Long-term conditions and mental health: The cost of co-morbidities

Posted:09 February 2012
Comments 20 comments

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Authors

Chris Naylor
Amy Galea
Michael Parsonage
David McDaid
Martin Knapp
Matt Fossey

Publication details

ISBN: 978 1 85717 633 9
Pages: 32

More than 4 million people in England with a long-term physical health condition also have mental health problems, and many of them experience significantly poorer health outcomes and reduced quality of life as a result.

In terms of NHS spending, at least £1 in every £8 spent on long-term conditions is linked to poor mental health and wellbeing – between £8 billion and £13 billion in England each year.

Long-term conditions and mental health: The cost of co-morbidities, published jointly by The King's Fund and the Centre for Mental Health, 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.

This 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.

See our co-morbidity conditions project work
Read Chris's blog: Effective chronic care means recognising the importance of mental health

Comments

I have been waiting for Surgery which should have been done 2 years ago and has been cancelled 6 times.... it.s Vascular Surgery and until this is done I cannot even approach the Surgeon who has to operate on both hips. I’m in pain most if the time with OA in both hips. It’s getting to a point where I struggle to get up and down the steps (7) outside my flat... even to try a short walk which would improve my quality of life... I am 81. My children live in the North of England and I’m in the South. Obviously I can’t see them given the current situation although we do talk on the phone. I don’t want to worry them but it’s hard to to say anything. I get very down .....

I feel really anxious most of the time , cant switch off and relax .

So sad to hear of your anxiety. I am in a bad place and would be happy to receive email if you need to talk.

Hi Martin,

So sorry to hear that you're having a difficult time at the moment, this is an extremely stressful time and I know that a lot of people are dealing with anxiety at the moment. If you're not able to access your usual GP service at the moment, I would really recommend contacting the helpline for one of the following mental health charities, who may be able to help:

Mind: https://www.mind.org.uk/
Anxiety UK: https://www.anxietyuk.org.uk/
There are also some online resources from SANE, sadly their telephone helpline isn’t currently operating: http://www.sane.org.uk/what_we_do/support/
And also online resources from Rethink: https://www.rethink.org/

I do hope this is helpful.

All the best,

Becca

hello. i am suffering with aniexy being self isolated and fear all time of the worse. i do my essentials like making something to eat and having a bath and even doing yoga in house but i get a depressing feeling even when i wake up. can anyone help me?

Hi, I have complex health issues from a brain tumour removal and am having issues with my care providers treating my physical health issues seriously (they mis diagnosed my brain tumour as a.stress band headache) as they put everything down to mental health as I have gad and depression. I have had deteriation of my arms and fatigue for 2 years and they will not send me to pain management or run any tests to help diagnose what I think is fibromyalgia or cronic fatigue. Working for a mental health charity I have had to be proactive and fight so hard and self diagnose but am still struggling for proper support. A person with physical issues with dementia would have BOTH their mh and ph supported but why people like me with both and probably neurological disabilities cannot get the services to work together to help me live some kind of purposeful life is beyond me.

I recently suffered a heat attack now the wait for my second operation is closing in and i'm at an all time low,my doctor has told me it could be depression/anxiety,caused through post treatment trauma.It gave me a lift,but surely there are better way's to deal with it other than taking tablet's

I conducted a survey of over 800 primary healthcare clinicians in the UK looking at depression following heart attack. The results clearly demonstrated those who had received training in the diagnosis and management of depression were far more proficient and confident in recognising and treating this. This vital element of long term health condition care needs to be fully integrated at all levels. Really pleased to see the publication of this report and hope it leads to improvements in the support and management of individuals, not conditions!

What about CERLETTI ( i.e. SHOCK THERAPY ) in UK? In Italy the SINi s going to give very high emphasis in remebering the inventor.What is your opinion on this matter?

I have several roles - as a Counsellor, a Quality specialist with a Hospice and as a volunteer providing support for Offenders. In every case there is a desperate need to 'join up' care plans and service provision, but very little structure to provide this. New models of encouraging joint working are largely ignored because they are new and so are not welcome additions to the funding list, event though they save money overall. 'Silo budgets' are a key problem - each agency points at others to provide resources for multi-disciplinary work, and is too busy to talk with others. There is extensive provision of private counselling services that can support NHS work, but absolutely no will to communicate by NHS professionals with the private providers, to the detriment of overall care. This is a clear example of the problems arising from competition. The private psychological service providers are partly to blame as we do not apply evidence-based practice sufficiently. The evidence is clear however - addressing mental health needs saves money for the community in improving health overall, improving employability, reducing crime, improving child care/family relations, reducing strain on carers, etc etc. There really is a need to co-ordinate this at Cabinet level as well as locally. Am I frustrated? darned right I am!