£11 billion cost of treating physical and mental health separately

The King’s Fund publishes a new report today which shows that the psychological problems associated with physical health conditions, and vice versa, are costing the NHS more than £11 billion a year and care is less effective than it could be. The report argues that by integrating physical and mental health care the NHS can improve health outcomes and save money.

The £11 billion a year is the collective cost of:

• high rates of mental health issues among those with long-term conditions such as cancer, diabetes or heart disease
• limited support for the psychological aspects of physical health, for example during and after pregnancy
• poor management of ‘medically unexplained symptoms’ such as persistent pain or tiredness.

The separation between physical and mental health has a high human cost: the life expectancy for people with severe mental illness (such as bipolar disorder or schizophrenia) is 15 to 20 years below that of the general population, largely as a result of physical health conditions.

The recently published Mental Health Taskforce report put the spotlight on the need to integrate physical and mental health. Bringing together physical and mental health: a new frontier for integrated care shows how this can be achieved.

The report identifies 10 areas where there is particular scope for improvement across the system from enhancing mental health input in acute hospitals and assessing physical health problems in mental health inpatient facilities, to increased support for GPs in managing people with complex conditions. It draws on innovative examples of how improvement can be made through integrated approaches such as bridging the gaps between secondary and primary care and by embedding both physical and mental health in routine care processes – which will also reduce the stigma around ‘mental health’. It also suggests how to enable change through practical steps like having a board-level champion for physical health in mental health trusts and vice versa.

Our research with service users and carers shows how all health and care professionals have a part to play in integrating physical and mental health by adopting a 'whole person' approach. A key way to achieve this is by helping the existing workforce to develop their skill-set by supporting learning between different groups of professionals and through a common foundation training in both physical and mental health to support the workforce of the future.

Chris Naylor, Senior Fellow at The King’s Fund said:

‘Traditionally physical and mental health have operated as distinct, separate systems in terms of both treatment and funding. That is no longer affordable financially or acceptable clinically. The government has set the goal of parity of esteem, meaning that mental health care should be “as good as” physical health care. We argue that there is an even greater prize at stake – that mental health care should be delivered “as part of” an integrated approach to health.’

He added:

‘When we spoke to patients they told us that they wanted to see health care professionals who recognised all of their care needs. What’s more, at £11 billion a year, the disconnect between treating physical and mental health is costing the NHS greatly and isn’t meeting patient needs.’

The report will be launched at a conference where Geraldine Strathdee and Norman Lamb are keynote speakers.