It is well documented that physical illness, especially if it is long-term, can have a significant and detrimental effect on a person’s mental health.
Body and mind go hand in hand, yet in the past health services have often focused almost entirely on treating the physical illness. Meanwhile, its impact on the patient’s mental health has received far less attention, in some cases going unrecognised and in many cases untreated.
Now that is changing, and with some remarkable results. In a pilot scheme run by NHS England, improved mental health care for patients with physical ailments reduced demand for GP appointments and cut hospital admissions by three-quarters. Now the scheme is being rolled out across the country as part of a programme of new services.
Since 2016, the NHS has been testing new services which integrate mental and physical treatments, as part of its ‘Improving Access to Talking Therapies’ programme. People with long-term health issues like diabetes, arthritis, heart or respiratory problems are now routinely given a ‘whole-person assessment’, focusing on what additional mental health care they need to manage their condition.
Helping people cope mentally with the pain and stress of physical health symptoms makes them better able to manage their condition longer-term, resulting in improved health and reduced demand for health and care services.
Early results from one site in Cambridgeshire and Peterborough show that timely and effective mental health care for people with diabetes, cardiovascular or respiratory illnesses have resulted in a three-quarters reduction in inpatient hospital attendance and a two-thirds drop in A&E admissions, freeing up £200,000 of NHS funding.
In Sunderland, extra ‘Psychological Wellbeing Workers’ have been recruited and trained to help people manage long-term conditions. These patients also are offered a ‘Managing Pain’ class, combining physical care with mental health therapy. Across the country, 3,000 mental health therapists are being placed into GP surgeries, to offer combined mind and body care to patients.
NHS England’s national director of mental health, Claire Murdoch, said: “Effective NHS mental health care for people with long-term illness is a game-changer for our patients and good news for taxpayers. By integrating talking therapies with treatment for diabetes and heart conditions, NHS patients get care for mind and body at the same time.
“Anyone who has to deal on a daily basis with the pain of arthritis or a serious backache knows that it not only slows you down physically, but darkens your mood, sometimes leading to serious mental ill health. As the NHS turns 70, integrated talking therapy services are a big step forward for our patients and a crucial part of putting mental health at the centre of our plans for the future of the health service in England.”
People with a physical health condition are more likely than the rest of the population to experience mental ill health. More than 16 million people in England are diagnosed with a long-term physical health condition, and a third of this group (5.3 million) will experience a mental health problem.
The mental impact of physical problems can be even more widespread for people whose condition is undiagnosed, with seven in ten people who experience medically unexplained symptoms – such as irritable bowel syndrome or chronic fatigue – also having depression or anxiety.
Mental health problems can make it harder to tackle physical conditions as well as costing the health system around 50% more, if left untreated. Offering access to physical activity alongside talking therapies is therefore beneficial to patients and can save taxpayers money.