped by the cultural setting (Friederike and Nadezhda 2012), the societal context (Behnia 2008), and the personal characteristics of the individuals involved (Rotter 1980).

It is often suggested that in client–professional relationships institutional trust overlaps with interpersonal trust (e.g., Smith 2001), especially in situations where the client is in a vulnerable position in relation to the professional and is dependent on their favorable actions (Christensen 2013). This is often the case in social work settings, in which the social worker has the power to make decisions that directly impact their clients’ lives. Furthermore, social workers possess expertise and specialized knowledge of the inner working of the welfare system, which underscores their clients’ dependency on them (Candlin and Crichton 2013). The significance of interpersonal trust in social work settings is due to the vulnerability and uncertainty that the client experiences in the service encounter. In approaching the welfare services, the client accepts the risk of disappointment and forms an expectation that the social worker does not act to their disadvantage (Smith 2001). This vulnerability can be heightened by the necessity to disclose personal information and often sensitive details about their life situation. In order to do so, the client needs to develop a high esteem for the social worker and perceive them as a competent and benevolent person who is honest and genuinely caring (Behnia 2008). Conversely, trust in the social worker may be jeopardized if they fail to deliver the expected outcomes (Candlin and Crichton 2013), or if the client experiences the worker as dismissive, insensitive, or in other ways uncaring (Smith 2001). A negative experience with a representative of the system may furthermore impact the client’s future service encounters and impede the formation of trust with other welfare workers (Behnia 2008).

In cases where trust in representatives of the welfare system has been damaged by negative experiences, trust between the client and the professional must be built up. Guido Möllering proposes a conceptual shift from “trust” to “trusting,” to emphasize how trust is a continuously (re)produced process that “enables actors to deal with irreducible uncertainty and vulnerability” (2013, 286). Rather than being a static psychological state or attitude, trusting is understood as an ongoing and dynamic process in which trustworthy relationships are initiated and maintained over time (Khodyakov 2007). Process approaches in trust research typically investigate interactions between trustors and trustees and how individual actors develop positive expectations when confronted with uncertainty and vulnerability (Möllering 2013). Such studies are concerned with the practice of trust in specific sociocultural contexts and how the people themselves interpret and negotiate trust development within those contexts (e.g., Olohan and Davitti 2017).

Möllering, drawing on the work of Niklas Luhmann and Georg Simmel among others, argues that an interpretive approach to trust research is best equipped for examining these processual and dynamic aspects of trusting (Möllering 2001, 2006, 2013). Möllering’s work examines how individuals manage irreducible uncertainty and vulnerability in trust relationships. All trust is partially blind and involves a willingness to act despite uncertainty. Due to this inherent risk, trusting requires one to leap into the unknown, without having complete information about the potential outcomes. Thus, trust is not solely based on rational calculation and optimization but involves what Möllering calls “suspension,” a process in which agents accept the risk of harm and maintain a state of favorable expectation. This suspension of doubt emerges through gradual exchanges and learning from interaction. Möllering argues that actors engage in “extensive signaling, communication, interaction and interpretation in order to maintain the continuous process of trust constitution” (2006, 79). He stresses that actors are therefore not just passive carriers of this process, but actively and reflexively create, shape, and maintain trust-building processes.

In this article, I adopt Möllering’s processual and interpretive view of trust to examine how outreach workers (as trustees) interpret and actively operationalize trust development into their everyday practices of outreach. I explore how workers navigate distrust and engender favorable expectations within challenging contexts of heightened vulnerability. The three themes I identify as central to trust development in street-based outreach expand on Möllering’s theory on trust-building processes. Although Möllering focuses primarily on the trustor’s perspective, his analysis nevertheless provides a useful framework for exploring how trustees, such as outreach workers, employ strategies conducive for trust development.

Fieldwork Methods

The findings presented in this article are drawn from seven months of ethnographic fieldwork that I carried out during 2022–23 in Helsinki, Finland. As a form of human service ethnography, the aim was to observe the everyday practices and field-specific conditions that give meaning to my informants’ perspectives (Jacobsson and Gubrium 2021). The research data consist of participant observations obtained while embedded with a team of municipal outreach workers. I spent a total of 180 hours in the field. The research data also include eleven recorded semi-structured interviews with current and past members of the outreach team, as well as three interviews with people experiencing long-term homelessness. Two of the latter interviews were with clients of the outreach team at the time of fieldwork. While not all outreach clients are people experiencing homelessness, it is one of the team’s most significant target populations.

