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The role of families in the lives of people with severe and multiple disadvantage

“Families, who’d have them?” – an often flippant utterance we’ve all said at one time or another, without genuine consideration as to what that means. Who would we be without the influence of our parents? The support of our brothers and sisters? The answer to these questions will likely depend on experiences in childhood and those when entering and during adulthood. But ultimately, genuine reflection on this question and on the role and impact of our families will often illicit a binary response; we’d be better or worse.

We cannot help the families we are born into, but this doesn’t mitigate the salient and long lasting social and economic impact they can have on our life chances. The data on intergenerational transmission makes for some terrible reading . Those who are born to families in poverty are increasingly likely to remain in poverty into adulthood, suffer poorer physical and mental health and less likely to achieve education – all of which, coalesce in adulthood and increase exposure to and likelihood of multiple complex needs.

This component of the literature is well understood; we understand that the family is crucial in determining a number of outcomes into later life. What is less understood and often overlooked, when considering adults facing multiple complex needs, is how families can support recovery and desistence into adulthood and later life.

Because for those with multiple complex needs, a supportive family – one which is caring, persistent and patient – can be the difference between desistence and criminality or addiction and recovery. This duality of the family as both a protective and affirmative, as well as something which can be adverse and damaging was a strong theme which emerged from our family workshops held in our Lived Experience Forums.

For some of the people we work with, their families were the bedrock of their recovery. Families in these contexts, provide emotional support in the form of being there to speak to; to share their pain and the emotional burden. Whilst simultaneously, providing practical support such as accommodation and financial support. Or even just making sure they turned up to their appointments on time.

Having people to be proud of you… that’s a big one

This support and unconditional love was seen as critical in sustaining recovery and desistence from crime:

Getting a birthday card or a Christmas card… that’s massive because when you’re in the zone you need that… to feel loved

For others they saw their families as a catalyst for change, both in the context of recovery and desistence from crime:

When I understood the impact of my offences on my children, how they were deeply traumatised and effected by my separation from them – My first reaction was ‘I wanted to kill myself.’ My second reaction was I needed to stop being so selfish and stay alive for them and the third was a realisation that I needed to change my life. They are my first thought and not an afterthought.

Whilst for some families were seen positively; as protective factors against the challenges posed by addiction and the criminal justice system. For others they were seen as contributing to criminal behaviours and addiction:

I had about 4 or 5 older cousins who were getting involved in petty crime, and in drug dealing… and they became my role models

Our service user forums also mentioned that families can be detrimental in recovery as they are punitive and mistrustful and this can affect recovery as it can leave you isolated, rejected and option less. What has become apparent, both through these workshops and by reviewing the literature, is that the families of those who have multiple complex needs are critical actors not only in determining their lives up until the present, but also in steering pathways now and in the future. How families are embodied within policy and interventions, going forward.


Revolving Doors Agency has today released a literature review, as part of our series of literature reviews which aim to collate and build an evidence base around multiple complex needs. This particular literature review seeks understand the role of the family, its affirmative and adverse effects across the life course and how these intersect with multiple and complex needs.

We are now consulting with practitioners to see how we can take the learning from this literature forward by producing a practical and concise guidance document. If you would be interested in contributing to this process please contact Daniel Honeybun (


Update 21 November 2017: Lankelly Chase has written a blog on our Families Literature Review. Read it here.