Complex cases

Multiple risks need special attention. In particular, children, particularly infants, are at higher risk of harm in families where there is abuse of alcohol and other drugs. They are at even higher risk if there are other risk factors such as domestic violence and mental health issues.

You need to identify complex cases early. In the community services sector, they are generally defined as:

• Life-threatening, high risk situations
• Cases with the following factors:
1. Serious or sustained abuse
2. Multiple difficulties in the family
3. Intellectual disability
4. Psychiatric condition
5. Chronic and serious drug addiction, especially polyaddiction (addiction to multiple substances simultaneously)
6. Risk of self-harm
7. Risk of violence or sexual abuse
8. Risk of blood-borne diseases (e.g. use of needles)
9. A wide range of other agencies is involved, e.g. community services, legal, medical and police agencies.
10. The family has been involved with protective and custodial agencies over a long period
11. The age of the client creates special considerations. (e.g. children, the elderly)
12. Cases with high public or political sensitivity. (These need more sensitive, experienced case investigation and management.)

Some organizations or industry standards require three or more of the above "complex" factors to be considered high risk. Other guidelines suggest that any one of them could be adequate grounds for residential care, in particular:

1. Serious or sustained abuse
2. Multiple difficulties in the family
3. Chronic and serious drug addiction, especially polyaddiction (addiction to multiple substances simultaneously) and any use of needles.
4. Risk of blood-borne diseases (e.g. use of needles)
5. Risk of self-harm
6. Risk of violence or sexual abuse
7. The family has been involved with protective and custodial agencies over a long period

In children's work, complex cases can include factors such as:

• Multiple abuse/injuries
• Ritual abuse
• Life threatening/high risk situations
• Multiple difficulties present in family
• Family/domestic violence
• Involvement of protective and custodial agencies in the family over a lengthy period
• Poverty including poor housing, inadequate and limited educational, health and social facilities, and high-risk communities or neighborhoods