Saturday, 2 April 2016

Integrating physical and mental health

The King's Fund is an independent charity working to improve health and care in England which has produced a report: Bringing together physical and mental health.

The report adopts a biopsychosocial perspective because " physical and mental health are closely interconnected and affect each other through a number of pathways."

"The case for integrated approaches applies to prevention and health promotion as much as to treatment and care; in the following sections [they] argue for much greater inclusion of a mental health and wellbeing perspective within public health programmes targeting risk factors for heart disease, lung disease, stroke, cancer and other preventable conditions."

"Similarly, integration of mental and physical health is particularly important in relation to the perinatal period. [The period before and after birth.] Although not an illness, this is a time when mental and physical health are very closely connected, and during which psychological needs are not always well addressed."

"[They] use the term integrated care to refer to the provision of health and care services in such a way that ensures that the various needs of an individual using these services are met in a co-ordinated way, with medical, social and psychological needs being addressed together."

"In the case of women during the perinatal period, there was often a related fear that by disclosing any concerns around mental health, they would be deemed an unfit parent and have their child taken away from them. Professionals can counter some of these reactions by acknowledging emotional distress and anxiety in a non-judgemental way, and discussing the forms of support available."

"Many of those interviewed believed that having someone to help with coordination someone with a good overview of both mental and physical health needs would be a significant step towards integrated care... Participants emphasised the need for care to be co-ordinated by someone who is easy to contact when difficulties arise."

"Participants suggested that a key feature of a well-co-ordinated system of care would be only telling your story once, illustrating that care co-ordination needs to be underpinned by common assessment processes and appropriate sharing of patient information across providers."

"An integrated approach towards mental and physical health would involve professionals anticipating how and when physical health conditions might have an impact on mental health (or vice versa), and suggesting appropriate pre-emptive action."

"Some highlighted specific improvements they felt would enable them to do so for example, shared electronic records that patients can access, combining information from mental and physical health consultations. There is a careful balance to be struck here though; some participants qualified their support for the idea of self-management with the observation that it is important that patient empowerment is not equated with the message that it is all up to you."

"Childhood health would be a particular priority, with a focus on intervening early to prevent the development of more significant problems later in life. This would include investment in evidence-based parenting interventions (Hutchings et al 2007), nursefamily partnerships or Sure Start (Melhuish et al 2008; Olds et al 2007), and schools-based programmes to promote social and emotional learning."

So the report is promoting the total view of the citizen; sharing physical, psychological and social information around the system using electronic records with an emphasis on childhood and parenting programmes.

It`s a familiar story.

1 comment:

  1. Thank you for contributing such a great story! I'm very excited to have found your report - it's well-researched and doesn't contradict real facts! Press your mouse button on to read someone's expressions!