Mental health providers have a lot to offer on integration - but we need to be aware of potential pitfalls | Sean Duggan

Sean Duggan

Momentum is high for integration within mental health, but we need to be careful about the practicalities explains Sean Duggan, chief executive of the Mental Health Network.

Few would argue against a properly joined-up health service, with its various parts operating seamlessly in people’s best interests and keeping them as close to home as possible.  

This is especially true for people accessing mental health services, who often need social care or physical health services too.  

But we must be mindful how we get there.

The speed of integration is accelerating, with integrated care systems set to be operational across the country by 2021. That is a good thing and the opportunities are vast.

We will be better able to plan services around the needs of a population while instruments of integration such as primary care networks will help us (in theory at least) provide better care for people with complex needs by pooling resources and preventing the escalation of illness.

Indeed, integration within the mental health system is developing at pace too. Provider collaborations, for example, use centrally held specialised commissioning funds transferred to groups of mental health providers to manage the budget and patient pathway for specialised care. The results include reduced out-of-area placements and improved patient outcomes.

Mental Health Network members are telling us we need to be careful about the practicalities of fast-paced integration. It is important to ensure areas such as community, mental health and primary care are empowered locally rather than overshadowed by the priorities of bigger acute hospitals.

Whatever happens, we cannot undermine the move towards parity of esteem for mental health, which has taken great strides in recent years.

And in seeking to join up services we need to make sure we do not hamper the ability of some providers to operate smaller-scale specialised services. Mental health services provide specialised, highly technical care and often take on a higher level of risk than many other parts of the system – we need to make the most of this expertise.

We believe mental health providers have a lot to offer as part of the integration journey – in fact, we have been working closely across sectors for some time.

In the Mental Health Network, our members encompass a range from the independent and third sectors, while many of our NHS trust members already provide both mental health and community physical health services. Others, such as Place2Be and Look Ahead, expand our reach wider than health and care to work with partners in education and housing.

Co-production is another thing we should be mindful of when building systems. Using the insight of lived experience in the design, delivery and evaluation of services can really enhance the journeys of care providers. However, it must be done in a real and meaningful way - valuing and supporting the views of people with lived experience can and does make a big difference to patient care and experience.

I’m proud to share what our vice-chair and carer representative Phil Hough told me about co-production at the network: “Co-production is a well-used term but sometimes it can be less than authentic. I have no such fear in talking about co-production in regards of the Mental Health Network, since supporting the network I have always felt valued and that my experiences added extra unique dimensions to the various programmes. I’m proud that the Mental Health Network board continues to support lived experience ensuring it’s always person-centred.”

So, the message we are getting from our members is that, yes, the move to greater integration is welcome. We believe mental health providers have much to offer but, as ever, we must be wary of unintended consequences and make sure a wide variety of voices are able to contribute to the design of our new systems.

Sean Duggan is chief executive of the Mental Health Network. Follow the network on Twitter @NHSConfed_MHN  

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