The hard edge of multiple problems

This is just the latest piece of research that reinforces the need to develop a more integrated system of social care. Although few argue against a more co-ordinated approach, we seem to have made very little progress towards constructing it with joined-up commissioning apparently as difficult to achieve as ever.

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Mapping severe and multiple disadvantage

A new report released by LlankellyChase foundation and Heriot-Watt University contains the most robust research to date on people with multiple complex needs.  Hard Edges: Mapping Severe and Multiple Disadvantage in England draws together previously separate datasets from the homelessness, offending and substance misuse treatment systems.

The report also takes into account available data around mental health and poverty.   It delivers the latest and most comprehensive statistics on people facing severe and multiple disadvantage: where they live, what their lives are like, how effectively they are supported by services, and the economic implications of the disadvantages they face.

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The Report

Although policy makers, practitioners and researchers all know that most people who are involved in crime, dependent on drugs and alcohol or are homeless suffer multiple problems, it has always been difficult to verify this on a national scale because the data sets tend to be separate from each other.

Even though the figures are shocking, it must be remembered that they represent a considerable under-estimate, since the numbers counted are essentially those which show up in official systems and we know that many people in all these groups are not being supervised by probation, receiving substance misuse treatment or receiving help with being homeless. Nevertheless, here is the key graphic:

SMD overlap

Findings

Many of the report’s findings confirm what many of us already feel we know:

  • There is a huge overlap between the offender, substance misusing and homeless populations.  For example, two thirds of people using homeless services are also either in the criminal justice system or in drug treatment in the same year.
  • Over half (55%) of the group with all three problems have also been diagnosed as having a mental health problem.
  • Local authorities which report the highest rates of people facing severe and multiple disadvantage are mainly in the North of England, seaside towns and certain central London boroughs. However, even in the richest areas, there is no part of England that is untouched by the issue of severe and multiple disadvantage.
  • People found in homelessness, drug treatment and criminal justice systems are predominantly white men aged 25-44 (8 out of ten of this group are men and just over 8 out of 10 are white)
  • As children, many experienced trauma and neglect, poverty, family breakdown and disrupted education. As adults, many suffer alarming levels of loneliness, isolation, unemployment, poverty and mental ill-health. All of these experiences are considerably worse for those in overlapping populations.
  • Half (48%) are perpetrators of domestic violence and almost one in five (18%) victims.

However, other findings challenge some of our assumptions. I admit to being surprised to find that 60% of this group are either living with children or are in regular contact with them.

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Conclusion

This is just the latest piece of research that reinforces the need to develop a more integrated system of social care.

Although few argue against a more co-ordinated approach, we seem to have made very little progress towards constructing it with joined-up commissioning apparently as difficult to achieve as ever.

 

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2 Responses

  1. The link between being a perpetrator of domestic violence and complex needs is unsurprising. While zero tolerance campaigns to raise awareness are undoubtedly helpful in prevention, do the campaigns create a harmful unintended consequence of additional stigmatisation which in turn can inhibit recovery, rehab and desistance? From an employment perspective, my work with recruiters has uncovered personal value judgements which commonly replace any notion of conviction relevance. Similarly reconnection with communities is especially difficult with such stigmatised criminal histories.

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