Comprehensive Services for Complex Needs: A Summary
This briefing summarises evidence for three ways of working with people with multiple and complex needs. Multisystemic Therapy, wraparound, and the link worker model all seek to address the repeated failures to help people facing multiple needs. We hope it will help a wide range of commissioners. These three models were developed in different contexts and target different ages and cohorts. However, all respond to a complex mixture of unmet needs and address interrelated outcomes such as reducing reoffending, improving mental health and preventing further exclusion. They illustrate the importance of a holistic, personalised approach which prevents crisis situations.
Research estimates that there are approximately 60,000 people across England facing multiple and complex needs, with many more at risk of entering this situation. Individuals in this group are overrepresented among short-sentence prisoners and repeat offenders. Many in this group are failed by mainstream services. They are excluded for disruptive behaviour or because they do not meet rigid and complicated thresholds for access. This means they frequently come into contact with the system at crisis point.
There is promising evidence that the models explored in this paper can work if implemented faithfully. All three have potential to save money through reduced demand on the emergency services, the criminal justice system and the care system. The briefing introduces and explains the three models, summarises the evidence, makes the financial case, and suggests key considerations for commissioners and research funders. We hope it will be helpful to commissioners with an interest in:
- reducing repeat offending, including among young people
- reducing levels of substance misuse
- improving mental health, particularly among young people and offenders
- reducing incidences of family breakdown
- reducing rough sleeping and social exclusion among adults.
