1. Complex Needs
Peter Cockersell
©2016 peter cockersell

2. The Root of Complex Needs
The root cause of so-called ‘complex needs’ lies in trauma, and especially compound trauma, usually combined with the impact of social deprivation and poverty
Psychological and emotional responses to the experience of trauma (including vicarious trauma) interact with social determinants to create high levels of poor mental health, substance dependency, criminality and social exclusion
©2016 peter cockersell

3. Multiple Deprivation Lankelly Chase’s ‘Hard Edges’ report (2015):
Severe multiple deprivation – prison, substance dependency treatment, homelessness within same year
58,000 people in England (164,000 with any two)
No mental health data available
85% had experienced childhood trauma
©2016 peter cockersell

4. Complex Trauma ‘Complex Trauma’ is not complex
The term is used to describe the experience of repeated and unprocessed experiences of trauma, usually beginning from an early age
A more exact term for this would be ‘Compound Trauma’
©2016 peter cockersell

5. Psycho-emotional Impact of Trauma
Trauma damages development, including affect regulation, sense of self, sense of time, and problem-solving
Trauma damages attachment patterns, and ability to form stable relationships
Trauma enhances the fear responses, and heightens long-term stress levels
Trauma stimulates the ‘claustro-agoraphobic dilemma’
©2016 peter cockersell

6. Behavioural Impact of Trauma
The way that the psychological and emotional effects of exposure to trauma and social deprivation
appear in behaviours
are
multiple
©2016 peter cockersell

7. Behaviours associated with compound trauma NMHDU 2010
Self-harm
Uncontrolled drug or alcohol use
Impulsiveness, careless of the consequences
Withdrawal, reluctance to engage
Anti-social
Self-isolation
Depression, anxiety
Aggression
Lack of daily structure or routine
Inability to sustain work or education
Bullying, or being a victim of bullying, or both
Offending
Unstable relationships
Relationships based on ‘using’
Personality disorders, psychosis
©2016 peter cockersell

8. Complex Needs St Mungo’s Client Needs Survey 2014
©2016 peter cockersell

9. Damaging relationships damage people
Trauma is Social
Trauma occurs between people, and between groups of people and an individual, and between society and groups of people - it is a social process, and part of socialisation
Damaging relationships damage people
Compound trauma could be described as a kind of antisocial socialisation
©2016 peter cockersell

10. Trauma and Recovery Healing relationships heal people
Along with equal and fair opportunities
©2016 peter cockersell

11. Most ex-homeless people cite a person who made all the difference to them
(The Escape Plan, Groundswell)
Never underestimate how important you can be to someone
©2016 peter cockersell

12. The Outcome – Increased Resilience
“I didn’t believe in myself, but it seems that other people believed in me; through their belief I could begin to do things.”
St Mungo’s client, 2014
©2016 peter cockersell

13. References on Trauma and Mental Health
Van der Kolk, Proposal for a Developmental Trauma Disorder Diagnosis, 2009; or Developmental Trauma Disorder, in Psychiatric Annals, 2005
Johnson and Haigh, eds, Complex Trauma and Its Effects, 2012
BPS Journal, special edition on psychology and social exclusion, January 2015
Solomon and Siegel, Healing Trauma, 2003
Roos et al, Homelessness and Adverse Childhood Events, in American Journal of Public Health, 2013
Masten, Ordinary Magic, in American Psychologist, 2001
©2016 peter cockersell

14.
©2016 peter cockersell