Coordinated care for mind and body

Nearly half of people living with mental illness also have at least one long-term physical condition. Yet their physical health needs often go unmet because our health system is not set up to easily coordinate care of the whole person, mind and body. This contributes to the fact that people with severe long-term mental health conditions live 15-20 years less on average than those without.

In 2019, we funded a three-year project to identify, research and trial ways in which mental health services could better meet service users’ physical health needs. Integrating our Mental and Physical Healthcare Systems project (IMPHS), was run by King’s Health Partners: a team made up of staff from South London and Maudsley NHS Foundation Trust, King’s College London, King’s College Hospital and Guy’s and St Thomas’. Every activity was shaped by ‘experts by experience’ – people who live with, have lived through, or care for someone with mental illness – including some recruited into paid project roles.

Making use of technology

The project led to a number of innovations in digital provision including the integration of mental and physical electronic health records, and the implementation of Consultant Connect, an application which enabled mental health teams to seek advice on the management of patients’ physical health from senior doctors working in specialities like cardiology or cancer care in partner hospitals.

Over 60 different medical specialities were contacted by Trust staff via phone or app, and more than 70% of queries resulted in the service user receiving care for their physical health at the mental health facility, avoiding the need for hospital transfer. IMPHS’ use of Consultant Connect was shortlisted for Best Mental Health Partnership with the NHS at the Health Service Journal Partnership Awards 2022.

Bringing expertise onto wards

IMPHS also trialled in-reach approaches – bringing experts onto mental health wards. A weekly Physical Health Clinic brought a consultant general physician into the Maudsley and Lambeth hospitals. The Clinic responded to more than 200 referrals, in 20% of which a hospital transfer was avoided by timely advice or a change to medication.

Another strand of the project brought in a pharmacist from King’s College Hospital one day a week. They directly supported service users with medication issues and answered queries from resident mental health pharmacists, who the project found lacked confidence in managing medications for physical health. A programme of webinars and guideline development worked to reskill this group in common conditions such as diabetes and heart disease, as well as mental and physical health co-morbidities – where two distinct issues are present at the same time – like depression and inflammatory bowel disease.

Peer support

A Health Champion scheme tested whether peer support could help people using Community Mental Health Services to improve their physical health. The Champions – volunteers with lived experience – encouraged service users to work towards their own physical health goals, such as being more physically active. Evaluation showed that the scheme was a positive experience for both parties and helped service users to succeed on their own terms.

Throughout the project, the focus was on making real and rapid change based on evidence. A number of initiatives tested during the project are now embedded in the way people are cared for across South London and Maudsley, and a programme of communications is sharing best practice with mental health services across the UK and beyond.

Further information

Mind and Body website

How is physical healthcare experienced by staff, service users, and carers in adult community mental health services in a south London mental health trust? A service evaluation – Frontiers in Health Services journal

View and download a booklet about the project below