mental health

Bringing together physical and mental health
1 2 3 4
5 6 7
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Enabling skills transfer – Many of the services seek to maximise their added
value by performing an educational function alongside a clinical one.
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Bridging the gaps between primary and secondary care – For example, by
providing new ways of accessing specialist support in general practice or
strengthening skills and confidence in primary care.
••
Redesigning the workforce – Several of the examples highlight opportunities
to create new professional roles at the interface between mental and
physical health.
••
Reducing stigma – The case studies highlight how integrated service models
can remove the stigma associated with using mental health services by
embedding support in routine care processes.
One important question remains: are these kinds of innovation capable of bringing
about integrated care as defined by service users and carers in Section 2? From
a user perspective, a key metric of success is the extent to which health and care
professionals are able to take a ‘whole person’ perspective and communicate with
patients in a way that supports this. The focus of the innovations described in this
section tends to be at a slightly different level, but nonetheless there is reason to
believe they could play a role in bringing about the kind of change required. As
alluded to above, part of the value of these integrated service models lies in their
potential to create an enabling environment for human and relational changes in
the workforce. By bringing together different groups of professionals, they can help
build skills and confidence, change beliefs and attitudes, and reframe the boundaries
of different professionals’ responsibilities.
The strength of the evidence behind the service models described here varies
considerably. Some approaches, such as collaborative care and certain forms of liaison
psychiatry, have a well-established evidence base both in the UK and internationally.
For other forms of innovation, however, there is a pressing need for much greater
investment in evaluation.
This section has shown that many examples of innovation exist. However, in the
main, these have not yet changed the wider culture of treating mental and physical
health as two separate issues, except perhaps in local areas. This raises the question
of how successes so far can be scaled up, and how the barriers to change can be
overcome. This is the subject of the following section.
Integrated service models: current developments and trends 57