Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
BMJ Open. 2021 Jun 3;11(6):e044634. doi: 10.1136/bmjopen-2020-044634.
To explore the perceived reasons underlying high mortality rates among people with multiple and complex needs.
Qualitative study using peer research.
North East of England.
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).
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.
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.
探讨导致具有多重复杂需求的人群死亡率居高不下的潜在原因。
采用同伴研究的定性研究。
英格兰东北部。
共进行了 3 次焦点小组讨论，参与者包括：（1）具有多重复杂需求的实际体验者（n=5）；（2）支持多重复杂需求群体的卫生、社会关怀和志愿组织的一线工作人员（n=7）；（3）这些组织的管理者和负责人（n=9）。
本研究的结果提供了具有多重复杂需求的人群及其支持者对可能导致过早死亡的潜在因素的宝贵看法。精神健康问题和物质滥用（通常是双重诊断）被认为会影响多重复杂需求群体的过早死亡。识别处于危险中的人群的机会包括重大生活事件（例如，丧亲、关系破裂）和过渡时期（例如，出狱、完成戒毒治疗）。此外，还强调了早期预防的重要性，特别是为经历过不良童年经历的年轻人提供支持。
通过解决双重诊断问题、在重大生活事件中提供更多支持以及投资于早期预防工作，可以降低多重复杂需求群体的高死亡率。未来的干预措施可以考虑到多重复杂需求的复杂性，并改善服务的可及性和导航。
