Barrier between physical and mental health ‘costs NHS £11bn’

8 Mar 16

The current lack of integration between physical and mental health services in the NHS increases costs by over £11bn a year, according to an analysis by the King’s Fund.

A review by the think-tank found care is less effective than it could be due to the current structures and better integration could save money.

The additional costs are calculated on the basis of the separate treatment of psychological problems associated with physical health conditions, and the physical impact of mental illness. This includes the high rates of mental health issues among those with long-term conditions such as cancer, diabetes or heart disease, and limited support for the psychological aspects of physical health, such as during and after pregnancy.

Chris Naylor, a 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,” he stated. “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.”

It is clear that the disconnect between treating physical and mental health was “costing the NHS greatly”, he added.

The report also found 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 the general population. This is largely as a result of subsequent physical health conditions.

There are ten areas for possible improvement, according to the report, from enhancing mental health provision in acute hospitals to increased support for GPs in managing people with complex conditions. Both physical and mental health should be embedded in routine care processes, which would also reduce the stigma around mental health, while a board-level champion for physical health should be named in mental health trusts and vice versa.

Responding to the report, Stephen Dalton, the chief executive of the Mental Health Network, which is part of the NHS Confederation, said he agreed health outcomes could be greatly improved by bringing mental and physical care closer together.

“We need to see the mental and physical health care of individuals as two sides of the same coin and which require equal attention, equal funding and coordination at the point of delivery.

“There is now a significant body of evidence that signposts the need for government to invest in mental health services after years of neglect.”