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Presentation delivered at the Assoication of Police and Crime Commissioners conference in Manchester 20 June 2013: Working with multiple and complex needs.
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Working with multiple and complex needs
Alan Kilmister – member National Service User ForumShane Britton – policy officer
Dominic Williamson - chief executive
Revolving Doors Agency
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
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.
What Revolving Doors does:
Development & partnerships
Policy and communications
Service user involvement
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
Multiple and complex needs• Multiple problems including:
o Poor mental healtho Substance misuseo Practical needs – housing, debt etco Family, relationships and social networkso Health and disabilityo 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.
Structural / environmentCommunityOpportunitiesQuality services
Public attitudesMedia
Multiple needs: understand the dynamic
Self : MindResilience
Cognitive abilityThoughts / emotionPerceptions /beliefs
Childhood
Contribution
InvolvementLearning
Work
Basic needsHousingMoneySafety
HealthMentalPhysical
Treatment
SocialFamilyLove
FriendsGroup identity
Multiple needs: negative dynamic
Structural / environmentPovertyUnemploymentQuality of services
DiscriminationStigmaNegative media
Self – MindMental / physical pain
Negative self imageChildhood traumaSubstance misuse
Contribution
ExclusionUnemploymentCrime - prison
Basic needsRent arrears
EvictionHomelessnessRough sleeping
Poverty
HealthCommon MH problems
Poor physical healthNo contact with GP
SocialFamily breakdown
IsolationNegative peer groups
No trusted relationshipOutsider identity
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
Limited Resources
Inadequate Staffed Services
Inadequate Staffed Services
Strategic PrioritisationStrategic Prioritisation
Inadequate Provision of Services
Inadequate Provision of Services
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
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
What can PCCs do?
1. Strategic leadership2. Commission creatively3. Consult with all those in
contact with the criminal justice system
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
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
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
Thank you
www.revolving-doors.org.uk
https://twitter.com/RevDoors
