mental health

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Bringing together physical and mental health

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Impact on the health system

The significant costs to the health system and the wider economy caused by

smoking, obesity, alcohol misuse and substance abuse are well established. What is

less well known is that a substantial proportion of these costs occur among people

with mental health problems. For example, the estimated economic cost of smoking

among people with mental health problems was £2.34 billion in 2009/10, of which

£719 million was spent on treating diseases caused by smoking (Wu et al 2015). In

the case of substance abuse, 85 per cent of people using alcohol services and 75 per

cent of those using services for drug addiction also have a mental health problem

(Weaver et al 2003).

What would a more integrated approach look like?

Local authorities would see people with mental health problems – and particularly

those with severe mental illnesses – as a priority target group for public health

interventions. This would include provision of tailored services to support healthy

living – for example, bespoke smoking cessation services (Gilbody et al 2015).

Voluntary and community sector organisations would play an important role

in supporting lifestyle changes, and families and carers would also be actively

involved in this. Screening services would be accessible for all. There would be clear

agreements over who holds clinical responsibility for the physical health side effects

of psychotropic drugs. Closer working between health, local government and other

sectors would help to address the social determinants of health for people with

severe mental illnesses. All mental health professionals would receive substance

misuse training, and there would be much closer working with addiction services.

More fundamentally, cultural change within the mental health workforce would

mean that all professionals see promoting physical health as being an important part

of their role.

Further guidance

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Recognising the importance of physical health in mental health and intellectual

disability. Achieving parity of outcomes (British Medical Association 2014)

The case for change: 10 areas where integration is needed most 25

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