The research plan was approved by the Ethics Committee of the Tampere Region and the City of Helsinki’s Social Services and Health Care Division. Before starting fieldwork, I presented the research plan to the outreach team. During this meeting, we discussed the practicalities and ethics of conducting research while embedded with the team. Informed consent from outreach clients was obtained verbally in cases where I met a person only once or in brief, chance encounters. For longer client interactions, obtaining informed consent was an ongoing process in which clients were frequently informed about the nature of the research and given the opportunity to decline or withdraw their participation at any time. Clients could choose to interact with outreach workers without my presence if they preferred. Additionally, I regularly consulted with outreach workers to ensure my presence was appropriate in specific situations. In cases where clients were unaware of my research or were otherwise unable to provide informed consent, I refrained from collecting any information about them. Clients I met regularly and formally interviewed provided written consent. No compensation was offered to participants, and all names used in this article have been pseudonymized.

In the fall of 2022, the outreach team was comprised of six women and four men, all ethnic Finns between the ages of 26 and 60. The members of the team were trained social service professionals, meaning they held bachelor’s degrees in social services from a university of applied sciences, as is typical in Finland. The team also included a registered nurse. They operated in units of two workers, each assigned an area of the city, which they patrolled nearly every day from Monday through Friday. On most days in the field, I met a team of workers around 8 a.m. and spent the whole 8-hour shift accompanying them as they patrolled the streets on foot and escorted clients to services, often by car. Occasionally, I joined outreach workers on early morning patrols, as this was the best time to find people sleeping outdoors. The work involved a great deal of intentional wandering around the city in search of people, as well as more stationary time spent observing public spaces and getting to know the people who spend their time there.

The outreach workers exposed me to a particular knowledge of the city and to the concealed lifeworlds of those they sought to help (Smith and Hall 2018). They were exceptionally perceptive and skilled at explaining the ins and outs of the social environments in which they operated. I came to understand that this was due to the high degree of self-reflection their work required and the habit of discussing cases among members of the team. Being embedded with the team allowed me to participate in these informal conversations and essentially become an apprentice to their work. This experience gave me a grounded understanding of their work routines and tactics, which in turn enabled the gradual development of the themes and analysis presented in this article. The following analysis has largely been built upon this ongoing dialogue with members of the team and our mutual reflections on the events that took place while I was in the field.

My particular interest concerning trust development emerged from the observation that while previous research literature on outreach practices consider the “repair of trust” fundamental to outreach practices (Smith and Hall 2018), the specific strategy workers employ to initiate such processes deserved more focused ethnographic attention (Smith and Anderson 2018). This initial interest crystallized during my fieldwork as trust development was something that outreach workers were highly conscious of when reflecting on their day-to-day work practices. I observed that trust is never guaranteed when workers engage a new person on the street and can easily be lost even after initial rapport has been developed. This led me to think about trust as an ongoing social process and to focus my attention on how outreach workers both initiate contact and maintain engagement over time.

The Finnish Context

While the outreach team in Helsinki does not specify their target population in stringent terms, they estimate that over a third of their encounters on the street involve individuals experiencing some form of homelessness. The team also provides support to other people facing barriers in accessing services, such as those experiencing substance abuse and mental health challenges. Although many of these clients are officially housed, they may still experience housing insecurity due to financial difficulties or domestic abuse. The team assesses the need for assistance on a case-by-case basis, with outreach workers possessing a large amount of control over professional discretion. As a result, individuals experiencing homelessness or housing insecurity are a key focus of the team’s work. To better understand the context in which these services are provided, it is important to consider the broader situation of homelessness in Finland.

Finland is often highlighted as one of the only European countries to have successfully reduced homelessness and consistently continues to do so. Long-term homelessness decreased approximately 70% between the years 2008 and 2023 (ARA 2024). This success is largely the result of sustained efforts to improve services for people experiencing homelessness, a political consensus on the need to eradicate homelessness, and a policy commitment to the Housing First model (Kaakinen 2023).

However, despite the significant progress made since 2008, challenges remain in meeting the government’s goal of eradicating long-term homelessness by 2027. While the total number of people experiencing homelessness continues to decline each year, the number of evictions has remained the same (Y-Foundation 2022). There also persists a continued demand for emergency housing services, compounded by a lack of affordable rental housing, particularly in major cities like Helsinki (Juhila, Raitakari, and Ranta 2022). Another concerning trend is the increasing number of immigrants experiencing homelessness in Finland (ARA 2024). Furthermore, the current right-wing coalition government, led by Petteri Orpo (NCP), has introduced a wide range of austerity-driven welfare reforms, which are likely to place further strain on the essential services and support relied upon by people experiencing housing insecurity.

