Understanding the life experiences of people with multiple complex needs: peer research in a health needs assessment.

Jill M Harland,Sophie Boobis,Emma A Adams,Sheena E Ramsay,Alice Wiseman,Mandy Cheetham

doi:10.1093/eurpub/ckab142

Jill M Harland, Sophie Boobis + Show 4 more

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https://doi.org/10.1093/eurpub/ckab142

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Abstract

BackgroundMultiple complex needs (MCN) describe a population experiencing a combination of homelessness, substance use, offending and/or mental ill-health. Using peer researchers, this study aimed to explore the perspectives of individuals with lived experience of MCN with regards to (i) issues leading to MCN and (ii) key intervention opportunities.MethodsAs part of a health needs assessment in Gateshead (North East England), trained peer researchers interviewed 27 adults (aged ≥18 years) with experience of MCN, identified using purposive sampling methods. Peer researchers designed a topic guide for interviews which were audio recorded and thematically analyzed.ResultsInterviewees reported adverse childhood experiences leading to MCN including abuse, bereavement, parental imprisonment, family break-up and inadequate support. Mental ill-health, substance use, poverty, early experiences of unstable housing and acute homelessness were identified as major precedents for adulthood experiences of MCN. Between 16 and 20 years, access to housing, social and mental health support was perceived as having the potential to prevent circumstances worsening. Individuals perceived removing barriers to mental health, housing and welfare and financial supports could help.ConclusionsThis study highlights the perceived role austerity, adverse childhood events and current service provision have in current and future experiences of MCN. Individuals expressed a need for future interventions and support to be judgement free and provided by workers who are educated about MCN and related adversity. Involving peer researchers and individuals with experience of MCN in future research and service provision could ensure appropriate measures and supports are put in place.

Highlights

IntroductionMultiple complex needs (MCN) is a broad definition and one of a number of terms (such as severe and multiple disadvantage and multiple exclusion homelessness) seeking to identify a population experiencing co-occurring issues of homelessness, substance use, crime and mental health problems.[1,2,3] This presence of overlapping vulnerabilities is associated with extreme health inequalities
Multiple complex needs (MCN) is a broad definition and one of a number of terms seeking to identify a population experiencing co-occurring issues of homelessness, substance use, crime and mental health problems.[1,2,3] This presence of overlapping vulnerabilities is associated with extreme health inequalities
Little health service research has used peer research methods, where people with lived experience are trained and involved in research to gain access to marginalized populations. This can provide more relevant and inclusive research informed solutions and elicit unique perspectives because of the shared experiences and ‘insider’ status peer researchers bring to discussions.[19]. This study explores this through co-conducting a health needs assessment (HNA) with peer researchers within the Gateshead Metropolitan Borough Council (GMBC) in the North East of England

Summary

Introduction

Multiple complex needs (MCN) is a broad definition and one of a number of terms (such as severe and multiple disadvantage and multiple exclusion homelessness) seeking to identify a population experiencing co-occurring issues of homelessness, substance use, crime and mental health problems.[1,2,3] This presence of overlapping vulnerabilities is associated with extreme health inequalities. Multiple complex needs (MCN) describe a population experiencing a combination of homelessness, substance use, offending and/or mental ill-health. Methods: As part of a health needs assessment in Gateshead (North East England), trained peer researchers interviewed 27 adults (aged 18 years) with experience of MCN, identified using purposive sampling methods. Conclusions: This study highlights the perceived role austerity, adverse childhood events and current service provision have in current and future experiences of MCN. Involving peer researchers and individuals with experience of MCN in future research and service provision could ensure appropriate measures and supports are put in place

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