The Multi-Agency Risk Assessment and Management (MARAM) Process is designed to support people where high levels of risk have been identified and a multi-agency approach would be beneficial. It brings together senior professional representatives from multiple agencies including the emergency services, health and social care to identify what needs to be done to reduce the risk. The professionals meet once a month to discuss multiple people. They will then decide if a review meeting is needed to manage the ongoing concerns.
MARAM does not replace statutory adult safeguarding. It is a framework for managing risk where the concerns do not come from a third party and the person is able to protect themselves, but they remain at risk. The referring agency needs to demonstrate that they have exhausted all strategies to reduce the risk before considering referring to MARAM.
Concerns that would meet the threshold for MARAM:
- vulnerability factors requiring pro-active prevention and protection measures to reduce the risk of escalation to a safeguarding response
- on-going needs or behaviour, placing the person and/or others at significant risk
- self-neglect including hoarding and concerns around fire safety where the person is able to protect themselves
- refusal or disengagement from care and support services where person is at significant risk without support
- noncompliance with medication or not adhering to treatment advice where this leaves the person at significant risk of harm
- complex or diverse needs, which either fall between statutory responsibilities or eligibility criteria, or span a number of agencies. For example, risks from the impact of neurodivergence, mental health, substance misuse or care leavers who are not eligible under the Care Act 2014 but present with vulnerabilities
- risks previously addressed via a section 42 enquiry but for which the need for ongoing risk management and monitoring has been identified
- repeated concerns around suicide risk and self-harm where this intersects with other risks and cannot be managed by secondary mental health services alone
- where the person is unable to maintain stable accommodation
*this list is not exhaustive