mental health

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Bringing-together-Kings-Fund-March-2016_1

Bringing together physical and mental health

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Impact on the health system

Poorly managed mental health problems in residential homes are associated with

challenging behavioural problems, non-compliance with treatment, and increased

nursing staff time (Katz and Parmelee 1994). Depression and other mental health

problems in older age can reduce motivation to manage physical health, adding to

health system costs – for example, in the form of emergency transfers from care

homes to acute hospitals.

What would a more integrated approach look like?

Staff working in care homes would have sufficient training to be able to detect and

manage dementia, delirium, depression and other conditions, with support and

supervision from specialists as required. They would understand how to promote

the mental wellbeing of residents – for example, by encouraging social connection,

physical activity and continued learning (National Mental Health Development Unit

2006). GPs working with older people in care homes would be able to identify those

in need of mental health support, and provide relevant education and advice to

care home staff (Chew-Graham et al 2014; Joint Commissioning Panel for Mental Health

2013c). Specialist mental health in-reach services would be available and accessible

in all residential settings – for example, to help staff manage residents who need

intensive support or who exhibit challenging behaviours (Joint Commissioning Panel

for Mental Health 2013a).

Further guidance

• • Guidance for commissioners of older people’s mental health services (Joint

Commissioning Panel for Mental Health 2013c)

The case for change: 10 areas where integration is needed most 41

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