Managing cases with complex needs at Marac

This briefing provides guidance to Maracs and other multi-agency meetings on managing cases involving substance misuse and other complex needs.

This guidance has been created by two national scrutiny panels; the panels gather together experts from all core agencies required for an effective Marac to reflect on anonymised cases, with the aim of troubleshooting common issues. The national scrutiny panel is held at the Home Office. SafeLives would like to thank those who attended the panels for their help and advice in developing this guidance.

Marac cases involving complex substance misuse and/or mental health issues are relatively common. Areas often observe that the number of cases with complex needs seems to increase each year. These cases often account for the large majority of repeat cases heard at Marac so having a rigorous and consistent approach is essential.

This guidance explores the basic principles of managing risks at multi agency meetings and how they relate to cases involving substance misuse and/or other complex needs which often go hand in hand such as mental health problems. It offers tips for researching cases and sharing information and action planning at the meeting.

What this briefing contains

• Introduction
• What are the basics?
  • Single point of contact (SPOC)
  • Attendance from core agencies at every meeting, with consistent representatives
  • The behaviour of the perpetrator is addressed
  • Needs of children including their safety is addressed in every case
  • GPs and professionals working in A&E may be the first to identify victims and perpetrators who present with complex needs
  • Services take responsibility to engage with victims and perpetrators
  • Victims are more likely to be in a relationship and leaving is not an immediate or foreseeable option
  • Change the Narrative
  • Researching case files and information sharing
  • Effective action planning
  • What if the victim or perpetrator is a young person with complex needs?
• Outside the Multi-agency meeting
  • If you’re part of a Marac strategic or governance group
  • If you’re a commissioner
  • If you work in Wales
  • Recommended Resources and Guidance for all practitioners & strategic leads