Complex Mental Health Needs Project

What are complex mental health needs?

Currently, adult mental health services include in-patient units, rehabilitation services and community-based interventions. Community services may include additional provisions that can be accessed depending on risk or diagnosis assessments. People with complex mental health needs have such significant clinical and/or risk needs that cannot always be adequately met by such generic services. Some service users experience a mix of mental health problems and they may require extra care or support to manage those problems. There are many different types of support and treatment that can be given, but it is not always clear which type is the best to offer. Gaining an in-depth understanding about service users who have such complex needs and the experiences of the care they have received will help to us think about how services should be best delivered in the future.

What are out of area placements?

When a patient is ‘placed’ in an out of area placement, it is usually because suitable psychiatric services are not available in their area. Often, such placements can result in the patient being moved a significant distance away from their home, away from local services, family and friends.

What is the Complex Mental Health Needs Project?

This project involves reviewing medical health records for service users who meet the criteria for this study. In order to understand the experience of service users who have complex mental health needs and who may have lived in different types of placements locally or away from home, we will review people’s treatment and management within the service over time. This project aims to inform the development of improved service models for people with complex mental health needs and is led by researchers at Liverpool John Moores University in collaboration with Cheshire and Wirral Partnership NHS Foundation Trust.

The project includes four components:

Description and analysis of clinical characteristics of the patient group

Using anonymised patient files, researchers will collect relevant data (as determined by various stakeholders) to enable an evaluation of the background of the patient and the pathways which led them to become part of the complex mental health needs group. Furthermore, this data will allow for analysis to be made on a group of patients as a collective.

Economic evaluation of patient pathways

An economic evaluation will be conducted to examine the resource use and cost impact associated with alternative care pathways to the NHS and other sectors of the economy (including social care). The evaluation will also explore patient health and non-health outcomes associated with alternative care pathways.

Qualitative evaluation of patients’ and carers’ experience

Semi-structured interviews will be carried out with patients and carers about their experience of services, decisions about their care and experience of being admitted into services. There will be a specific emphasis on any experience without of area placements. Thematic analysis will be conducted to identify areas of importance which will be addressed.

Qualitative evaluation of clinical decision-making in relation to this patient group

Building on the preliminary analysis from the steps 1-3 (outlined above), a small number of vignettes will be created which illustrate the key issues relevant to service development for this cohort of patients. Thematic analysis will be conducted to identify central themes that can inform a new service model.

Who should I contact for more information about this study?

Principal investigators:

Dr Pooja Saini - | Prof Taj Nathan –


Dr Jason McIntyre - | Dr Antony Martin - | Dr Amrith Shetty -

Research Assistants:

Anna Balmer - | Sam Burton – | Laura Sambrook - | Hana Roks –

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