Every NHS hospital should have a liaison psychiatry service as standard, according to a new report from Centre for Mental Health and the NHS Confederation Mental Health Network.
Liaison psychiatry services provide immediate access to specialist mental health support for people being treated for physical health problems, most often in general hospitals and in some cases in the community.
The report, Liaison Psychiatry in the Modern NHS, finds that liaison psychiatry services can save an average hospital £5 million a year by reducing the number and length of admissions to beds. It adds that even bigger savings could be achieved in future if liaison psychiatry services were extended to work in the community to prevent crises from happening at all.
People who have a long term physical health condition are more than twice as likely to have a mental health problem as the general population. This can have a huge effect on a patient's chances of recovery. For example, someone with chronic heart failure is eight times more likely to die within 30 months if they also have depression. Altogether, there are over 4.6 million people with a long term physical health condition and co-morbid mental health problem, all of whom would benefit from more integrated physical and mental health care.
Half of all hospital inpatients have mental health conditions such as depression and dementia. Identifying and managing these conditions quickly and effectively helps people to recover and reduces their length of stay in hospital.
There is a wide variation in the way liaison psychiatry services work and who they help. Many offer training and support to other clinical staff as well as providing mental health care themselves.
The report concludes that well run liaison psychiatry services can be highly cost-effective, saving more money than they cost. The greatest immediate impact can be achieved by supporting older patients in hospital but liaison psychiatry services also have the potential to offer better care at potentially lower cost to many other groups, both in hospital and in the community.
Sean Duggan, chief executive of Centre for Mental Health, said: "Liaison psychiatry is still seen in some quarters as an optional extra in the NHS. This needs to change. Tackling the artificial divide between mental and physical health will help people to recover more quickly and save the NHS money. To do this we need a dedicated liaison psychiatry service in every hospital."
Paddy Cooney, interim director of the NHS Confederation's Mental Health Network said: "There are a number of NHS organisations doing some really great work to improve liaison psychiatry services. But we need to see this become standard practice so that all patients in need of urgent mental health support can access it when they need it.
"Evidence shows the significant economic and health benefits that these services can deliver. Failing to treat people's mental and physical health problems together can have negative consequences for the individual, and costs the NHS more money in the long term.
"Joined up working between NHS organisations is key to making mental health services effective for the people who need them. I hope this report will provide the necessary evidence to show just how important it is that these services become commonplace in the NHS."
Dr Paul Gill, Chair of the Royal College of Psychiatrists Faculty of Liaison Psychiatry, said: "This report is most welcome. For too long, patients in our acute hospitals have not had reliable access to skilled mental health care. Hospitals that do have access to liaison psychiatry services attest to their value and importance. Quality improvement programmes, such as PLAN, already exist, and assist liaison teams in evaluating and improving their service. Surveys conducted by PLAN have identified the value that both patients and hospital staff place on these teams. Unfortunately, there are too few liaison psychiatry teams, and too many hospitals do not yet have access to them. We call on commissioners to take note of this report, and invest in services that cover every acute hospital in the UK."