People who live with long term health conditions can be more vulnerable to mental health conditions. When mental and physical ill health are combined, a person's quality of life can be seriously affected.
When we surveyed 500 people with a long term condition, more than one third were suffering with mild to severe anxiety or depression, and over a quarter reported feeling optimistic about the future, 'none of the time' or 'rarely'.
In response to the need for better mental health support for people with long term conditions, the Living Better project set up five local reference groups in Scotland to assess how existing services were addressing the mental health needs of people with long term conditions.
Working with partners including the Royal College of General Practitioners (RCGP) Scotland and the Universities of Edinburgh and Stirling we collected data on the mental health needs of over 500 people with diabetes, coronary heart disease and chronic obstructive pulmonary disease. We were also supported by the British Heart Foundation, Chest Heart and Stroke Scotland, Diabetes UK and Action on Depression.
Involving medical practitioners, patients and representatives from voluntary sector health organisations, we developed local plans and initiatives to build on and improve existing services.
Living Better developed training interventions for both professionals and for patients to improve the way mental health and wellbeing is addressed. A total of 16 training workshops and courses have been delivered through the Living Better pilot sites to 136 participants.
Many of the health professionals we spoke to said that:
- the stigma of mental illness can often make it difficult for many primary care nursing staff to address the mental health and wellbeing of people with long term conditions
- many primary care nursing staff lacked the time, skills and confidence needed to address mental health and wellbeing in chronically ill patients
- there was a need for greater awareness of appropriate social support services provided by localÂ authorities and the voluntary sector, and ways of accessing these services.
In response to these issues, we developed the following responses:
Supporting patients to manage the mental health impact of living with a long term condition through:
- Half day 'Living Better with a Long Term Condition' courses
- A six week self-management course 'Living Better with COPD'
- Two patient leaflets 'Diabetes and Mood' and 'Heart Disease and Mood'.
- Awareness raising events at local health fairs and melas.
Supporting health professionals to develop their knowledge and understanding about the mental health of people with long term conditions through:
- One day training courses on mental health awareness for primary care staff and long term condition specialist nurses
- A half day training course on culturally sensitive mental health screening and assessment training for health professionals
- Support with the development of new pathways to encourage the identification of mental health concerns and appropriate support to address them.
Key learning points for health professionals included:
- Greater understanding of mental health and mental illness
- Increased knowledge of screening and assessment tools
- Increased confidence about talking about mental health with patients and colleagues
- Better knowledge of local sources of support
Key learning points for patients were:
- Greater understanding of the link between physical health and mental health
- Ways of managing and improving your own mental wellbeing.