The United States continues to struggle with the world’s highest incarceration rates (Drucker 2013), a mental health care system that has been described as “in shambles” (Frank and Glied 2006), and a social safety net that is often unable to reach the most vulnerable (Bitler et al. 2017). In the richest and most established democracy in the world, we know that this is not due to a lack of wealth or of institutions. Rather, we see assert here that the difference may be a matter of approach.

To illustrate this, we present here an approach that “The Connection” has employed in the U.S. state of Connecticut. The Connection is a large, statewide agency of 600 staff and 45 residential and out-client programs providing services in the areas of community justice, behavioral health, and family and housing support. Unlike most agencies, it provides all these services under one rubric, which forces it not only to coordinate areas that are usually separated through specialization and sometimes opposing philosophies, but also to find common root causes that involve a client in these systems in the first place. Through these challenges, not only has The Connection been able to survive, but also maintained flexibility at a time when large-scale service organizations are suffering from rigid bureaucracies, has expanded in size and in budget multifold at a time when most are scaling down, and has filled critical service gaps for the state, providing for some of the most high-risk, stigmatized, or vulnerable populations.

How is this possible? We hope to present here a brief summary of what we know about the agency (Please see Ethical statement; a list of independent evaluations are available upon request), in the hopes that it can inform practices elsewhere within the United States and abroad. First and foremost, a unique character of The Connection is that it insists on a human approach, no longer how large it becomes. Far from being non-descriptive or irrelevant, this philosophical orientation composes the core of its operational principles. Addressing the needs of individuals and families as paramount leads staff to draw upon the vast resources of the agency, rather than to match the client with a branch of services one “belongs to”—and thus restricting the client to that domain. Secondly, being person- rather than system-centered, it has encouraged creative adaptation over bureaucracy with growth. Rather than becoming more rigid with size, The Connection has incorporated flexibility and “humanity” through some key practices: it has maintained a “small programs” culture by allowing its individual program directors considerable control; it has encouraged creative ideas at the grounds level, where practitioners and clinicians are likely to know best what the needs are; and it has actively worked to bring together the individual programs within the larger ecology of the agency so as to share resources.

This approach is ingrained in the institutional culture through ongoing training programs for staff. The main conceptual framework consists of: trauma-informed care (active listening and empathic questioning techniques), citizenship-based case management (validation as citizens with dignity and responsibility), and peer provider programs (active participation of those who have overcome similar challenges). By assessing the effectiveness of its programs, The Connection has been a pioneer in conducting concurrent research, far before the practice became widespread, and over more than 20 years has built partnerships with the University of Connecticut, Wesleyan University, Yale University, Central Connecticut State University, the University of New Haven, and other academic institutions. To help integrate the wide range of programs and geographic locations, The Connection has launched the Institute for Innovative Practice, which is an entity within the agency that serves as a “think tank” to help unify the organization’s vision as well as to forge bridges between research, practice, and advocacy, as in Fig. 1.

Fig. 1
figure 1

The Connection’s integrative model

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While allowing the autonomy of its numerous smaller programs, an organizing principle for the whole is not lacking—mainly, the agency relies on a shared, guiding “vision”. There may be concerns about quality control while allowing individual programs such great autonomy, but keeping approaches open actually allows for better adherence to purpose. Furthermore, the Institute is a semi-open meeting where virtually any problem can be addressed as they arise, and the manner of response brainstormed. Through these mechanisms, the Institute endeavors to keep the agency’s sights on “human-centered” values at the ground level, while making use of the essential human drive that produces practical efficacy: meaning and motivation.

Scientific support for how The Connection works is discussed elsewhere (Lee et al. 2018); theoretical support for its approach lies in passing the critical litmus test, “How well does it help the client?” Affirming clients’ humanity by refusing to reduce them to their component parts allows the promotion of self-determination, hope, and mutual support (Davidson et al. 2005). As they choose their own identities, they lead themselves to new social and behavioral possibilities—such as new jobs, family life, and prosocial ways of living and working within the community. For some clients, new confidence arises from modeling themselves after staff who serve as peer providers who share their own experiences of overcoming challenges. The greater continuum between staff and client, the empathic and personal engagement of professional providers, and the autonomy that clients retain of their own care enhance a culture of belonging, initiative, and active participation that offer the strengths, we believe, to make the difficult integration of services possible.