Vanguards are failing on mental health integration, claims King’s Fund

Many of the vanguards for new care models are failing to exploit opportunities for integrating mental health care, the King’s Fund has revealed.

Its report Mental Health and New Models of Care found many of the vanguards had often fail to prioritise mental health, despite integrating physical and mental health being one of the three key priorities in the Five Year Forward View.

The authors do not even think that the vanguard work is sufficient to test whether integrating mental health with new models of care is making a difference.

It calls for vanguards to make mental health support a core component of new forms of primary care, and to improve mental health work in emergency departments.

It is time to turn the rhetoric into reality

The King’s Fund stresses the importance of focusing on perinatal mental health, children and young people, “where some of the greatest opportunities for prevention lie”.

It calls for mental health to be a central part of evaluations of the vanguard sites, and for other areas to aim higher than the vanguards: “It is time to turn the rhetoric into reality.”

Why integrating mental and physical healthcare matters
  • People with mental health problems use significantly more unplanned hospital care for physical health needs than the general population.
  • Inadequate treatment of mental health problems among hospital inpatients has been linked to higher rates of re‑attendance at A&E after discharge.
  • Poor mental health is a major risk factor for a wide range of physical health conditions, and can also be a consequence of physical illness. Around 30 per cent of people with one or more long-term physical health conditions also have a mental health problem.
  • Depression and anxiety disorders lead to significantly poorer outcomes among people with diabetes, cardiovascular disease, chronic obstructive pulmonary disease (COPD) and other long-term conditions.
  • Compared with the general population, people with severe mental illnesses are 4.7 times more likely to die from liver disease, 4.6 times more likely to die from respiratory disease, 3.2 times more likely to die from cardiovascular disease, 1.7 times more likely to die from cancer, and overall die 10–20 years earlier.
  • Co-morbid mental health problems raise total health care costs by at least 45 per cent for each person with a long-term condition and co-morbid mental health problem.
  • Between 12 per cent and 18 per cent of all NHS spending on long-term conditions is linked to poor mental health and wellbeing – between £8 billion and £13 billion in England each year.
  • The lifetime effects of perinatal mental health problems cost the NHS an estimated £1.2 billion for each annual cohort of births.

Source: King’s Fund

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