1. Partnerships & Development
2. Programmes
3. Families and social networks

Our experience suggests that mental health problems, homelessness, debt, substance misuse and offending behaviour all impact on the family relationships of adults with multiple needs.  

“My parents don’t want to know me anymore. I’m an embarrassment to them.  I don’t blame them, but I’ve had so many problems and they don’t see I’m trying to change.”

Client of Neighbourhood Link, Islington

“When I came in here, my kids went to live with my Mum.  Now the Council have written to her saying they’ll evict her if she let’s me go back to hers, ‘cos they say I dealt drugs on the estate…  They say I can’t have my kids back till I’ve got housed.  How can I get housing if I can’t stay with my Mum and I’m banned from Council housing?”

Prisoner, HMP Holloway

With the support of the Tudor Trust and Monument Trust, we have just completed a three-year research and development programme exploring approaches that would strengthen the family relationships and social networks of adults with multiple needs.

Phase 1

The research phase of this work, completed in March 2009, focused on practitioners from adult services working with this group who had had little experience of engaging with families. It explored their attitudes towards including families in their work.

Key findings from Phase 1:

The report demonstrated both the complexity of family relationships in the client group and the complexity of working with their families. Some practitioners were well aware of this complexity while other practitioners, who did not exhibit this level of understanding, were in danger of operating outside their area of competence.  

The research identified the need for staff from adult services to develop new relationships with other agencies and new skills to engage more effectively with family members - both in the interests of supporting adults with multiple needs, and in order to provide relevant support to families. In particular, the research highlighted the need to develop culturally sensitive responses to families. 

However, the research also highlighted the considerable resource implications of undertaking family work. 

The Unfamiliar Territory research report can be downloaded here. Alternatively, a summary of the research is also available to download here.

Phase 2

Drawing on the findings from this research, we have worked with three delivery partners who, in their different ways, have explored how a family focus might be developed and improved in their existing work with adults with multiple needs.  There are some common themes which emerge which both complement and illustrate the findings of the phase one research and which provide the basis for the work in the final phase.

St Mungo’s is London’s largest provider of services for homeless people. Our work with them focused on the family-related needs of homeless women. Recommendations arising from this work have since been incorporated in St Mungo’s new women’s strategy. A summary of the findings from the research is available to download here.

Thames Valley Partnership work in partnership with local services to tackle social exclusion and to work towards creating stronger, safer communities. We were keen to work with them because of their expertise in supporting the families of offenders through their Family Matters project. As part of their work with us, they undertook research into how these families experience the criminal justice system, their support needs and ways in which children’s services and criminal justice services can work together to better meet these needs. The research is available to download here.

PLIAS is a black and minority ethnic (BAME) led resettlement organisation working with offenders in North-West London on release from prison.   Most of its work focuses on accommodation, training and employment. Family work had not previously been an area of focus for PLIAS. Our work with them focussed on the need to develop capacity within their own organisation, forge links with potential statutory and voluntary organisations in their area which could provide a service to BAME families and build relationships with faith groups. A peer support group around family problems has been established for their service users and will continue to be supported by Revolving Doors.

Key findings from Phase 2:

In many cases the families of individuals caught in the spiral of homelessness, mental health, substance misuse and offending are out of the picture and invisible.  Contact may have been lost and relationships damaged - sometimes irreparably - so that family is out of sight, but not necessarily out of mind

Concerns, anxieties and the pain of loss are common to many adults with multiple needs - but are rarely addressed by the agencies and individuals working with them.

Agencies providing support to adults with multiple needs find engaging with the wider family difficult, confusing and complex.  It involves contact and links with different agencies, policies and protocols and requires changes at all levels in the organisation.

Work with adults with multiple needs tends to focus on the individual and pays little attention to their family or wider social networks. However engaging with families improves and strengthens resettlement work, and improves outcomes.

Women tend to have more complex and more deep-seated problems, including more emotionally complex relationships with partners and children. Many have grown up in chaotic or abusive family settings with periods in care. They often have poor coping skills and difficulty in building and sustaining healthy relationships.

The failure by agencies to pay attention to the individual’s wider family needs can act as a barrier to engaging with treatment plans and achieving other resettlement targets.

Imprisonment has a very damaging effect on family relationships and the impact of the criminal justice system at every stage makes it difficult for offenders to maintain constructive relationships with their families.

The invisibility of prisoners’ families means that their needs remain largely hidden. A systematic method of identifying these families, assessing their needs and putting support packages in place is required at a number of points in the criminal justice system.

Adults and families/children in need of support are usually served by different organisations in both statutory and voluntary sectors. A joint approach is needed not only to improve outcomes but also to break inter-generational cycles of exclusion, poor mental health, drug and alcohol problems and offending. 

Organisations working with multiple needs need to understand the roles of other organisations and to be better linked with family services. This requires an investment of time and energy, a commitment to multi-agency approaches and the willingness to break down barriers.

Given the prevalence of drug and alcohol abuse, homelessness and poor mental health in this client group it is inevitable that the most likely contact with statutory services is if the child is thought to be at risk and removal of the children becomes an issue. This reinforces the stereotype that social services only exist to take children away from families.

Organisations and practitioners working with adults with multiple needs recognise a cycle where problems of mental health, substance misuse and offending are repeated through generations - with those who have experienced disrupted and unhappy family relationships continuing these patterns in their own later relationships.

This suggests the need for intensive very early intervention with the families and children of adults with multiple needs aimed at strengthening and supporting family relationships. 

Phase 3

The final phase of the work drew on the findings from both the research and development phases. Throughout the work it became clear that better joint-working between children’s services and adult services was frequently required to improve outcomes for adults with multiple needs and their families.

The final phase was led by the Thames Valley Partnership and aimed to:

• Develop capacity and improve front-line responses to the families of adults with multiple needs and in particular of those affected by imprisonment.
• Improve and strengthen multi-agency work, adapting their existing model to improve services for the families of adult offenders with multiple needs.
• Create access to earlier preventive services for children of adults with multiple needs in the interests of long-term prevention and breaking the intergenerational cycle of offending and poor life outcomes.

We worked with the Thames Valley Partnership to host an event bringing together children’s services and services for adult offenders from across the South-East of England. More information about the Relative Importance Conference can be found here.