mental health



Bringing together physical and mental health

1 2 3 4

5 6 7

in some areas than others. Often, the examples identified cut across two or more

of our 10 priorities, and as such we have not organised this section using the same

framework as the previous section.

At the end of this section we reflect on whether the integrated service models

described are capable of delivering the vision for integrated care identified by service

users and carers in Section 2.

Enhanced support in primary care

Primary care is a crucial component of efforts to build a closer connection between

mental and physical health. A number of innovations in the UK and elsewhere

are giving primary care an enhanced role at the interface between mental and

physical health, in particular for people with long-term conditions and/or medically

unexplained symptoms.

Collaborative care

The collaborative care model provides an evidence-based approach for supporting

people with co-morbid physical and mental health problems in primary care, and

was recommended by the National Institute for Health and Care Excellence (NICE)

for treatment of moderate to severe depression alongside a chronic physical health

condition (NICE 2009a). However, outside of research trials, the approach has not yet

become routine practice in England.

The core components of collaborative care are:


proactive management of physical and mental health conditions by a case

manager, working closely with a GP and/or other primary care staff


regular supervision meetings involving the case manager and a mental health



use of standardised treatment protocols by the case manager (this may include

monitoring medications and delivering brief psychological interventions).

As part of a recent research trial, the collaborative care model has been used by

general practices in the Greater Manchester area to integrate care for people with

Integrated service models: current developments and trends 45

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