Too often people with multiple needs are denied the support they need. They may be labelled as too high risk to work with, ‘hard to reach’ or the extreme poverty and difficulties they find themselves in may be viewed as ‘life-style choices’.

It is possible to engage with and help those with the most complex and entrenched needs. What is more they make the most progress. Key to this is a person centred and individualised support approach. People’s pathways of progress and recovery are different, relapses and setbacks are part of this pathway.

It is essential that services acknowledge and accommodate this reality rather than punish it by excluding people or closing cases. Some people will take longer than others to make progress.

People with multiple needs are diverse and should not be seen as a uniform group. It is vital that those designing services recognise this and take steps to understand their potential service users in detail.

People’s needs are interrelated and not mutually exclusive. Homelessness, substance misuse, mental ill-health, reoffending and domestic abuse often affect the same people. Individually these are all challenging issues, together they create a level of complexity that can be difficult to address.

It is crucial that these issues are tackled together, holistically, and not separately. Systems must be fit for purpose and the voice of Lived Experience is essential in ensuring this.