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Calls for merge of physical and mental health

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Patients with mental health conditions have lower Patients with mental health conditions have lower life expectancy

Patients with severe mental health problems are living 20 years fewer than the average person, according to primary care professionals calling for the merging of mental and physical healthcare.

Project lead at the Bradford District Care NHS Trust Kate Dale opened the King's Fund's conference on mental health in primary care on 7 June. She detailed her trust's new system which aims to coordinate the mental and physical needs of patients in Bradford who have severe mental illnesses (SMIs).

Using the SystmOne primary care IT system, the trust's new framework is an effort to standardise data entry for patients in ways specific to physical health risks that come with SMIs. The system is now in all Bradford GP practices with a view to expand into secondary care.

Ms Dale said: 'There are serious problems with diagnostic overshadowing where a major physical problem is ignored due to the more prevalent symptoms of SMIs.

'Only certain mental health patients are subject to regular health checks so we need a system which encourages more checks. As no one is an expert in everything we hope this system can spoon feed suggestions to nurses where appropriate.

'The main problem we face now is compatibility with other systems and we are working to be able to run this on IT systems which differ to ours across the country.'

The need to bring physical and mental healthcare closer together dominated talks across the day, as did the current topicality of mental health in the public sphere.

In an early speech, Mind chief executive Paul Farmer said: 'Now is the time to get progress pushed through. Mental health has never been under such a spotlight.

'Our helpline is busier than ever and people are becoming more aware of what mental health means. We must identify the changes which must be made and see that they are pushed through while all eyes are on us.'

There were calls for shared accountability between physical healthcare staff and their mental counterparts from Peter Pratt, a pharmacist at Sheffield Health and Social Care NHS Trust. He said parity of esteem would come when all staff held responsibility for both types of health.

Keynote speaker Harold Pincus, from Columbia University, US, said systems with parity could be developed but the needs of individual localities must be taken into account. Discussions were held on how to best educate non-specialist primary care staff on mental health issues and practice.

Nottinghamshire mental health volunteer Paul Radin spoke at the end of the event on his personal experiences with mental health, where he said the third sector - charity and voluntary - was currently picking up the slack from primary care.

He said: 'All it would take is for a GP to take five minutes to sit and talk with me but they are often too busy or not well trained enough in mental health.

'Most people becoming aware of mental health problems can find a solution in their friends and family, but we need to make our primary care system better prepared for those who have run out of options.'

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Maybe we need to look at the USA nurse teaching / education route where all registered nurses learn mental and physical health and the NCLEX exam tests on all
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