Islington community MARAC referral form

Potential escalation of ASB

There have been a number of incidents by the same perpetrator on the same victim(s) in the last 6 months and they are increasing in severity or frequency.

Professional judgement

You as a professional consider the victim/perpetrator to be particularly vulnerable or at risk of serious harm or death.

Perception

Impairment that may limit mobility or capacity/learning difficulties.

Mental health issues

Drug or alcohol misuse

Limited support network

What do you wish to achieve by referring to the CMARAC?

I need help to access support from a service/services
I have the right services involved but need help progressing actions
The victim perpetrator is falling between services, I need a joined up approach
The victim perpetrator is hard to engage, I need a coordinated plan to support them
I have exhausted options, I need help identifying next steps
I believe the victim is being cuckooed and I need a multi-agency response.
Other, please describe

Do you need this case to be discussed at the Domestic violence MARAC to address issues of domestic violence?

Yes
No