The factors most commonly associated with the occurrence of child abuse and neglect, and identified in families involved with child protection services, are domestic violence, parental substance abuse and parental mental health problems (Cleaver, Nicholson, Tarr, & Cleaver, 2007; Cleaver, Unell, & Aldgate, 1999; Scott, 2009). The significance of parental substance misuse, mental health problems and domestic violence is made clear in the National Framework for Protecting Australia's Children, which states "A particular focus is sustained on key risk factors of mental health, domestic violence and drug and alcohol abuse" (Council of Australian Governments, 2009, p. 21). Families in which parents present with these problems are often situated within a wider context of exclusion and disadvantage (e.g., housing instability, poverty, low education, social isolation and neighbourhood disadvantage). Parents may also be struggling to come to terms with their own experiences of trauma and victimisation. These types of problems are complex, often inter-related, and chronic in nature and rarely occur in isolation. Where these problems occur within families, the families are described as "families with multiple and complex problems".

This paper investigates the separate impacts of parental substance misuse, domestic violence and parental mental health problems. It presents evidence regarding the extent to which these problems co-occur and a discussion of the wider context of exclusion and disadvantage, its causes and its consequences. Finally, it provides an overview of research and theory for working with families with multiple and complex problems.