Severe and Multiple Disadvantage Research Project

What is the project about?

In January 2015, Lankelly Chase released the Hard Edges report, highlighting what life is like for people facing ‘severe and multiple disadvantage’ (SMD). Severe and Multiple Disadvantage is generally defined as a combination of homelessness, drug and alcohol abuse, offending, and mental health issues. However, whilst the findings from Hard Edges provided valuable insight into what SMD looks like for the general population, we do not know what proportion of the respondents identified as LGBT. As a result, we are unsure how LGBT people may experience severe and multiple disadvantage in similar or different ways.

There are several studies suggesting that LGBT people may be over-represented in certain aspects of severe and multiple disadvantage, or may experience them differently. For example, previous studies show that as many as 1 in 3 homeless youth are LGBT (Crisis, 2005), that LGBT people are more likely to be substance dependent (University of Central Lancashire, 2014) and that LGBT people are more likely to face mental health challenges such as depression and anxiety (King et al 2008). What we don’t know, however, is how these factors interact to affect the lives of LGBT people, or if there are other factors not yet researched within current SMD literature (for example, domestic abuse or sex work) that may constitute severe disadvantage for LGBT people.

As a result of this gap in knowledge, we have been funded to conduct research with LGBT people to understand what constitutes severe and multiple disadvantage for this group, exploring their experiences and the impact it has on their lives, and using this information to support the development of services which are truly responsive to LGBT people. This study breaks new ground in developing an understanding of the specific severe and multiple disadvantage needs of a population where there is already a strong evidence base around some inequalities, but where few studies have drawn this evidence together in order to paint a picture of complex needs.

How are we conducting the research?

LGBT people with lived experience of severe and multiple disadvantage play a central role in the research process. As such, we’re adopting a ‘peer led’ approach, ensuring that those with lived experience take the lead on the design, development, delivery, and dissemination of the research. To achieve this we have set up a ‘core group’ of people with lived experience who play an essential role in shaping the project, advising on all aspects of the project plan and also participating directly in data capture (through ‘peer interviewing’) and data analysis. Importantly, we ensure that the research process is mutually beneficial for the core group members, offering training and payment for those who wish to carry out interviews, access to an NVQ in health and social care, and the option to engage with volunteering opportunities within the LGBT Foundation in return for their valuable time and expertise.

What will the findings be used for?

Our project is a piece of action-research that seeks to deliver real change for LGBT people experiencing SMD. It therefore includes an accompanying policy-focused dimension, enabling practical application of the evidence generated to positively influence policy and the severe and multiple disadvantage agenda.

The LGBT Foundation and members of the project’s Steering Group are already closely linked with commissioners and policy makers in Greater Manchester, and the devolution agenda presents a timely opportunity: historically, the majority of commissioning decisions have been controlled centrally, but devolution offers an opportunity to influence local commissioners to provide services that suit local need. We will create a worked case study which could be utilised by other devolved authorities to ensure both that LGBT communities’ needs are better met, and that the VCSE sector is involved as an equal partner in devolution plans.

We will also develop a series of ‘action workshops’ with partner organisations designed to facilitate conversation between people with lived experience and policymakers about how we can take the research findings forwards in ways which will tangibly improve the lives of LGBT people experiencing SMD.

Internally, we will embed service user involvement into our working, building on the findings from the research and from the action workshops to inform and improve the design and delivery of the services offered at the Foundation and the work that we do with commissioners and policy makers.

How can you get involved?

There are lots of ways that you can support the project:

  • Referring yourself - do you identify as lesbian, gay, bisexual, or trans? Have you experienced multiple life difficulties? Get in touch with Sophie at to see how you can get involved!
  • Referring people to us – do you work with people who are experiencing severe and multiple disadvantage? Please tell them about our study and let them know how they can get involved and have their voices heard.
  • Professional networks - do you know of any organisations that might be able to help us recruit participants for the core group or the interviews? Can you tell colleagues and partner organisations about our research?
  • Reviewing your working practices – could this research change the way that you do things moving forwards to better meet LGBT needs? Do you have any good practice to share?
  • Feedback- do you have experience or knowledge of other areas you think we should consider as part of the research? We would welcome any suggestions!

If you would like to know more, please contact