Early Doing and Thinking Complexity: The Multiple and Complex Needs Initiative

This chapter describes the emergence and evolution of a government-funded program in Victoria, Australia, directed at people experiencing multiple and complex co-existing problems: ‘a combinations of mental illness, substance dependency, intellectual impairment, acquired brain injury, and who posed a risk to themselves and/or others’ (DFF&H 2021, p. 13). They were also often homeless. The author was central to the development of this innovative program as chair of the panel overseeing its establishment and initial roll-out during the first 5 years in early 2000s. Very little theoretical or conceptual work, in particular complexity theory, was available to guide the program developers. They themselves initiated and progressed understanding both of CT and the challenges of working across and within systems. The invaluable insights gathered from this process of doing – thinking – doing (doing while thinking and thinking while doing) provides readers with a dynamic account of thinking complexity and acting pragmatically in highly complicated situations, demonstrating the complexity not so much of service users but of service systems. The chapter details some of the lessons learned regarding making assessments, sequencing interventions and the skills and knowledge needed for working in complicated and evolving settings characterised by change, risk and uncertainty.