Work

Exploring high mortality rates among people with multiple and complex needs: a qualitative study using peer research methods

Year: 2021

Type: article

Abstract: ABSTRACT Objective To explore the reasons underlying high mortality rates among people with multiple and complex needs and potential preventive opportunities. Design Qualitative study using peer research Setting North East of England Participants Three focus group discussions were held involving: 1) people with lived experience of MCN (n=5); 2) frontline staff from health, social care, and voluntary organisations that support MCN groups (n=7); and 3) managers and commissioners of these organisations (n=9). Results Findings from this study provide valuable insights from people with lived experience and staff on the complexity underpinning high mortality rates for individuals experiencing multiple and complex needs. Mental ill-health and substance misuse (often co-occurring dual diagnosis) were highlighted as significant factors underlying premature mortality among multiple and complex needs groups. Potential triggers to identify people at-risk included critical life events (e.g. bereavement, relationship breakdown) and transitions (e.g. release from prison, completion of drug treatment). Early prevention, particularly supporting young people experiencing adverse childhood experiences was also highlighted as a priority. Conclusion High mortality in MCN groups may be reduced by addressing dual diagnosis, providing more support at critical life events, and investing in early prevention efforts. Future service delivery should take into consideration the intricate nature of multiple and complex needs and improve service access and navigation. ARTICLE SUMMARY Strengths and limitations of this study This study employed focus group discussions with individuals with multiple and complex needs and service providers to understand the complexity underpinning high morality rates for individuals experiencing multiple and complex needs. Peer researchers contributed to all stages of this study, including developing the aims, data collection, interpretation, and shaping recommendations. Using peer researchers enhanced our access to participants and improved interpretation of data The main limitation is that the study only recruited individuals in one region in the North East of England. Views from individuals with MCN and service providers in other areas of England might have led the results to being more generalisable.

Source: BMJ Open

DOI: 10.1136/bmjopen-2020-044634