Do “complex needs” need “complex needs services”? – part one
| Pages | 127-134 |
| DOI | https://doi.org/10.1108/MHSI-05-2013-0018 |
| Published date | 16 August 2013 |
| Date | 16 August 2013 |
| Author | Robin Johnson |
| Subject Matter | Health & social care |
Do “complex needs”need “complex needs
services”? – part one
Robin Johnson
Robin Johnson is Visiting
Fellow at the International
Centre for Public Services
Management, Business
School, Nottingham Trent
University, Nottingham, UK.
Abstract
Purpose – This paper – the first of two – aims to trace the origins of, and suggest the underlying intentions
behind, the recent appearance of the new term “complex needs”, amongst commissioners, service
providers and some service user groups.
Design/methodology/approach – The paper takesa narrative approach, describing the early appearance
of the term “complex needs”in services for those excluded from and/or stigmatised in mental health
services. This is then contextualised with UK Government policy papers.
Findings – Contemporary usage of the term “complex needs”may at times be inconsistent and confusing;
but it reflects government concerns that service provision has become too narrow in focus, and less needs-
led. The concept embodies an implicit critique of overly narrow practice, and holds the prospect of more
systemic change.
Originality/value –“Complex needs”is relatively new,as a quasi-technical term; as is any analysis locating
its usage in the context of current overly narrow service definitions.
Keywords Multiple exclusion, Personality disorder, Commissioning, Evidence-based practice, Personality
Paper type Conceptual paper
New kid on the bloc of terminology
In the last few years a new term, “complex needs”, has begun to appear in the descriptions and
discussions amongst service providers and commissioners, especially in relation to areas such
as mental health and with other excluded or marginalised groups. Like most useful innovations
in language, the term serves to address and focus on a range of problems and concerns, and to
touch upon related issues that other frameworks either did not cover or did not cover
adequately – to take us where other terms did not reach.
“Complex needs” has had, so far as we can discern, three or four distinct routes into its current
role, gathering meaning and momentum at every turn. In this first of two papers, therefore,
I propose to explore the roots of the term – for brevity let us call it “CN” – and the way it has
entered our services vocabulary. In the second paper, I will explore in more depth how this
development relates to other attempts to wrap services around the needs of individuals, suchas
personalisation, individual budgets and “lead professional” co-ordinating roles; and in particular,
what lessons we might learn from the early example of the Care Programme Approach in mental
health, regarding attempts to tackle multi-faceted needs in an inter-agency world.
In fact, it is my contention in these two papers that the term CN is trying not simply to focus on a
newly discovered and previously marginalised or overlooked client group. Rather, it is
something more radical – an attempt to escape the pigeon-holing of client groups, the overly
tight specifications of eligible client groups and suitable outcomes, which has be devilled needs-
led service development since the inception of the purchaser/provider split. This, I will argue,
has been in large measure actually responsible for the blind spots and gaps in services that we
are now seeking to fill.
DOI 10.1108/MHSI-05-2013-0018 VOL. 17 NO. 3 2013, pp. 127-134, CEmerald Group Publishing Limited, ISSN 2042-8308
j
MENTAL HEALTH AND SOCIAL INCLUSION
j
PAGE 127
Get this document and AI-powered insights with a free trial of vLex and Vincent AI
Get Started for FreeStart Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant
-
Access comprehensive legal content with no limitations across vLex's unparalleled global legal database
-
Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength
-
Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities
-
Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting
Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant
-
Access comprehensive legal content with no limitations across vLex's unparalleled global legal database
-
Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength
-
Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities
-
Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting
Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant
-
Access comprehensive legal content with no limitations across vLex's unparalleled global legal database
-
Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength
-
Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities
-
Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting
Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant
-
Access comprehensive legal content with no limitations across vLex's unparalleled global legal database
-
Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength
-
Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities
-
Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting
Start Your Free Trial of vLex and Vincent AI, Your Precision-Engineered Legal Assistant
-
Access comprehensive legal content with no limitations across vLex's unparalleled global legal database
-
Build stronger arguments with verified citations and CERT citator that tracks case history and precedential strength
-
Transform your legal research from hours to minutes with Vincent AI's intelligent search and analysis capabilities
-
Elevate your practice by focusing your expertise where it matters most while Vincent handles the heavy lifting