Currently, there are 3,429 people experiencing homelessness in Finland, of which 1,018 are classified as long-term homeless (ARA 2024). Homelessness is concentrated in major cities, particularly in the Helsinki Metropolitan Area, which accounts for 43% of the homeless population in Finland. Of the total number of people experiencing homelessness, 78% are men, 22% are women, 24% are immigrants, and 15% are young people under the age of 25 (ARA 2024). These figures are, of course, crude estimates, as a significant number of homeless individuals remain hidden from the official count recorded by Finnish municipalities. In practice, this means that a person is officially registered at a residence but, for various reasons, cannot actually live there and instead relies on “couch surfing” and other short-term arrangements. Women and young people, in particular, tend to experience these more elusive forms of homelessness (Housing First Network 2020; Kaakinen 2023). Furthermore, while there are limited data on homelessness among sexual and gender minorities in Finland, a recent survey of EU countries found that LGBTQI people face housing difficulties and homelessness at disproportionately higher rates than the general population (European Union Agency for Fundamental Rights 2024).

Experts emphasize that the social composition of the homeless population in Finland has shifted dramatically in recent years (Kaakinen 2023). In 2008, the main target population among the long-term homeless consisted of individuals sleeping outdoors or in halfway housing, with alcoholism as the most common addiction. Today, the core of the homeless population is younger and more heterogeneous than in the past, with many individuals experiencing drug-related dual diagnoses and remaining largely out of reach of welfare services.

Outreach workers and other street-level welfare workers in Helsinki report several major barriers their clients typically face when accessing welfare services (see Etsivä Lähityö 2023). Outreach workers frequently encounter people with untreated medical and psychiatric conditions, often exacerbated by precarious housing situations. Clients seeking help independently are discouraged by long waiting times, dismissive service encounters, and inadequate treatment. While outreach workers are usually successful in connecting their clients to appropriate services, many clients ultimately do not “stick” with these services, often returning to the streets without finding long-term solutions for their problems. This is arguably due, in part, to the ongoing dehospitalization of services, which emphasizes outpatient treatment while reducing hospital bed availability (Alanko 2017). The emphasis on outpatient care, particularly in psychiatric services, tends to favor those with milder problems while excluding those with more complex psychiatric conditions, who would benefit from comprehensive care addressing their broader challenges (Alanko 2017). Alcohol and drug detoxification programs are frequently at full capacity, forcing clients to wait for treatment, during which time they may lose motivation to address their addiction. Moreover, clients with undiagnosed mental health disorders are often denied access to psychiatric services, such as therapy, if they have untreated alcohol or drug addictions.

These barriers to access highlight the need for mental health and substance abuse services to work in conjunction with housing services for the homeless. There is also a growing demand for more proactive and flexible services to reach and support the most vulnerable populations, who often remain outside the scope of conventional services. This requires placing greater emphasis on multiprofessional outreach work on the street and lowering the threshold for accessing rehabilitation services (Kaakinen 2023).

It is within this context that the outreach team in Helsinki searches for and engages its target population. In the following sections, I draw on both my field notes and interviews to analyze how the workers nurture trust in their everyday encounters on the street.

Findings

The outreach team in Helsinki consists of four working pairs, who patrol different geographic areas of the city (north, south, east, and west). During the time of fieldwork, the team additionally incorporated an online outreach worker and a pair of workers who specifically target food aid distribution points around the city. The outreach workers patrolling the streets spend much of their time visiting people and places known to the team, while occasionally they receive “a notification of concern”: a message or phone call detailing a concern regarding someone’s health or safety. A notification of concern may be sent by a member of the social services, but often it is a security guard, librarian, or even a private citizen who contacts the outreach team. On most occasions, the team is able to respond to such concerns immediately and send one of the working pairs to the location detailed in the notification. During these encounters, the workers assess the person’s immediate needs and offer information about available resources and services, such as emergency housing, substance abuse rehabilitation, or medical care. Outreach workers may also accompany clients to various services and facilitate their interactions with other street-level workers. Yet, for many of their long-term clients who consistently decline available services, the workers offer psychosocial support and companionship rather than solely material assistance. This type of “affective rapport” (Koch 2021) forms the foundation of trust development between outreach workers and their clients.

The following analysis is presented in three parts. First, I describe the challenging conditions in which outreach workers operate and how gradual engagement is a defining characteristic of trust development in these contexts. Next, I discuss the role of authentic interaction in generating personal trust between the outreach workers and their clients. Finally, I examine how outreach workers leverage the team’s reputation to reach new clients, integrate new workers, and help restore their clients’ confidence in the welfare system.

