mental health

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Bringing together physical and mental health

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Supported self-management

Self-care is a core part of effective management of long-term conditions, whether

mental or physical. What sometimes goes unacknowledged is the effect that mental

health can have on a person’s ability and motivation to manage physical conditions,

and vice versa. Integrated approaches to self-management that help a person look

after both their physical and mental health therefore offer an important opportunity

to improve the effectiveness of self-management.

LIFT Psychology in Swindon provides a good example (see Appendix F). Among

other things, it is a provider of IAPT services. However, LIFT is distinct from most

other IAPT providers in that the guiding principle is to offer the ‘least intervention

first time’, which in practice means that the first level of support offered to all

prospective service users is participation in a group-based self-management course

chosen from a range of available options. Many of these courses focus on teaching

psychological self-management skills relevant to people living with long-term

conditions – such as living well after a stroke; managing panic, anxiety and worry (for

example in relation to respiratory conditions); or building confidence or overarching

skills such as interpersonal communication. LIFT also provides psychologically

informed self-management courses for people living with medically unexplained

symptoms such as chronic pain, based on CBT techniques and graded exercise.

Alongside self-management groups, LIFT also provides guided self-help through

one-to-one appointments with a psychological wellbeing practitioner based in the

patient’s GP surgery. In addition to working with service users, the team provides

training sessions for teams in other parts of the health and care system – for

example, on motivational interviewing or mindfulness-based techniques. This was

seen as important in terms of spreading the impact of the service.

Section summary

Taking the examples described in this section collectively, several common features

stand out. Although they are highly diverse, many include a focus on the following.

• • Redefining ‘core business’ – As well as creating something additional, the most

promising approaches also push the boundaries of existing services and attempt

to shift notions of who is responsible for what.

Integrated service models: current developments and trends 56

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