From Fragmentation to Integration: Rethinking Housing and Care for Complex Needs in Urban Contexts

This article applies critical realism to examine and enhance service design for individuals with learning disabilities and complex needs in urban contexts. Drawing on policy research, it highlights systemic barriers of institutional fragmentation, uneven resources, and delayed planning, and argues that critical realism helps uncover the deeper social and structural mechanisms shaping these challenges. Using a qualitative case study approach in Scotland, the study combines interviews, focus groups, and policy analysis involving stakeholders from health, housing, and social care sectors. Findings reveal that meaningful support requires cross-sector collaboration, a shared understanding of needs, and a human rights-based framework. Critical realism offers tools to trace the causal mechanisms behind service failures and identify pathways for more equitable, context-sensitive interventions. The study calls for reimagining urban governance through integrated, reflexive, and person-centred approaches, ensuring that cities provide inclusive, community-based support systems for marginalised populations.