Physical and mental illness - the need for an integrated approach

Simon Lawton Smith, Head of Policy at the Metal Health Foundation:

"Mental health and physical health have traditionally been seen as two separate entities. There is growing evidence to support that mental health and physical health are very closely linked, interdependent, and even inseparable, leading to new challenges facing the health care system. And for new challenges we need new policy.

The King’s Fund and Centre for Mental Health last  week published a report dealing with this issue, titled Long-term conditions and mental health: the cost of co-morbidities. It is estimated that  over 4 million people in England with a long-term physical illness also suffer from a mental health problem - a staggering statistic. And this has a very profound effect on health outcomes. For example, patients with chronic lung diseases spend twice as long in hospital if they also have a mental health problem, and depression can lead to a threefold increase mortality rates after a heart attack. As well as the sheer human cost of experiencing both physical and mental health problems at the same time, it also costs the NHS an extra £13 billion every year.

The report confirms what we have been arguing at the Mental Health Foundation for years – that we need  better integration between mental and physical health care, both to improve clinical outcomes and to save billions of pounds. The report suggests, for instance, integrating mental health support with primary care and chronic disease management programmes, and improving the provision of liaison psychiatry services in acute hospitals. It also recommends that all medical professionals from every field should have basic mental health training and skills, so important  if all healthcare providers are to  intervene early to reduce the risk of serious mental health problems.

The Foundation believes that integration of physical and mental health care must remain a priority for the new commissioning bodies being established under the Government’s Health and S0ocial Care Bill, currently going through parliament. Working alongside Mind, Rethink Mental Illness, the Centre for Mental Health and the Royal College of Psychiatrists we have recently been successful in ensuring that a clause on "parity of esteem" between physical and mental health has been added to the Bill.  

But we cannot take our foot off the pedal. Getting the health service to understand the complex links between physical and mental health, and to provide the appropriate response to help people recover as quickly as possible, remains a challenge."

Published 15 February 2012 |
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