Multiple and complex needs People with multiple and complex needs may experience several overlapping problems at the same time, such as mental ill health, homelessness, drug and alcohol addiction, offending and family breakdown. These individuals tend to fall through the gaps between services because no one takes overall responsibility for helping them to break the cycle they are in. They can find themselves in a downward spiral, living chaotic lives and experiencing poverty, stigma and discrimination. An increasing proportion of the people we work with are presenting with multiple needs, with approximately 60 per cent of our clients in this category. Nationally there are an estimated 58,000 people living in crisis due to the complexity of their needs and the lack of effective support services. Working with people with complex problems poses a number of challenges and we are committed to ensuring that our services are responsive to their needs. Our complex needs services in action At the cutting edge of this work is our Lottery-funded Fulfilling Lives in Islington and Camden project, which provides intensive one-to-one interventions to support individuals while at the same time working with a network of local service providers to learn lessons for systemic change. Meanwhile, across all our services, the roll out of the Psychologically Informed Environments (PIE) approach supports staff to work more effectively with people who have experienced complex trauma while creating a therapeutic service environment that aids client recovery and wellbeing. With its strong emphasis on addressing psychological and emotional needs and empowering people to break cycles of damaging behaviour, our Opportunities Programme is another key element in our multiple needs strategy. It can be particularly difficult to support people with multiple needs to achieve lasting outcomes in education, training and employment, as evidenced by the failure of government initiatives such as the Work Programme to achieve results when working with ‘hard to reach’ groups. Our recovery services in Camden and Islington have demonstrated considerable success in this area, enabling clients to pursue employment or education opportunities while engaging in and completing treatment.