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New report reviews ‘what works’ for people facing multiple and complex needs

New report reviews ‘what works’ for people facing multiple and complex needs

29 January 2015

A report published today by Revolving Doors Agency and Centre for Mental Health shows that some of the most excluded and disadvantaged people in society can be effectively helped through better, more targeted support.

The report, Comprehensive Services for Complex Needs: A Summary of the Evidence, assesses the evidence for three programmes designed to work directly with people facing multiple and complex needs: Multisystemic Therapy; wraparound; and the link worker model. It shows these programmes can address important issues such as crime and homelessness, while improving clients’ wellbeing.

The briefing outlines both the cost-benefit and the effectiveness of these service models. While highlighting the need for further robust research regarding some outcomes, our review found promising evidence that:

  • All three models can reduce reoffending rates. In a UK trial Multisystemic Therapy reduced the percentage of young people reoffending by 26%
  • All three models have potential to save public money in the long run, through reduced reoffending, reduced demand on costly emergency responses, and fewer young people going into care
  • There is promising evidence that the link worker model helps the long-term homeless into stable homes and improves their mental health.

People facing multiple and complex needs experience a combination of problems at once, such as mental ill health, substance misuse, homelessness and offending. The report comes at a key time; it follows the 2014 Autumn Statement, in which the government committed to “look to develop and extend the principles of the Troubled Families programme to other groups of people with complex needs from the next Spending Review”[1].  

Funding effective support has the potential to address important priorities for local leaders. The evidence review shows the models can reduce reoffending rates, improve access to mainstream healthcare, reduce homelessness and reduce the amount of children going into care.

Vicki Helyar-Cardwell, Director of Research and Development at Revolving Doors, said:

“People facing multiple and complex needs exist in all our communities, but they are too often written off as ‘too difficult’ to help or simply overlooked as services focus on single issues. However, providing effective support for people with multiple needs should be a priority for local leaders in light of recent government commitments. In a time when local authorities need to make savings, programmes which can address key local priorities, such as reducing reoffending and preventing young people going into care, as well as potentially saving money should be seriously considered”.

Centre for Mental Health chief executive Sean Duggan said:

“People with multiple and complex needs have been overlooked for too long. This briefing sets out three promising ways in which local services can get together to produce cost-effective solutions. If we are serious about achieving parity for mental health, engaging and effective support for people with complex needs should be a focus for sustained action in every local community.”


Contact Lucy Terry on 020 7940 9745 or lucy.terry@revolving-doors.org.uk for more information.



The report, published online at http://www.revolving-doors.org.uk/documents/comp-services-complex-needs-summary-of-the-evidence, is published today by Revolving Doors Agency and Centre for Mental Health.

Revolving Doors is a charity working across England to change systems and improve services for people with multiple problems, including poor mental health, who are in repeat contact with the criminal justice system. We do this through: policy work; research and development; and we also run a national service user forum of people with direct experience of the issues. We work with partners in the fields of criminal justice, health, employment and social care. www.revolving-doors.org.uk

Centre for Mental Health is an independent national mental health charity. We aim to inspire hope, opportunity and a fair chance in life for people of all ages living with or at risk of mental ill health. We act as a bridge between the worlds of research, policy and service provision and believe strongly in the importance of high-quality evidence and analysis.

We encourage innovation and advocate for change in policy and practice through focused research, development and training. We work collaboratively with others to promote more positive attitudes in society towards mental health conditions and those who live with them. www.centreformentalhealth.org.uk