Guardian Healthcare Network: Long-term conditions and mental health

The Guardian Healthcare Network recently held a live debate on how the NHS can cope with the growing number of people with long-term health conditions and mental health problems. See the full article here, but here some points which really resonated with me:

"If you get mental health right, then costs elsewhere in the system can go down. Liaison psychiatry services helping people in hospital who have physical and mental health problems can save the hospital four times the money it costs to provide the liaison service."
Chris Naylor

Good mental health benefits physical health - targeting both during an inpatient stay seems a very effective and holistic approach to returning the patient to independent (in every sense of the word) living as soon as possible. 
  
"There's a three-way interaction between the mental, the physical and the social There's evidence from Glasgow showing that the social conditions you live play a big role. If you have physical health problems and you live in a relatively deprived area, your chances of experiencing mental health problems increases dramatically."
Chris Naylor

"The PBR regime for acute physical health is not very well designed for long-term conditions We need to be thinking about developing a payment system which is linked to integrated care pathways, not single episodes of treatment."
Michael Parsonage

SO TRUE! From experience, doctors often neglect the wider picture, instead focusing on single episodes of ill health. If single episodes are rare and unrelated as they are for most healthy people, this approach is appropriate. If however doctors get you walking again after a relapse of a long-term condition, but then "wash their hands of you", the long-term condition remains, and relapses become more frequent with underlying conditions often worsening too.

"Concepts of "mental" and "physical" are unhelpful We need a more person centred, integrated approach and this has to start in primary care and public health. It is too late when people get sucked deep into the health care system."
"The report perpetuate the idea that medical conditions exist separately instead of being part of the person as a whole We need to understand the root causes of health conditions and their fundamental interconnectedness. To some extent the concepts of "mental" and "physical" are also unhelpful. We need a more person centred, integrated approach and this has to start in primary care and public health."

Andrew McCulloch

Couldn't agree more!