How mental health impacts life expectancy

RSA Open Public Services Network, November 2015

The RSA OSPN (Open Public Services Network) is an innovative programme providing independent assessment of government and public services performance data.

This project was funded by the Cabinet Office and we worked with Mind to map mental health inequalities across the UK.  Their interactive tool, ‘Living a Long Life? How Mental Health Impacts Life Expectancy’ gives service users and the public access to data highlighting how well local health providers are looking after people with mental health conditions. Local areas across England are banded on how well they support mental health service users.

Click here to view the interactive website.

Click here to view their report ‘Getting the message on mental health’.

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Focus on: People with mental ill health and hospital use

Nuffield Trust, October 2015

A new study published by the Nuffield Trust and Health Foundation, suggests that people with mental ill health are not having their physical health adequately managed, despite being known to the NHS for their mental health needs.  People with mental ill health had almost five times more emergency hospital admissions last year relative to people without; yet the vast majority of these emergency admissions were not explicitly to support mental health needs, and a proportion of them were potentially preventable.

Click here to read the full report.

Click here to read the summary.

Integrated primary care for patients with mental and physical multimorbidity: cluster randomised controlled trial of collaborative care for patients with depression comorbid with diabetes or cardiovascular disease

BMJ, 16 February 2015

The objective of this study was to test the effectiveness of an integrated collaborative care model for people with depression and long term physical conditions.

The design of the study was a  cluster randomised controlled trial in 36 general practices in the north west of England.

 Collaborative care included patient preference for behavioural activation, cognitive restructuring, graded exposure, and/or lifestyle advice, management of drug treatment, and prevention of relapse. Up to eight sessions of psychological treatment were delivered by specially trained psychological wellbeing practitioners employed by Improving Access to Psychological Therapy services in the English National Health Service; integration of care was enhanced by two treatment sessions delivered jointly with the practice nurse. Usual care was standard clinical practice provided by general practitioners and practice nurses.

19 general practices were randomised to collaborative care and 20 to usual care; three practices withdrew from the trial before patients were recruited. 191 patients were recruited from practices allocated to collaborative care, and 196 from practices allocated to usual care. After adjustment for baseline depression score, mean depressive scores were 0.23 SCL-D13 points lower (95% confidence interval −0.41 to −0.05) in the collaborative care arm, equal to an adjusted standardised effect size of 0.30. Patients in the intervention arm also reported being better self managers, rated their care as more patient centred, and were more satisfied with their care. There were no significant differences between groups in quality of life, disease specific quality of life, self efficacy, disability, and social support.

The study concludes that collaborative care that incorporates brief low intensity psychological therapy delivered in partnership with practice nurses in primary care can reduce depression and improve self management of chronic disease in people with mental and physical multimorbidity. The size of the treatment effects were modest and were less than the prespecified effect but were achieved in a trial run in routine settings with a deprived population with high levels of mental and physical multimorbidity.

Click here to read the full text article.