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Life experiences of people with multiple complex needs

Sheena Ramsay (Principal Investigator)

This study involved colleagues from Newcastle University, Gateshead Council, Teesside University, Northumbria University, charities (e.g. Fulfilling Lives Newcastle/ Gateshead), and people with lived experience. 


Multiple complex needs (MCN) describe a population experiencing a combination of homelessness, substance use, offending and/or mental ill-health. We undertook two studies where we looked to 1) explore the unmet health and care needs of this population and 2) explore the perceived reasons underlying high mortality rates  





Mental ill-health, substance use, poverty, early experiences of unstable housing and acute homelessness were identified as major precedents for adulthood experiences of multiple complex needs. 



Between 16 and 20 years, access to housing, social and mental health support was perceived as having the potential to prevent circumstances worsening. 




Mental ill health and substance misuse (often co-occurring dual diagnosis) were perceived as influencing premature mortality among multiple and complex needs groups.




Poor navigation and limited collaboration across services also led to negative outcomes for people experiencing multiple complex needs. 


Actions to prioritise prevention and health promotion:
•    Make every contact count not just those in health and social care
•    Target preventive interventions at ‘critical life events’
•    Ensure timely and effective access to support services


Actions to assist in focusing on the individual:
•    Collaborate with people with lived experience for service provision/development and research
•    Create a tiered person-centred treatment/care pathway that is trauma informed and free of stigma


Actions to implement a whole-system approach:
•    Improve collaboration and communication across all areas of service provision (especially mental health and substance use)
•    Improve service continuity and navigation
•    Introduce whole system commissioning models


Actions to explore opportunities to support supporters:
•    Create supportive work environments to ensure the MCN workforce has the required supports to continue providing exceptional care
•    Ensure families and carers of people with MCN have access to support to prevent burn-out and improve early recognition of support
•    Create conditions that empower community led peer support services 

Find out more




Part of this work was funded by a small seed grant from Public Health England as part of the Research Hub Initiative.

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