Toggle Main Menu Toggle Search

Open Access padlockePrints

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

Lookup NU author(s): Rachel Perry, Emma AdamsORCiD, Jill Harland, Dr Grant McGeechan, Professor Amy O'DonnellORCiD, Professor Sheena Ramsay



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© Objective To explore the perceived reasons underlying high mortality rates among people with multiple and complex needs. 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 multiple and complex needs (n=5); (2) front-line staff from health, social care and voluntary organisations that support multiple and complex needs groups (n=7); and (3) managers and commissioners of these organisations (n=9). Results Findings from this study provide valuable perspectives of people with multiple complex needs and those that provide them with support on what may be perceived factors underlying premature mortality. Mental ill health and substance misuse (often co-occurring dual diagnosis) were perceived as influencing premature mortality among multiple and complex needs groups. Perceptions of opportunities to identify people at risk included critical life events (eg, bereavement, relationship breakdown) and transitions (eg, 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 multiple and complex needs groups may be reduced by addressing dual diagnosis, providing more support at critical life events and investing in early prevention efforts. Future interventions could take into consideration the intricate nature of multiple and complex needs and improve service access and navigation.

Publication metadata

Author(s): Perry R, Adams EA, Harland J, Broadbridge A, Giles EL, McGeechan GJ, O'Donnell A, Ramsay SE

Publication type: Article

Publication status: Published

Journal: BMJ Open

Year: 2021

Volume: 11

Issue: 6

Online publication date: 03/06/2021

Acceptance date: 20/05/2021

Date deposited: 10/08/2021

ISSN (print): 2044-6055

ISSN (electronic): 2044-6055

Publisher: BMJ Publishing Group


DOI: 10.1136/bmjopen-2020-044634

PubMed id: 34083333


Altmetrics provided by Altmetric