Gradual Engagement

Although the first encounter between outreach workers and a person on the street may appear brief and inconsequential, it is crucial, as it can set the stage for either gradual engagement or, conversely, incongruence and avoidance on the part of the client. A typical encounter on the street illustrates the challenges outreach workers face in engaging a new person:

On a bright and brisk morning in September, two outreach workers, Mari and Pasi, stood outside a coffee house at the central railway station in Helsinki. As they prepared to begin their day’s work, one of them received a phone call from a local library. The librarian informed them that there was a young man that ‘looked like he might need some help’. The outreach workers had nothing scheduled until the afternoon, so they decided to hop on the next tram and head over. When they arrived, the workers searched the library but couldn’t find anyone fitting the description. They continued searching nearby parks and after some time they came across a young man sitting alone on the grass, bathing in the warm sunlight. The soles of his leather boots were nearly completely worn out, leaving only the loose vamps to cover his feet. Pasi walked up to the man and promptly introduced us. Pasi told him that the team had received a call, and that people were worried about him. The man replied that he was okay and that he was visiting Helsinki to meet up with his romantic partner but had lost his phone on the way. He said he had no place to stay. As he didn’t know any of the shelters in the city, Pasi offered him a small map of the local services. They explained that he could visit a low-threshold day center nearby to warm up and find some food; they reassured him that he can visit there anonymously and that he wouldn’t be bothered with any questions. He took the map and nodded. He was shivering. Mari offered to get him new boots and a sleeping bag, which he declined.

“You’re cold,” Mari said.

“Actually, it’s not that bad,” he replied.

“But you’re shivering,” she insisted.

“I said I’m fine. I think I know my body better than you.”

“Well, that’s true and I have no intention to meddle in your affairs. I’m just worried about you because the nights are getting a lot colder now.”

The man seemed reluctant to continue the conversation, so the outreach workers left. Later that day the librarian called back and said that the man was still hanging around the library, but the outreach workers never saw him again. (Fieldnotes, 2 September 2022)

Potential clients may avoid contact with service providers for a number of reasons. Members of the outreach team say that some of their clients are initially suspicious toward the workers due to previous negative experiences of forced treatment while others experience symptoms of paranoia due to a mental health disorder. Many outreach clients have exceptionally negative views of the welfare services, as explained by one of the workers: “A big part of this job is fixing the years and even decades worth of negative encounters and experiences that they [clients] have had of different services.” Clients may have concerns for their personal safety, for instance in emergency housing services. Rumors of violent altercations between residents spread on the street and create a strong reticence in many of the team’s clients. Other clients experience feelings of personal unworthiness or may lack the confidence that their circumstances could ever turn for the better. Some possess a strong ethos of self-reliance and do not feel comfortable with asking others for help, while others may feel ashamed of the conditions in which they live and do not wish to be “seen.” Establishing contact is inevitably a very delicate matter, as outreach workers must single out a member of the public as a potential client, which in itself confers upon them a stigmatized social status. Tom Hall describes this as “the stigma of assistance”: the shame of being noticed and exposed by an outreach worker in public (2017, 83). Furthermore, many of the team’s clients who have pursued help in the past, have found that services do not align with their individual needs or have experienced other types of barriers to access that have eroded their confidence in the welfare system.

In these circumstances, outreach workers must develop a sensitivity to recognize the appropriate pace of engagement for each individual client. A more direct approach, such as the one previously described, may at times backfire. In one such instance, a person who was reported sleeping at a railway station was approached by two outreach workers. The person immediately rejected their approach, and the outreach workers were later told that this person was no longer seen at the station, evidently as a consequence of being exposed by the workers. Later, the workers came across the same person spending time at another station. This time the workers decided not to approach the person directly. Instead, they employed a more gradual and indirect approach of engagement, as described by Pasi, one of the workers who was involved in the case:

Perhaps they see us helping someone else and they come to realize we aren’t forcing anything on them. And maybe during a morning shift we get an extra coffee and ask them if they want one, give it to them and we don’t start talking about anything else. We give them the opportunity to approach us if they want to.

In this manner, Pasi and his colleagues allow a potential client to observe them and gradually glean information about them: “We don’t have to rush it. And because we know where people spend their time, we can always circle back another day and wait for a more opportune moment.” Through repetitive indirect contact the workers may eventually build a positive expectation about themselves in the eyes of the potential client. The outreach workers must demonstrate that the client’s autonomy will be respected and that the workers’ intentions are genuine. By increasing familiarity and engagement incrementally over time, the workers may reach a point in which they can approach the person on the street with more direct questions about their life situation and offer support. As one of the more recent recruits Maija puts it: “It’s only now after a full year on the job that I’ve finally been able to establish a relationship with my clients in which they open up and speak to me about their problems.” Yet, even after initial trust has been established, outreach workers stress the importance of continuing to introduce services at a pace that does not overwhelm them. The client must maintain a sense of control and autonomy.

