Today, we are launching a new report, ‘Crossing Boundaries: Improving integrated care for people with mental health problems’, highlighting that current support for people with mental health problems is based on the flawed idea that physical and mental health care are separate issues. The report outlines the key factors in achieving integrated healthcare, singling out the commitment of leaders and frontline staff to cross-boundary working as the single biggest factor.
Good integrated care for people with mental health needs remains the exception rather than the rule. The year-long Inquiry* calls for a fundamental change in thinking about health care, and for commissioners and practitioners to recognise the benefits of integrated, holistic approaches to care that involve not just health and social care services, but factors such as education, employment, housing and poverty.
Simon Lawton Smith, Head of Policy at the Mental Health Foundation says:
“The need for an integrated approach to supporting people with mental health problems was identified 65 years ago when the NHS was founded. Failure to provide integrated care is not a failure of understanding what needs to be done, it is a failure of actually implementing good practice in organisational strategies and the day to day business of organisations and staff.
“We identified nine structural factors that can help to establish effective integrated care for people with mental health needs. However while these are all helpful, the key message from our inquiry is that it is the quality of people involved that makes or breaks integrated care – leaders with a determination to drive forward integrated care at an organisational level, and staff who understand the holistic nature of health care and are have no professional defensiveness about working closely with colleagues in other disciplines, and with patients and families.”
Key messages from the Inquiry
In terms of how current care provision can be better integrated, the Inquiry identified two underpinning essentials:
• having the right people in the organisation – both leaders who will drive forward integration at a strategic level agenda and staff who understand and respect the roles and responsibilities of other professions and are willing to work with patients and across organisational and professional boundaries
• cross-boundary inter-professional training and education – there is a pressing need for more interprofessional education and training on mental health, both in terms of its genesis and indivisibility with physical health. This must be ongoing with continuing professional development.
The Inquiry identified nine areas where good practice can play a role in facilitating integrated care for people with a mental health problem:
1. Information-sharing systems
2. Shared protocols
3. Joint funding and commissioning
4. Co-located services
5. Multidisciplinary teams
6. Liaison services
7. Navigators
8. Research
9. Reduction of stigma
To find out more about the key factors to achieve integrated care, download the full report