Mental Health Integration: what does it take to make it work?
For a number of years, the NHS has been grappling with the issue of how best to deliver care to a growing and ageing population with often complex needs. Historically, services across primary, acute, mental health and community care were all delivered in separate silos. However, recognising the need to create a more seamless experience for patients, realise efficiencies and importantly, improve outcomes, the NHS, in partnership with local councils and other organisations, has been striving to take an integrated approach to delivering care, by taking collective responsibility for improving the health of the population they serve.
The NHS Five Year Forward View and the NHS Long Term Plan have both outlined the need to better integrate services, and in particular, with mental health care services. The NHS has good reason to do this: More than four million people in England with a long-term physical health condition have mental health problems (such as those with cancer, diabetes, heart disease and chronic pain) and at least £1 in every £8 spent on long-term conditions is linked to poor mental health (totalling £8 to £13 billion in England each year). And, in Mental Health, it is well documented that people with severe mental illness die 15 to 20 years earlier than the general population.
Based on an analysis of the emerging integrated care organisations being established across the UK, The Kings Fund has documented nine principles for integrating mental health in new models of care. These are:
- The commissioning, design and implementation of new models of care should be consistent with the requirement to deliver parity of esteem.
- New care models should address and measure outcomes that are important to patients and service users, identified through a process of co-design.
- New models of care should extend beyond NHS services to include all organisations that may impact on people’s health and wellbeing.
- Mental health should be considered from the initial design stages of new models of care.
- New care models should take a whole-person approach spanning an individual’s physical, mental and social needs.
- Invest in building relationships and networks between mental and physical health care professionals.
- New models of care should enhance the provision of upstream, preventive interventions to improve mental health and wellbeing.
- Every clinical interaction should be seen as an opportunity to promote mental and physical wellbeing.
- All frontline staff should receive appropriate training in mental health, regardless of the setting in which they work.
Nine principles for success: integrating mental health in new models of care, 18 May 2017, https://www.kingsfund.org.uk/publications/articles/nine-principles-success-mental-health-integration
The above show that the challenge is not an easy one; if you look at any one of these nine principles, they are incredibly challenging to deliver, and require systemic change on a number of levels (e.g. financial, service delivery, leadership). There is clearly no ‘one size fits all’ approach and, from a patient experience perspective, integration needs to go beyond mental and physical health services; i.e. health and social care integration with other public services, such as the police, and with schools and employers to name a few.
Watch a recording of our recent Webinar
Given these challenges, what does it really take to make mental health integration work? We held a webinar on Thursday 4 April 2019 from 1pm-2pm to ask this very question to a panel of experts. Together we discussed questions, challenges and practical solutions to support NHS leaders to deliver mental health integration.
Our webinar speakers included:
- Andy Bell, Deputy CEO, Centre for Mental Health
- Brian Dow, Deputy CEO, Rethink Mental Illness
- Sean Russell, Director of Implementation for Mental Health, Wellbeing and Radical Prevention, West Midlands Combined Authority
- Yasmin Akram, Public Health Registrar, West Midlands Combined Authority
To access a free recording of this webinar, please click here.
If you have any questions about this webinar or about our Mental Health Phone Advice & Guidance services, please call us on 01865 261467, email email@example.com or visit our Mental Health Advice & Guidance webpage.