Closing the gap between physical and mental health training.

Abstract

Mental illness and physical ill health are inextricably linked. Separating the two has led to significant health inequalities and barriers to health care for some of our most vulnerable patients. In March this year, the King’s Fund built on findings from the Independent Mental Health Taskforce to the NHS in England’s Five Year Forward View for Mental Health 1 by publishing Bringing Together Physical and Mental Health: A New Frontier for Integrated Care .2 Both documents emphasise the need to integrate physical, mental, and social care. The latter cites the factors that have led us to this point: ‘... institutional and cultural barriers, separate payment systems for physical and mental health care, and the trend for increasing sub-specialisation in professional education.’ 2 New approaches should ensure that mental and physical health needs are considered together and that people with a mental disorder have equal access to services for their physical health as others. This is not an original concept. ‘Parity of esteem’, the principle of affording equal value to mental and physical health, was enshrined in statute within the Health and Social Care Act 2012. Despite this, the scale of the physical health gap between those with chronic mental illness and those without remains vast. Those with severe mental illness are less likely to attend routine screening3 or access medical assistance. People with bipolar affective disorder and schizophrenia are, on average, likely to die 15–20 years earlier than those without.1 Approximately two-thirds of these deaths are from potentially modifiable risks and diseases such as smoking, obesity, diabetes, ischaemic heart disease, and malignancy. The relationship …