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Severe and multiple disadvantage: development and applications of a concept

Alice Lemkes (Department of Law, University of Leeds, Leeds, UK)

Housing, Care and Support

ISSN: 1460-8790

Article publication date: 1 August 2022

Issue publication date: 25 November 2022




This paper aims to remove the self-evidence of the concept of severe and multiple disadvantage (SMD) by drawing upon a historical as well as a critical perspective to show its contingency.


This paper will introduce the concept of SMD by examining how it has come to be understood in the way that it has. This paper does so by exploring key texts which have informed the development of the concept as well as its conceptual near neighbours such as “multiple needs”. This paper traces some advancements of the concept within practice and further research with a focus on the Fulfilling Lives programme and the Lankelly Chase Foundation. Finally, the author reflects critically upon the concept and the manner in which the concept has become operationalised.


This analysis demonstrates how a particular definition of SMD has come to dominate over the past few years because of the research and practice of key organisations. On the one hand, this has further marginalised alternative definitions and ways of working, but on the other hand these stakeholders have been able to influence the way in which UK policy has taken up the concept within its governmental priorities.


To date, research has taken the term SMD for granted which limits the ability to critique its definitions and applications. This is an important and timely contribution because concepts are all-too-often taken for granted and at a pivotal moment when SMD has become nationalised through policy, critique is a political, potentially transformative, act.



Lemkes, A. (2022), "Severe and multiple disadvantage: development and applications of a concept", Housing, Care and Support, Vol. 25 No. 3/4, pp. 127-137.



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