Background Multiple complex needs (MCN) describe a population experiencing a combination of homelessness, substance use, offending and/or mental ill-health. Using peer researchers, this study aimed to explore the perspectives of individuals with lived experience of MCN with regards to (i) issues leading to MCN and (ii) key intervention opportunities. Methods As part of a health needs assessment in Gateshead (North East England), trained peer researchers interviewed 27 adults (aged ≥18 years) with experience of MCN, identified using purposive sampling methods. Peer researchers designed a topic guide for interviews which were audio recorded and thematically analyzed. Results Interviewees reported adverse childhood experiences leading to MCN including abuse, bereavement, parental imprisonment, family break-up and inadequate support. Mental ill-health, substance use, poverty, early experiences of unstable housing and acute homelessness were identified as major precedents for adulthood experiences of MCN. Between 16 and 20 years, access to housing, social and mental health support was perceived as having the potential to prevent circumstances worsening. Individuals perceived removing barriers to mental health, housing and welfare and financial supports could help. Conclusions This study highlights the perceived role austerity, adverse childhood events and current service provision have in current and future experiences of MCN. Individuals expressed a need for future interventions and support to be judgement free and provided by workers who are educated about MCN and related adversity. Involving peer researchers and individuals with experience of MCN in future research and service provision could ensure appropriate measures and supports are put in place.

中文翻译：

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了解具有多种复杂需求的人的生活经历：健康需求评估中的同行研究

背景 多重复杂需求 (MCN) 描述了经历无家可归、物质使用、犯罪和/或精神疾病的组合的人群。本研究使用同行研究人员，旨在探讨具有 MCN 生活经验的个人在 (i) 导致 MCN 的问题和 (ii) 关键干预机会方面的观点。方法 作为盖茨黑德（英格兰东北部）健康需求评估的一部分，训练有素的同行研究人员采访了 27 名具有 MCN 经验的成年人（年龄≥18 岁），使用有目的的抽样方法确定。同行研究人员为采访设计了一个主题指南，该指南被录音和主题分析。结果 受访者报告了导致 MCN 的不良童年经历，包括虐待、丧亲之痛、父母监禁、家庭破裂和支持不足。精神疾病，物质使用、贫困、早期的不稳定住房经历和急性无家可归被确定为 MCN 成年经历的主要先例。在 16 至 20 岁之间，获得住房、社会和心理健康支持被认为有可能防止情况恶化。个人认为消除心理健康、住房和福利以及经济支持方面的障碍可能会有所帮助。结论 本研究强调了紧缩政策、不良儿童事件和当前服务提供在 MCN 当前和未来经验中的作用。个人表示需要未来的干预和支持，以自由判断，并由受过 MCN 和相关逆境教育的工人提供。