The gradual building of trust with a client on the street often culminates in scheduling a visit to a welfare service. Outreach workers regularly accompany clients to healthcare services, social services, or Housing Support for guidance in matters related to homelessness. Outreach clients face a wide range of challenges during service encounters. They may have practical issues, such as lacking an ID, a bank account, a phone number, or an address, or they may require moral support during interactions with office workers. According to members of the team, office-based welfare workers are sometimes overwhelmed by the exceptional challenges their more “difficult” clients face and may become impatient with clients whose situations they do not fully understand. Additionally, clients may have cognitive challenges or struggle to communicate their circumstances and needs. In these situations, outreach workers act as “brokers” between their clients and the welfare system. In one such case, the outreach workers were assisting a client who was suffering from psychotic episodes and hallucinations, as described by Mari:

First, we went to the health center and waited in line, only to be told that we actually needed to go to the emergency room instead. So we took the client there, and understandably, they were really frustrated. At that moment, the client was more lucid and understood everything that was going on, but at the same time they were becoming increasingly anxious. When we got to the reception desk, the nurse asked about their symptoms, and the client just blurted out, “Well, I see little green men, for fuck’s sake.” I had to step in and encourage them to explain things more clearly. I told them, “Come on, try to describe what’s really going on.” If they had left it at that, the staff might not have taken them seriously. So I gently prompted, “Didn’t you say you were seeing flies and things like that?” And then they responded, “Yeah, I saw flies.” So in a way, I was able to help them hold it together despite their frustration at being shuffled from place to place.

This example illustrates how outreach workers assist clients in navigating the welfare system by physically accompanying them and ensuring that they reach the appropriate services. In this instance, Mari furthermore helped their client manage their frustration and supported them in articulating their symptoms in a way that ensured that they were taken seriously by the medical staff. The team’s long-term commitment to their clients places them in a unique position to offer both practical and moral support in situations of heightened vulnerability. Through ongoing engagement, the team develops an intimate understanding of their clients’ experiences and struggles, both within and outside the welfare system. This enables them to offer help based on their clients’ unique circumstances and individual needs.

Möllering (2006) identifies gradualness as a defining characteristic of trust development. Building on Luhmann’s “principle of gradualness,” Möllering argues that the process of trusting is “a matter of gradual experience and learning from interactions” (2006, 85). Trust development is often rather tentative and is determined by the circumstances and risks involved in specific social relationships. This is particularly evident in the case of outreach work. Outreach workers typically encounter an initial guardedness when first approaching a new person on the street. This caution on the part of their target population—especially those experiencing street homelessness—is a common response to the everyday challenges of maintaining personal safety in the face of uncertainty and vulnerability. Trusting the wrong person and exposing one’s vulnerability may quickly lead to unforeseen and detrimental outcomes for people living in precarious circumstances. Outreach workers mitigate their clients’ sense of risk and vulnerability by gradually increasing familiarity and allowing their clients to determine the pace of interaction. Once personal trust between workers and clients has been established, outreach workers can facilitate their clients’ access to services by accompanying clients and offering both practical and moral support.

Authentic Interaction

As previously discussed, outreach workers are frequently required to repair negative experiences of service providers and a lack of confidence in the welfare system (see also Klop et al. 2018; Smith and Hall 2018). Informality plays an important role in the process of establishing rapport between outreach workers and their target population (Andersson 2013). Members of the outreach team routinely spend time chatting with people on the street, often without a specific objective other than establishing or maintaining familiarity with their target population. When outreach workers approach people on the street, they aim to gradually build personal engagement through casual small talk, humor, and the act of “hanging out.” This informal approach to engagement provides a relaxed and unhurried atmosphere in which the client can articulate their needs in their own words and in their own time.

The team also visits clients experiencing homelessness in places where they sleep, for instance, in forests, parks, railway stations, or even on small islands off the coast of Helsinki. A central characteristic of outreach encounters in these environments is that their professional power is not mediated through spatial structures (Andersson 2013). By approaching people in their own environments, outreach workers can avoid reinforcing feelings of dependency and powerlessness that so often characterize their clients’ experiences in the institutional settings of the welfare services.

Trust in outreach encounters is therefore typically achieved through highly personalized engagement in the client’s own environment. Outreach workers stress the importance of genuineness and authenticity in building and maintaining trust. According to the team, clients are acute observers of people and use non-verbal signals as evidence of the workers’ credibility. Workers who hide behind rigid role performances are less likely to develop rapport with clients, as they come off as distant and inauthentic. As Pasi explains:

When we meet people in the street environment, I think the worst thing you can do is be inauthentic. Not everyone’s style is the same, but if you show who you are and give something of yourself, you are more likely to earn their trust. You need to be careful of being too official and stiff or using overly formal language. That’s why you need to have some personality in the way you do things.

Similarly, Luhmann argues that interpersonal trust requires the trustee to withdraw from role-conformity and standardized expectations of behavior. Rather, they should be replaced by a self-representation “as only he, as one individual personality, with his unique style, can guarantee to fulfill” (Luhmann 1979, 62). Luhmann argues that it is only through this representation of the individual self that a person may be perceived by a trustor as a truly free and transparent agent. Their trustworthiness is based on a personal and transparent commitment to win over and cultivate trust, rather than the impersonal execution of predetermined actions based on role expectations.

