Support for patients with comorbidities - new evidence

1 August 2012

Education for Health welcomes a paper published by The King's Fund and the Centre for Mental Health which found that at least one pound in every eight spent by the NHS on long term conditions is linked to poor mental health and well-being - between 8 billion and 13 billion pounds in England each year.

Education for Health welcomes this review of existing research evidence.

King's Fund logoLong-term conditions and mental health: The cost of co-morbidities reviewed a range of research evidence, supplemented by case studies of innovative practice from within the UK and abroad, and suggests that care for a large number of people with long term conditions could be improved by:

  • integrating mental health support with primary care and chronic disease management programmes
  • improving the provision of liaison psychiatry services in acute hospitals
  • providing health professionals of all kinds with basic mental health knowledge and skills
  • removing policy barriers to integration, for example, through redesign of payment mechanisms.

The review found that the association with long term conditions and mental health problems was particularly strong for diseases such as COPD, cardiovascular disease, diabetes and musculoskeletal disorders.

The paper suggests that developing more integrated support for people with mental and physical health problems could improve outcomes and play an important part in helping the NHS meet the quality, innovation, productivity and prevention challenge.

The authors conclude that the prevailing approach to supporting people with long-term conditions is at risk of failing unless we recognise the role of emotional and mental health problems in reducing people's ability and motivation to manage their physical health.

Education for Health's Clinical Lead Bev Bostock-Cox commented:

"The link between physical and psychological health is well documented and in general practice we already routinely assess people with coronary heart disease and diabetes for depression as part of the Quality and Outcomes framework.

"Many people will have more than one long term condition, however, and this increases the chance of low mood, which then impacts on adherence to both pharmacological and lifestyle interventions.

"Education for Health's courses recognise the importance of the mind-body link and encourage holistic assessment of the patient at all times. It is vital that nurses carrying out annual reviews of people with long term conditions are trained to recognise signs of poor health, both mentally and physically; our training helps them to understand how to do this effectively."

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