Presentation delivered at the Assoication of Police and Crime Commissioners conference in Manchester 20 June 2013: Working with multiple and complex needs.

1. Working with multiple and
complex needs
Alan Kilmister – member National Service User Forum
Shane Britton – policy officer
Dominic Williamson - chief executive
Revolving Doors Agency

2. Themes for today’s session
– Understanding multiple and complex needs
– What works
– What can PCC’s do?
By understanding and addressing people’s multiple
needs we can transform lives, reduce reoffending ,
make communities safer and save money

3. What Revolving Doors is for
Our mission is to change systems and improve services for people
with multiple and complex needs who are in contact with the
criminal justice system.
We demonstrate and share evidence of effective interventions
and promote reform of public services through partnerships with
national and local political leaders, policy makers, commissioners
and other experts and by involving people with direct experience
of the problem in all our work.

4. What Revolving Doors does:
Development &
partnerships
Policy and
communications
Service user
involvement

5. An issue for PCCs
• Repeated contact
with the police
• Acquisitive crime and
anti-social behaviour
• Reoffending
• Vulnerable adults
and repeat victims
“A significant proportion of crime is committed by offenders
who have multiple problems” – Ministry of Justice - Breaking
the Cycle

6. Multiple and complex needs
• Multiple problems including:
o Poor mental health
o Substance misuse
o Practical needs – housing, debt etc
o Family, relationships and social networks
o Health and disability
o Underlying emotional problems resulting from history of being
in care as a child, abuse, neglect, violence, bereavement,
isolation and self harm
o Behavioural and attitudinal problems, including anger
management, hopelessness, institutionalisation, impulsivity.
• Complex because these issues occur at once, and interact to
create a cycle of crisis and crime and because services are
poor to respond.

7. Structural / environment
Community
Opportunities
Quality services
Public attitudes
Media
Multiple needs: understand the dynamic
Self : Mind
Resilience
Cognitive ability
Thoughts / emotion
Perceptions /beliefs
Childhood
Contribution
Involvement
Learning
Work
Basic needs
Housing
Money
Safety
Health
Mental
Physical
Treatment
Social
Family
Love
Friends
Group identity

8. Multiple needs: negative dynamic
Structural / environment
Poverty
Unemployment
Quality of services
Discrimination
Stigma
Negative media
Self – Mind
Mental / physical pain
Negative self image
Childhood trauma
Substance misuse
Contribution
Exclusion
Unemployment
Crime - prison
Basic needs
Rent arrears
Eviction
Homelessness
Rough sleeping
Poverty
Health
Common MH
problems
Poor physical health
No contact with GP
Social
Family breakdown
Isolation
Negative peer groups
No trusted
relationship
Outsider identity

9. The research literature also confirms what service users tell us:
that when they have multiple needs people experience a poorer
response from services
• Complex Responses (2011) identified a number of negative
elements in their experience of frontline services
• Driven by
Mismatch in expectations
Poor quality of staff-client
relationship
Fragmented Service response
Complexity
Delay
Service exclusion/denial
Limited
Resources
Inadequate Staffed
Services
Strategic Prioritisation
Inadequate Provision of
Services

10. Solutions - What Works?
• ‘Someone on your side’ - A trusted relationship within a team
• An assertive, persistent outreach and engagement
• Tailored to individual’s needs, capabilities, gender and culture
• Community based but linked to each stage of criminal justice system
• Applies a holistic, psychosocial understanding of multiple and complex
needs, including impact of complex trauma
• Flexible approach, responsive in crisis and relapse
• Co-produced with service users, involving them at all levels
• Draws on the experience of peers in recovery
• Coordination of services, brokering access and creating integrated
pathways especially treatment and housing
• Supported by strategic stakeholders and commissioners
• Gathers data to demonstrate impact, including cost benefits

11. Current context
• Social Justice Strategy
• Justice reforms – Rehabilitation strategy
• Justice reinvestment
• Community budgets
• Troubled families programme
• Greater integration – JSNAs, MOPAC etc
• Big Lottery Fulfilling Lives programme
• Deficit reduction and cuts to budgets

12. What can PCCs do?
1. Strategic leadership
2. Commission creatively
3. Consult with all those in
contact with the criminal
justice system

13. What can PCCs do?
1. Strategic leadership
– Create a strategy that draws
together opportunities for
change in your area
– Bring partners together,
including health, offender
health commissioners, local
authorities and housing to
tackle shared issue
– Build local data and evidence
around this problem
– Make the most of local liaison
and diversion services

14. What can PCCs do?
2. Commission creatively
– Maximise opportunities to joint commission with
partners and match funding around shared issues
– Contribute to community and pooled budgets in local
areas, like Tri-Borough in London
– Use capacity of VCSE – link with local networks and
commission services that focus on prevention, early
intervention and diversion (where appropriate)
– Ensure police officers have options when responding
to an incident

15. What can PCCs do?
3. Consult with all those in
contact with the criminal
justice system
– Service user involvement
improves policy and
services, but also helps
individuals involved in their
recovery
– Can use existing networks
and VCSE organisations
with strong service user
involvement in your area

16. Thank you
dominic.williamson@revolving-doors.org.uk
shane.britton@revolving-doors.org.uk
www.revolving-doors.org.uk
https://twitter.com/RevDoors