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Long-term conditions and mental health

The relationship between mental health and physical health is bi-directional, meaning one can affect the other.

People living with long-term physical health conditions are two to three times more likely to experience mental health conditions than the general population. In addition, people with long-term conditions that experience mental health problems are more likely to experience poorer outcomes in their physical health and quality of life.

People with long-term conditions experiencing depression should be offered interventions such as talking therapies as part of a stepped-care model. Since 2018/19, all NHS Talking Therapies services should have a pathway for people with long-term physical health conditions and medically unexplained symptoms.

Living with a mental health condition can have an impact on a person’s physical health in various ways. For example, it may impact on a person’s ability to attend and engage with appointments for physical health problems.

People with severe mental illness (SMI) are at a greater risk of poor physical health and die on average 15 to 20 years earlier than the general population in England. Major causes of death in people with SMI include long-term physical health conditions including diabetes, hypertension, respiratory and cardiovascular disease.

People with SMI should receive an annual physical health check. This includes checking alcohol consumption, blood glucose, blood pressure, body mass index, lipid profile and smoking status.

Policy on long-term conditions and mental health

The Government intends to publish a Major Conditions Strategy in summer 2024. It will cover mental health alongside other conditions such as cardiovascular disease and cancer.

In August 2023, the Department of Health and Social Care published the Major conditions strategy: case for change and strategic framework. The framework notes that one in four adults has at least two health conditions and includes a focus on living with major conditions.

The NHS Long Term Plan, published in 2019, set out plans to continue to expand NHS Talking Therapies services for adults and older adults, with a focus on those with long-term conditions. The plan said that by 2023/24, a total of 1.9 million adults and older adults would be accessing treatment. In 2022/23, 1.22 million people had at least one treatment appointment, and 672,000 people finished a course of treatment.

The NHS Long Term Plan also said that by 2023/24 390,000 people with SMI would be receiving physical health checks. In the 12 months to 31 March 2024, 361,210 out of 527,556 people on GP SMI registers were in receipt of all six elements of the health checks. 


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