EXPLORING HIGH MORTALITY RATES AMONG PEOPLE WITH MULTIPLE AND COMPLEX NEEDS: A QUALITATIVE STUDY USING PEER RESEARCH METHODS

Perry, R.; Adams, E. A.; Harland, J.; Broadbridge, A.; Giles, E. L.; McGeechan, G. J.; ODonnell, A.; Ramsay, S. E.

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. Keywords: multiple complex needs, mortality, prevention, interventions