mental health



Bringing together physical and mental health

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Key messages


Integrated care initiatives in England and elsewhere have paid insufficient

attention to the relationship between physical and mental health. This aspect

of integration should be a major part of efforts to develop new models of care

in NHS England’s vanguard sites and elsewhere.


The case for seeking to support physical and mental health in a more integrated

way is compelling, and is based on four related challenges:


high rates of mental health conditions among people with long-term

physical health problems


poor management of ‘medically unexplained symptoms’, which lack an

identifiable organic cause


reduced life expectancy among people with the most severe forms of

mental illness, largely attributable to poor physical health


limited support for the wider psychological aspects of physical health

and illness.


Collectively, these issues increase the cost of providing services, perpetuate

inequalities in health outcomes, and mean that care is less effective than

it could be. The first two issues alone cost the NHS in England more than

£11 billion annually.


The report identifies 10 areas where there is particular scope for improvement.

These span the full range of health system activities, illustrating that change is

needed across the system. Commissioners and providers can use these 10 areas

as a guide to identify where some of the most significant opportunities for

quality improvement and cost control lie.

• • Examples of innovative service models described in the report demonstrate

that there are opportunities to redesign care in ways that could improve

outcomes and may also be highly cost effective. These include various forms of

enhanced support in primary care, integrated community or neighbourhood

teams, comprehensive liaison mental health services, physical health liaison

within mental health services, and integrated perinatal mental health care.

Key messages 4

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