Skip to main content

Comprehensive services for complex needs: A summary of the evidence

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. Their needs often include mental illness, offending, homelessness and substance misuse. They are overrepresented among short-sentence prisoners and repeat offenders.

Many people in this group are failed by mainstream services. They are excluded for disruptive behaviour or they do not meet rigid and complicated thresholds for access. This means they frequently come into contact with the system at crisis point. Many are repeatedly imprisoned for short periods of time; some are excluded from GP surgeries, and so repeatedly attend A&E; many are unable to sustain stable housing and end up homeless. For families with multiple and complex needs, repeated family breakdowns and a chaotic environment often result in children being taken into care.

This briefing summarises evidence for three ways of working with people with multiple and complex needs: Multisystemic Therapy; wraparound; and the link worker model. These models seek to address the repeated failures to help people facing multiple needs. They were developed in very different contexts and target different ages and cohorts, but all respond to a complex mixture of unmet needs and address interrelated outcomes such as reducing reoffending, improving mental health and preventing further exclusion.