To highlight the informality of street encounters, outreach workers tend to contrast their work on the street with the work they have previously done in the social and healthcare services. These institutional settings are viewed by members of the team as controlled environments where the interaction between the professional and their clients is conditioned by rules and a fixed agenda. Teemu, an outreach worker with a diverse work history in the welfare services, reflects on this difference in the following way:

Now when I think about it, of course it’s different when you meet people on their own turf, on the street, in their own spaces, compared to before, when I worked with people in institutional or office settings [. . .] a lot of the time in outreach we meet people and just talk with them without any specific agenda. It’s not necessary for us to limit our interaction to a strict 45-minute time slot and to tell them, “So, here’s your problem and this is how we’re going to fix it!”

With the 45-minute session, Teemu refers to the typical length of an office appointment in many social work settings. Most members of the team have extensive work histories in the social services, halfway houses, hospitals, and other similar institutional settings. The self-understanding of the outreach workers is shaped in opposition to the perceived inflexibility of these institutional settings (Andersson 2013). In social work settings, workers dominate interactions with clients through their control of resources and through the formalized spatial arrangements of the bureaucratic encounter (Eräsaari 1995). Clients, in turn, must comply and behave “properly” in order to access the resources they need (Lipsky 2010), while the workers allocate support based on perceived deservingness (Koch 2021).

In contrast, members of the outreach team do not make executive decisions that directly impact their clients’ access to resources. This enables them to be more informal and flexible in their approach, developing relationships with clients based on personal engagement rather than transactional exchanges. It also allows clients to be their “normal selves” around outreach workers, without fear of being disqualified from services. Workers furthermore emphasize the importance of showing genuine interest in the client and finding common ground, rather than approaching them from a position of authority and prioritizing problem-solving. This helps to unsettle the framing of outreach as a control measure of “problematic others” and to approach people as individuals (Ponzoni and de Ruyter 2022, 10). Ideally, the client feels that their experiences and perspectives are validated and that the outreach workers are on their side.

A key practical benefit of the rapport developed in informal settings is that workers become adept at communicating with clients in everyday, colloquial language. Outreach workers often find themselves clarifying their clients’ situations to other welfare workers to help them qualify for services. One reason for this is that office-based welfare workers often rely on rigid, bureaucratic language, which can create misunderstandings that rarely serve the client’s best interest. In such cases, outreach workers step in as mediators to bridge this communication gap. Katja, one of the team’s most experienced outreach workers, describes a moment in which this role was particularly evident:

Generally speaking, the use of jargon or bureauctratic language is a complete disaster, and even I struggle to understand it sometimes. I remember once I was in a meeting, and the client said they’re going to detox. The worker sharply asked, “Who promised you a spot in detox?” And so I stepped in and said, “I’m sorry, but they actually meant we’re going to the reception tomorrow to see whether we could get them into detox treatment, but no one has actually promised anything yet.” [laughs]

In this instance, the client was referring to detox simply as a physical place they planned to visit, while the caseworker understood detox as a welfare service with strict admission criteria, rules, and procedures. This led the caseworker to misunderstand the client and challenge them aggressively on their perceived presumption. Katja recognized the misunderstanding and decided to diffuse a potential conflict. Her story illustrates how the team’s rapport with clients allows them to understand the client’s perspective and communication style, which helps to prevent misunderstandings that might undermine trust. By engaging with clients in informal settings and building authentic relationships, outreach workers can advocate on their behalf, helping clients navigate services that might otherwise be inaccessible or confusing.

Team Reputation Management

While trust development between outreach workers and their clients typically involves a gradual and rather lengthy process of familiarization—often spanning months or even years—this process can be accelerated with the help of intermediaries. Workers regularly depend on the positive reputation the team has previously established among their target populations. Clients with long-standing connections to the team frequently act as gatekeepers and provide credibility and a positive reputation to the workers. The team’s positive reputation carries implicit obligations and expectations that guide interactions between workers and clients. Outreach workers rely on this reputation not only to reach new clients but also to integrate new team members and help restore their clients’ confidence in the welfare system.

Trust in street-based outreach does not develop in isolation but is often shaped by a broader network of relationships. Möllering argues that in contexts of low familiarity actors may overcome the inherent risks of trusting an unknown other based on the reputation among peers formed in previous encounters (2006). In a similar vein, Khodyakov argues that the initial creation of trust can be facilitated significantly through the use of second-hand information provided by a “trustworthy intermediary” (2007). This allows outreach workers to bypass initial suspicions they may face from individuals who are not familiar with the team and their work methods. The following encounter demonstrates a typical way this process takes place in outreach:

Two outreach workers, Noora and Sami, stood outside a metro station in the early afternoon. The entrance to the station was bustling with commuters. At the corner of the street, they saw a small group of young men huddled together and talking intently amongst themselves. A few others were sitting on the curb nearby. The spot was locally known as a meeting place for young drug addicts due to its vicinity to low-threshold services. The outreach workers decided to approach the group. Two of the men, Janne and Aki, were clients of an opioid substitution treatment center. The outreach workers knew Janne from previous encounters, which provided an initial entry point for approaching the group. Aki was his friend.

