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'We can bridge the divide between mental and physical healthcare'

Beth Ingram
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It is time we stopped talking about mental health and physical health as separate and unrelated. 

The current system creates a false divide in which one is prioritised over the other. If you’re seen to have a physical health issue then you’re directed primarily towards physical health services, and if you’re seen in the context of your mental health then you’re often only directed towards mental health services.

“The narrative on the overlap between physical and mental health is too often reduced to overly simplistic public health advice”

The two are rarely ‘allowed’ to co-exist or interact with each other within our care pathways but we know this is far from the reality of how our bodies exist and our lives play out.

Furthermore, the narrative on the overlap between physical and mental health is too often reduced to overly simplistic public health advice. We’ve all been informed countless times of the importance of sleep, diet and exercise on mental health, which is all absolutely true and evidenced; but why does that advice always seem to be the entire scope of the conversation?

Everyday nurses see the consequences of poor mental health on physical health and poor physical health on mental wellbeing and yet, what is it that gets in the way of talking to our correlating colleagues about how these issues interact?

The current points of contact are too often reduced to those in mental health crises who need physical health input, medically unexplained symptoms and, in a limited way, as part of the management of chronic health conditions.

But what does the research say? We know from several studies, including one recently done by the University of Oxford, that people diagnosed with serious mental health issues die on average 15-20 years younger than the norm. That is a larger mortality gap than is seen even in heavy smokers.

Likewise, the King’s Fund recently produced a report that showed 30% of those with long-term physical health conditions also have a mental health diagnosis. It is clear that our mental health and physical health not only interact with each other but are closely intertwined in the first place.

Interventions generally recognised as psychological, such as talking therapy and mindfulness have been shown to be helpful in the management of physical health conditions. Likewise we know that traditionally physical aspects of a person’s lifestyle such as nutrition and diet, fitness and vitamin levels can have an enormous effect on a person’s emotional wellbeing.

“While policy change is definitely welcome, there are real and significant cultural changes that need to be addressed”

There has also been recognition at a national policy level, including the recently published NHS Long Term Plan, that we need to create integrated care systems that encompass physical, mental and social health.

While policy change is definitely welcome, there are real and significant cultural changes that need to be addressed across organisational and professional divides.

Our experience on the ground with We Can Talk is that staff working in acute (physical) health settings feel incredibly out of their depth when it comes to supporting the mental health of those they treat. This is also mirrored when it comes to mental health staff supporting the physical health of their patients.

We need the system to integrate better but we also need to think about how we build that shared understanding and enable cultural change. That progress won’t simply come from co-located spaces or improved access to referral routes but rather from building our understanding and knowledge about each other.

Nurses and patients have a powerful opportunity to work together in developing a shared understanding of all our healthcare needs and to lead change across the system.

Beth Ingram is a young advisor for Common Room and We Can Talk. She works to ensure that the lived experience of young people continues to be at the centre of everything we do. She also runs Hearts & Minds, a peer support charity for young people with mental health problems. Robin Barker is a registered nurse in mental health, director of Healthy Teen Minds and the project lead for We Can Talk.

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