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Multiple Needs: Time for political leadership

The government has stated its determination to tackle an escalating set of crises: homelessness, substance misuse, mental ill health and persistently high re-offending rates. Despite some progress, there is currently a fundamental flaw in the way we deal with these problems: we treat them as separate when they are connected. If this doesn’t change, things will only get worse – with appalling human and financial consequences.

Right now, in England, an estimated 58,000 people are living with multiple needs. These individuals face a series of simultaneous challenges – they battle drug or alcohol addiction, experience mental health problems, sleep rough and are in frequent contact with the criminal justice system. Each issue compounds another, sending people’s lives on a downward spiral towards rock bottom.

Our public services either do not recognise or struggle to respond to this reality, and therefore fail to meet people’s needs. Services are designed and funded as if
people fit into neat boxes or go through problems in a tidy one-by-one sequence – each engaging with a single aspect of what are complex and interrelated problems.

A lack of coordination between services means that:

  •  people are turned away from services because their needs are judged either too mild to meet a threshold, or too severe to be manageable
  • organisations don’t communicate with each other to ensure that people’s full range of needs are met
  • local areas fail to manage crucial transitions, for example from childhood to adulthood, or as people leave institutions such as the care system or prison.

So people’s situations get worse, and when support finally arrives it has to be more intense and prolonged, and frequently from emergency rather than planned services. The pressure on those services and the cost to the taxpayer escalates. The cumulative cost of multiple needs across England is staggering, estimated at between £1.1bn and £2.1bn per year.

Things cannot go on like this. In this briefing, the Making Every Adult Matter (MEAM) coalition sets out how the government can bring about the nationwide change we need.