Published on March 11, 2014
Designing integrated care for people with both mental and physical health needs Sean Duggan
Mental and physical health are inseparable 4.6m people have a long-term physical illness and a mental health condition Cost of treating this group £10bn extra to NHS Quarter of outpatient appointments relate to ‘medically unexplained symptoms’: cost £3bn People with severe mental illness live 15-20 years fewer than average 70% of people with schizophrenia smoke
Prevalence of co- morbidity 30% of people with a long-term condition have a mental health problem Depression 2-3 times more common in people with heart disease and those with diabetes Panic disorder is 10 times more common in people with COPD One-fifth of people with arthritis have depression
Impact of comorbid long-term conditions Depression increases mortality after a heart attack by 3.5 times People with diabetes are likely to die sooner and get complications (eg retinal daage) if they also have depression Mortality rates for people with asthma and depression twice those for asthma alone
Liaison psychiatry Liaison psychiatry services offer immediate help to patients in general hospitals with mental health needs Liaison psychiatry is now included in the NHS Mandate and the Crisis Care Concordat
Collaborative care Integrated care for people with co-occurring conditions outside hospital, eg diabetes and depression Timely access to psychological therapies Support for self-management Advice on employment, finances, etc as required
Complex needs Treatment for medically unexplained symptoms can include a range of effective psychological therapies Centre evaluation of City and Hackney service for his group (and others) to be published March 2014
Premature mortality in psychosis Action to reduce 20-year mortality gap: Access to smoking cessation: most people with psychosis want to quit Medication reviews and weight management crucial from first episode of psychosis Access to mainstream screening programmes
For more information: email firstname.lastname@example.org follow us @CentreforMH visit: www.centreformentalhealth.org.uk
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