“So, who are you guys, anyway?” Aki asked the workers, as he looked up and down their vests. They wore the municipal logo on the front with “outreach” (lähityö) written underneath.

“We’re outreach workers from the city of Helsinki, and we meet people on the street and offer help to whoever might need it,” Sami responded. Aki, who didn’t seem very convinced by the rather vague answer, stared at the outreach worker with probing eyes.

“Aki, these people can help you,” Janne interjected. “They can help you much better than I can.” This seemed to appease Aki’s initial misgivings and he began to tell the outreach workers about some financial difficulties he was currently experiencing. He said he didn’t have any money for bus tickets, which he needed for his daily commute to the opioid substitution treatment center. Sami stepped Aki aside, pulled out a large personal organizer and began sorting out his situation. While he tracked down Aki’s caseworker by phone, Noora continued to make small talk with the rest of the men sitting on the curbside. (Fieldnotes, September 12, 2022)

In the above example, Aki ultimately depended on his friend Janne as a familiar and trustworthy person, who could vouch for the outreach workers. This allowed Aki to resolve his lack of familiarity with the outreach workers and to form a positive expectation of their intentions without needing to form an assessment of their trustworthiness on his own. This illustrates how trust development between outreach workers and clients often involves a wider network of trusted intermediaries who provide credibility to members of the team.

The team leverages the positive reputation they have established on the street for accessing hard-to-reach populations. For instance, clients regularly inform the team about others who have recently become homeless or otherwise might need their help. Clients may also point out a new person on the scene and suggest the outreach workers go check on them. Occasionally individuals who are unfamiliar to the team may approach an outreach worker on the street and say, “I heard what you did for my friend Pekka and I was wondering if you guys could help me out with something too.”

Familiarity with the team and their principles of practice furthermore ties the individual worker to the reputation of the team as a whole. In fact, several outreach workers pointed out how at times it seemed irrelevant which member of the team was interacting with a particular client, and whether the client even knew them from before:

When I first started working, I had people approach me as if I knew them from before, and we were just carrying on an earlier conversation. It was because I had the outreach jacket on and the team had already put in the work and the outreach brand was already in place, so to speak. It really helped me getting started. (Anne)

Another outreach worker, Katja, similarly noted that the team’s reputation not only provided an entry point for engaging new clients but also carried implicit expectations:

We have this sense of “goodwill” that has developed around the outreach team. Even when I was new at the job, I could sort of piggyback on what former outreach workers had accomplished. People know about us, and they’re like “you’re the good guys and you always help me,” and I might reply that “I’ve never met you before, but I can try.” [laughs]

New members of the team inherit and maintain the team’s established reputation, which functions as a guiding framework for their everyday interactions with clients. This reputation shapes the implicit expectations that clients have of the outreach workers, aligning with Luhmann’s argument that “an element of social control is built into relationships of trust” (Luhmann 1979, 64). The client’s expectation functions as an “instrument of obligation,” and the outreach worker commits themselves to a role that aligns with this expectation, or else risks losing the client’s trust (Luhmann 1979). For the team in Helsinki, these expectations include that outreach workers always aim to help their clients, that information shared with workers remains confidential, that workers do not coerce clients into services, and that all interactions with workers are voluntary. Although each new relationship with a client is shaped by unique circumstances and personal idiosyncrasies, the worker can never stray far from these implicit expectations. This means that trust is not just an individual achievement but a collective asset, that is shaped by the team’s history of engagement and reliability.

However, the role of the outreach worker extends beyond simply maintaining trust at the interpersonal level. Since the outreach team facilitates their clients’ access to services, the trust built between workers and clients provides a potential pathway to restoring trust in the welfare system. Clients who have been let down by the system in the past may still be willing to engage with outreach workers because they see them as distinct from the impersonal bureaucracies. The physical proximity and familiarity with clients make them appear more like allies than officials, even when they are, in fact, part of the system they are trying to help clients navigate. Outreach workers therefore aim to leverage the team’s positive reputation and extend it toward other welfare providers. Katja describes how she actively works to reframe her clients’ perceptions of the system in a more positive light:

I act as a bridge between both sides. Of course, I position myself more on the client’s side—I advocate for them and their rights. That’s the core of my work. But at the same time, I also work in the other direction by speaking positively about welfare services and workers, telling clients, “I know this person, we’ve worked together for a long time, they’re great.” Because it doesn’t cost me anything to give another worker credit, and it might make the next interaction easier. If something went wrong in the past, maybe next time it won’t, because there’s already a positive expectation. After that, it’s up to the worker to live up to it and prove that I was right when I said they were a good person.

