From an American concept to a Dutch tool
In order to understand the origins of the SSM we need to look to the United States. In the 1990s, Diana Pearce and here colleagues developed the Self-Sufficiency Standard. This consisted of a method to determine the economic or financial self-sufficiency of people. The standard was a response to the observation that some families did have an income above the official national poverty line, but could not make ends meet with this income because the costs of living varied strongly from region to region.
Virtually simultaneously with this development, there was a growing need in the US for a method that would make the outcomes of care measurable, clear and manageable. This need was met by the 'Results Oriented Management and Accountability Self-Sufficiency Taskforce (ROMA), which developed a system that made an explicit link between the outcomes of care and the efforts involved with that care. Inspired by the work of Pearce, and in line with the system as described by ROMA, the Self-Sufficiency Matrix (SSM) was developed in 2004. Instead of one (financial) dimension, the matrix consisted of a range of outcome measurements that described the situation of an individual or family in the area of self-sufficiency. By now the SSM is applied in different American States and it has many application areas in care - e.g. case management, personal feedback, policy, research).
The SSM version that is used in Utah formed the basis for the Dutch Self-Sufficiency Matrix (SSM) in 2009. The SSM was the initiative of the Amsterdam Public Health Service and is a response to the lack of tools that measure to what extent a person is able to provide for his own needs. Without the SSM, the self-sufficiency of a client was based on the (subjective) opinion of the provider and/or by using measuring tools, which are complex, time consuming and/or determine a different, albeit related, construct (e.g. the HoNOS, developed to assess mental health and social functioning). The SSM appears to meet an important need.
During the development of the SSM, the Amsterdam Public Health Service was assisted by different researchers, professionals, and policy employees from the Social Services of Amsterdam (DWI), Rotterdam Council, and a large number of employees of different institutions from mental healthcare, addiction work, social-support and probation services.