Supporting the health of people with multiple and complex needs

Supporting the health of people with multiple and complex needs
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New research has revealed insights into why many people with multiple and complex needs often die early, and offers suggestions on how to help support their health and wellbeing to avoid unnecessary deaths in the future.

According to new research, people who experience homelessness, drug and alcohol problems, mental ill health, and repeat offending, die early due to desensitisation to death, often through suffering vast loss and lack of hope. People with these needs also experience severe health inequalities, and their chance of dying early is almost seven times higher on average for men and 12 times higher for women than the general population.

To understand this, researchers from Fuse, the Centre for Translational Research in Public Health, worked in collaboration with Fulfilling Lives Newcastle Gateshead and its peer research network to undertake research directly informed by people with experience of multiple and complex needs, and those working to support them in the health, social care and voluntary sectors in Newcastle and Gateshead (North East England) through focus groups and a regional event.

Health inequality

The researchers found that those with lived experience of multiple and complex needs had vast experience of loss and this, coupled with a lack of hope that things could change for the better, meant they had become desensitised to death. The study also found that mental ill health, when combined with drug and alcohol problems and the poor co-ordination and collaboration between support services, increases vulnerability and the risk of people dying prematurely.

Angela Broadbridge, Research and Evaluation Lead for the Fulfilling Lives Newcastle and Gateshead programme said: “This research was hugely important to the Fulfilling Lives Newcastle Gateshead team, having experienced the collective grief of the deaths of 10% of our client cohort within the first six years of our National Lottery Community Fund programme.

“Our team wanted to understand high death rates amongst the people we support on the programme and our Experts by Experience Network wanted to take the lead on exploring this issue within their own community.

“This funding and the important partnerships formed made for a sensitive study of a traumatic topic and the experience of working alongside Fuse researchers has also been an important steppingstone to other co-produced research projects and we look forward to building on these relationships into the future.”

Finding solutions

The report suggests opportune moments of intervention when people should receive targeted support through critical life events, such as bereavement and relationship breakdown, and significant transitions, such as completing treatment, release from prison, or service discharge.

The researchers suggest deaths could be prevented by:

  • Introducing holistic, person-centred approaches
  • Building a sense of community for those who feel excluded from society
  • Improving connections and support across the health and wider care system
  • Placing the focus on prevention, particularly in early childhood
  • Exploring opportunities to support carers, providers, and families

Dr Sheena Ramsay, Clinical Senior Lecturer at Newcastle University and lead of the Fuse Healthy ageing research programme, said: “People with multiple complex needs experience disproportionate levels of ill-health and mortality. This piece of work provides important insights into addressing these high death rates, particularly, through early intervention at critical life stages and transition points, and through person-centred holistic approaches. The work has been especially valuable in co-producing research with ‘Experts by Experience’ and creating meaningful and mutually beneficial partnerships.”

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

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