Strathdee MH Parity FT

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Geraldine Strathdee, parity of esteem, foundation trust network

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<ul><li> 1. Valuing Mental Health Geraldine Strathdee, National Clinical Director of Mental Health, NHS EnglandOctober 16th 2013 Geraldine.strathdee@nhs.net</li></ul> <p> 2. Valuing mental health in the NHS Why does the NHS need to value mental health The impact of mental health on outcomes &amp; costs Parity between mental health &amp; physical health what would it mean in practice Fast tracking Value in the NHS what role can the FT network have in delivering it? Asking for your narrative, brains, expertise, insights &amp; leadership for England 3. The clinical and economic impact: 2012 Figure 1: Morbidity among people under age 65Physical illness (e.g. heart, lung, musculoskeletal, diabetes)Mental illness (mainly depression, anxiety disorders, and child disorders) 4. Why does the NHS need to value mental health because mental ill health it is very common &amp; it impacts on all outcomes How common is mental ill healthCommon ConditionsOutcome impactPrimary care :Depression &amp; anxiety Substance misuse Children's conditions PsychosisPremature mortality : 15-25 years Quality of life in LTCs Recovery from illness Patient safetyAlcohol &amp; drugs Depression &amp; self harm Dementia Psychosis relapsePremature mortality Quality of life for LTCs Recovery from illness Patient safety Patient experienceADHD, ASD Depression Substance misuse PDPremature mortalityPsychosis Neurodevelopmental Substance misuse Personality disorders Complex multi axialPremature mortality : 15-25 years Quality of life Recovery from illness Patient safety30-50% of daily workloadAcute care 40% of A&amp;E in London 40% acute beds in London 50% acute outpatient clinicsPrisons &amp; offenders 70-80% especially young men Specialist mental heath services 5. Mental health Value: depression and anxiety are the commonest healthcare comorbidities &amp; have major impact on Costs Chris Naylor, Kings fund Between 12% and 18% of all expenditure on long-term conditions is linked to poor mental health and wellbeing at least 1 in every 8 spent on long-term conditions.180% 160%% increase in annual per patient costs (excluding costs of MH care) International research finds that co-morbid MH problems are associated with a 45-75% increase in service costs per patient (after controlling for severity of physical illness)140% 120%100% 80%Depression Anxiety60% 40% 20% 0%http://www.kingsfund.org.uk/publications/long-term-conditions-and-mental-health 6. Commissioning for Value with partners Life span care pathways focusing on downstreamPrevention &amp; health promotionEarly identification &amp; early interventionTimely Access to services offering choice, quality outcome focusCare at home or in the least restrictive settings,Crisis response that is easy to access &amp; expertParity for people with physical &amp; mental health &amp; in relationships with our service users Integrated physical &amp; mental health &amp; social care Where every contact is a kind enabling, coaching experience 7. Parity and equalities: There is a disparity in the number of people with mental illness in contact with services, compared to physical health, yet it is a major cause of premature death &amp; lives lived in distress and misery26% of adults with mental illness receive care 92% of people with diabetes receive careBy condition.Anxiety and depression PTSD Psychosis ADHD Eating disordersAlcohol dependence Drug dependence% in treatment24 28 80 34 25 23 14Mental health problems are estimated to be the commonest cause of premature deathLargest proportion of the disease burden in the UK (22.8%), larger than cardiovascular disease (16.2%) or cancer (15.9%)People with schizophrenia die 15-25 years earlier Depression associated with 50% increased mortality from all disease 8. Prevention &amp; Early intervention (Knapp et al, 2011) highly effective treatments deliver valueFor every one pound spent the savings are: Parenting interventions for families with conduct disorder : 8 Early diagnosis and treatment of depression at work: 5 in year 1 Early intervention of psychosis 18 in year 1 Screening &amp; brief interventions in primary care for alcohol misuse 12 Yr 1 Employment support for those recovering from mental illness: Individual Placement Support for people with severe mental illness results in annual savings of 6,000 per client (Burns et al, 2009) Housing support services for men with enduring mental illness: annual savings: 11,00020,000 per client (CSED, 2010). 9. Parity and premature mortality Annual primary care QOF assessments of people with mental illness and those with diabetesParity mapping between people with diabetes cf those with Diabetes Severe mental illness SMI %age assessed No. patients2,488,948422,966BMI ( Body Mass Index)94.9%79.4%Cholesterol96.1%71.7%HbAC197.5%64.8%BP98.4%84.1%Total97.3%74.7All with p</p>

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