People with long-term conditions, such as diabetes or heart disease, are two to three times more likely to experience mental health problems than the general population.
However, a systemic failure to identify these problems and provide effective support is resulting in poorer outcomes for patients and could be costing the NHS billions, according to a report published by The King’s Fund and Centre for Mental Health. Where a mental health problem is identified alongside a physical health illness, the two have traditionally been treated separately with services designed around conditions, rather than patients. A growing volume of research evidence suggests that more integrated approaches, with closer working between professionals responsible for patients’ mental and physical health, can improve outcomes while also reducing costs. Researchers found that by exacerbating physical illnesses, co-existing mental health problems substantially increase the costs related to care for long-term conditions. Overall, £1 in every £8 spent on long-term conditions is linked to poor mental health, equating to £8-£13 billion of NHS spending each year. For example, co-existing mental health problems can lead to:
• Increased hospitalisation rates – patients with chronic lung disease spend twice as long in hospital if they also have a mental health problem.
• Increased outpatient service use – diabetes sufferers with mental health problems access twice the amount of outpatient services as those with diabetes alone.
• Less effective self-management – poor mental health means that people with heart disease or other long-term conditions are less likely to look after their physical health, take medication as intended and attend medical appointments.
Not only do associated mental health conditions carry a significant financial cost for the NHS, the report shows they also contribute to poorer clinical outcomes for patients and lower quality of life. For example, studies have shown that depression increases mortality rates after a heart attack by 3.5 times; children with diabetes are more likely to suffer retinal damage if they also have depression; and co-existing mental health problems can have a greater effect on quality of life than the severity of the physical illness. Sean Duggan, chief executive, Centre for Mental Health said: “Failing to support the mental health of people with long-term physical conditions is costing the NHS billions of pounds at a time it can ill afford to spend money unwisely. Untreated or poorly managed mental ill-health among this group is cutting lives short, reducing quality of life and increasing health inequalities. Responding better, by contrast, will save lives, increase fairness and cut costs.”
