Sarah Reed Turning PointIn this guest blog, Sarah Reed emphasises the importance of raising awareness of the issues people with complex needs and dual diagnosis face and the need to give them more support.

In the past few years it has been commonplace to read about the effects of unemployment, the lack of parity between physical and mental health, the intergenerational impact of alcohol misuse and increased homelessness. What we hear less about is the distinct issues, challenges and barriers that face people to which all of the above apply. 

The All Party Parliamentary Group (APPG) on Complex Needs and Dual Diagnosis aims to address this through a series of factsheets being published from this month, following an inquiry launched last year. 

The APPG is a group of Parliamentarians and stakeholders interested in those with multiple complex needs. The Group was established in 2007 and is chaired by David Burrowes MP and Lord Victor Adebowale CBE. Turning Point, a health and social care organisation with 50 years’ experience of supporting people with complex needs, acts as the secretariat. 

Last year the APPG launched its first inquiry – aiming to:

Reach a common definition of ‘complex needs’

Speak to experts with experience to highlight the barriers facing people with complex needs that have challenged successive governments 

Highlight examples of good practice where these challenges have been overcome. 

The Group committed to produce a series of factsheets, with the aim of bringing those with complex needs to the fore of the political agenda. The first was published this month and provides a definition of complex needs to help form a coherent understanding of this group, inform policymaking and influence service delivery.

As you can imagine, any definition of ‘complex needs’ is going to be broad –intentionally so because we are talking about people who are vulnerable and regularly excluded from services. It would be self-defeating to offer any definition that was in any way exclusive.  Therefore, the agreed definition is: ‘a person with complex needs is someone with two or more needs affecting their physical, mental, social or financial wellbeing.’ This could include, but is not limited to mental health issues, substance misuse, learning disabilities, social isolation, offending behaviour, trauma and poverty.

The definition highlights the likelihood of individuals experiencing ‘several problems simultaneously’ that are ‘often severe and/or long standing, often proving difficult to ascertain, diagnose and treat.’ This leads to ongoing inequalities, problems accessing services and people often falling through the gaps in service provision. 

Although data collection too often focuses only on individuals’ primary diagnosis, we know that thousands of individuals fall within this definition and face staggering health inequalities. Groups such as Gypsy Roma Travellers, for example, have a life expectancy 10-12 years less than the settled population (Irish Traveller Movement in Britain, 2012) while mental ill health is far more common among homeless people than the general population with homeless people 9 times more likely to take their own life (St Mungo’s, 2013).

At APPG meetings we often hear from people about the multiple barriers they’ve faced trying to get support that addresses all of their needs and the frustration they feel when they’re continually shunted around the system to no avail. Not only are people left feeling helpless, their recovery can be delayed and in some instances a lack of support can lead to premature death. 

This is unacceptable. As the factsheet highlights, society often fails to understand and coordinate the support people need. Insufficient attention in this area, nationally and locally, means that people are facing unnecessary social and economic costs that cannot continue unchecked. 

Our hope is that by firstly raising the profile of this group, and through subsequent factsheets highlighting the barriers and existing good practice out there, we can change the way services are designed and delivered for good. 

You can read the first factsheet by the All Party Parliamentary Group on Complex Needs and Dual Diagnosis – Defining Complex Needs here  


Irish Traveller Movement in Britain (2012) The Health and Wellbeing of Gypsies and Traveller: An Irish Traveller Movement in Britain Briefing. London: Irish Traveller Movement in Britain. Available at:

St Mungo’s (2013) Health and Homelessness: Understanding the costs and role of primary care services for homeless people. London: St Mungo’s. Available at:

About the author

Sarah Reed is external affairs manager at Turning Point and clerk to the APPG on Complex Needs and Dual Diagnosis