This illustrates how outreach workers themselves become trusted intermediaries between the client and the system. Workers not only facilitate access to services but also seek to influence their clients’ perceptions of the welfare system. By extending the team’s positive reputation toward the system itself, their clients may gradually develop positive expectations of other welfare workers and be more willing to engage with them in the future. This process of gradually repairing institutional trust is a crucial aspect of outreach, as many clients have had negative past experiences in their interactions with workers in institutional settings. Outreach workers must therefore carefully balance their role as brokers between the client and the system. If workers align too closely with institutions, they risk losing credibility among their clients. Conversely, if they position themselves solely as client advocates, they may reinforce client skepticism toward services rather than helping to rebuild confidence in them.

Conclusion

Smith and Hall (2018, 380) describe the key principle of outreach work—that is, the meeting of clients on their own turf—as “the slow and sometimes frustrating gaining of trust from those with good reason to be distrustful.” Outreach workers aim to build trusting relationships with people in need who have either been let down by the system or otherwise distrust its representatives. Many of their clients have not entered a formal office space in years and avoid contact with authorities whenever possible. Workers therefore initiate contact in situations and settings that they do not control. They are guests in spaces where they are rarely invited. Gaining trust in these circumstances is slow and requires informal and oftentimes creative approaches to work practices. Furthermore, trust is never guaranteed and requires active maintenance, especially in challenging contexts of heightened vulnerability.

In this article, I have drawn on ethnographic observations of a team of outreach workers in Helsinki and analyzed their strategies for building trusting relationships with people on the street. Based on a processual and interpretive view of trust (Möllering 2006), I have illustrated how trust emerges gradually through informal interactions, in which workers establish authentic relationships with their clients. The team’s reputation among their target population is built on their tactful, non-coercive approach to care and support, along with their willingness to engage clients on their own terms. Workers rely on this reputation not only to reach new clients and integrate new team members but also to help extend their clients’ trust to other welfare workers and restore confidence in the system.

Outreach clients often face co-occurring conditions and complex challenges, including housing insecurity, health issues, financial difficulties, substance addiction, and abusive intimate relationships. These compounding challenges make it difficult for them to receive assistance within mainstream service settings, where they are frequently labeled as “difficult clients” and avoided by service providers. The combination of the clients’ multifaceted struggles and the often-stigmatizing experiences within services can render available support inadequate, if not unattainable. Rebuilding trust in such circumstances requires workers to demonstrate genuine empathy and interest in the clients’ perceived needs, while also offering personalized support.

However, trust development in street-based outreach is only a small—albeit important—aspect of the client’s access to welfare services. Once a modicum of personal trust is achieved, and the client is willing to allow the outreach workers to support them in accessing the services they are entitled to, the next hurdle is helping their client cope with a complex and diminishing welfare system. In Finland, public social and healthcare services are currently facing extensive budget cuts introduced by the right-wing coalition government. During my fieldwork, I observed outreach workers struggle with limited resources, particularly within substance abuse rehabilitative services. Qualifying their clients for housing and rehabilitative services often required workers to negotiate complicated rules and stringent service parameters that rarely accommodated clients’ individual needs. Workers were able to maintain trust with clients even in moments of disappointment and frustration due to their perceived position as brokers between the system and the client. Clients frequently relied on workers to explain correspondence from welfare services and facilitate interactions with social and healthcare workers. Outreach workers supported their clients by ensuring they complied with appointment schedules, waiting with them in service ques, and advocating on their behalf with service providers when necessary. I also observed workers leveraging their extensive professional networks within the welfare system to secure adequate care and support for their most vulnerable clients.

Although these aspects of street-level bureaucracy have been thoroughly researched elsewhere (e.g., Koch 2021; Smith and Anderson 2018), it is important to acknowledge that successful outreach programs depend on low-barrier services that offer comprehensive, multi-professional support and long-term solutions for their clients, especially those experiencing street homelessness. Otherwise, outreach workers are forced to perform endless crisis management rather than offering their clients lasting alternatives to life on the street.

While the analysis in this article is based on the perspective of outreach workers as trustees, future research could explore how clients, as trustors, experience and interpret trust development processes in their encounters with representatives of the welfare system. The client perspective may offer further empirical evidence of how system trust (and mistrust) overlaps with personal trust in the asymmetrical relationship between professionals and clients. These relationships are furthermore influenced by factors such as ethnicity, gender, and sexual orientation. In contexts of heightened vulnerability, they can provide both opportunities for connection as well as potential barriers for trust development. Future research would therefore greatly benefit from focused ethnographic attention on how these intersecting factors affect trust development between outreach workers and their clients.