An Exploration into Core Tenets, Fidelity, and Policy
Shivam Shah
Nearly half of all people with a diagnosable mental health problem also have a long-term physical condition such as diabetes, asthma or coronary heart disease. The coexistence of mental and physical health problems has serious adverse consequences, both for patients and for the health system, including:
- Poorer clinical outcomes;
- Lower quality of life;
- Reduced ability to manage physical symptoms effectively;
- Significantly increased costs of care.
This calls for a whole-person approach to intervention which seeks to integrate treatment for mental and physical health needs in a seamless way. The best evidence for this points to the collaborative care model.
Collaborative care is a form of systematic team-based care involving:
- A case manager responsible for the coordination of different components of care;
- A structured care management plan, shared with the patient;
- Systematic patient management based on protocols and the tracking of outcomes;
- Delivery of care by a multidisciplinary team which includes a psychiatrist;
- Collaboration between primary and secondary care.
Further information and a review of the evidence around collaborative care is set out in the attached paper by Shivam Shah. It was written during his summer placement at the Centre for Mental Health and submitted as a dissertation towards an MSc degree in International Health Policy and Health Economics at the London School of Economics and Political Science.
