mental health

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

Bringing together physical and mental health

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at least 600,000 more adults each year with depression or anxiety should be

able to access evidence-based psychological therapies by 2020/21, with a

particular focus on helping people who are living with long-term physical

health conditions.

These are important goals and pursuing them should help to take the system in

the right direction, as part of the wider changes described in this report. A further

example of integration of physical and mental health beginning to gain momentum

at the policy level is provided by the recent national service specification for diabetes

transition services, which includes recommendations on mental health support for

people with diabetes (NHS England 2016).

These and other developments show the important role that national policy-makers

and clinical leaders can play in enabling the development of integrated approaches

to physical and mental health. What is needed now is for leadership and ownership

of this agenda to move beyond the confines of ‘mental health strategy’ and become

part of wider strategic thinking for the system as a whole.

Conclusion

There is a compelling case for seeking to support mental and physical health in

a more integrated way. The scale of the problem has been clear for some time,

manifested in the elevated mortality levels among people with mental illnesses, the

scant regard often paid to the psychological dimensions of physical illness, and the

costly and harmful mismanagement of medically unexplained symptoms. These

issues cost the NHS in excess of £11 billion annually, and result in poor care for

people and their families.

What is starting to become clearer is that these are often solvable problems. In many

cases, there are evidence-based interventions available that offer cost-effective ways

of improving outcomes for people using the health and care system. The challenge

lies in scaling up these approaches and embedding them in routine practice. The

new models of care introduced by the Forward View have breathed new life into

integrated care programmes in many parts of the country. These must be used to

accelerate progress in the 10 priority areas outlined in this report. If integration of

mental and physical health does not form a major component of these programmes,

it would be a significant missed opportunity.

Discussion71

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