Long term conditions and medically unexplained symptoms

Around 40% of people with depression and anxiety disorders also have a long-term condition (LTC) such as cardiovascular disease, Chronic obstructive pulmonary disease (COPD), diabetes and musculoskeletal disorders. Around 30% of people with an LTC and 70% with medically unexplained symptoms (MUS, also known as persistent physical symptoms) also have mental health comorbidities. Mental and physical health care are often provided by separate services which, if not coordinated, can be inconvenient for the person, costly to the NHS and likely to produce sub-optimal outcomes.

Building on NHS Talking Therapies’ existing dedicated workforce, development of NHS Talking Therapies services for people with LTCs and MUS is underway (called ‘NHS Talking Therapies LTC Services). These services will ensure that people with LTCs and MUS have the same access to NICE recommended psychological therapies as other people. They bring together mental and physical health providers so they can work in a coordinated way to achieve the best outcomes for all people, irrespective of their diagnosis. This bringing together of mental and physical health providers will look different depending on local areas but it may often include co-location, multidisciplinary teams, and joint working.

Delivering care in an integrated way to ensure that a person’s mental and physical health needs are met together:

  • enhances the whole team’s capability to provide more comprehensive, accessible and holistic care: this can reduce costs through encouraging the prompt uptake of treatment and it decreases the likelihood of people not attending appointments.
  • promotes mental health awareness and faster diagnosis: identifying and addressing a person’s needs more quickly and accurately can in turn reduce the number of frequent attenders and repeat assessments.
  • promotes coordination and encourages the development of a single jointly developed care plan: this can lead to greater efficiencies and improved relationships within teams and services.
  • is more cost effective and can reduce a person’s use of physical health services.