Improving the health of people with both mental and physical health issues – 

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A collaborative approach to finding what research questions could help the most

by Dr Liz Newbronner, Dr Ruth Wadman & Olivia Taylor

Over the last two years we have been exploring the most important research questions for people with both physical and mental health issues (with a focus on severe mental ill health whose life expectancy can be reduced by up to 20 years). With the aim of giving a voice to those living with both physical and mental health issues, their families and the health and social care professionals who support them in deciding the most important questions to be answered. We have:

  • Agreed the scope of work
  • Conducted an online survey for research topics/questions – we received over 500 suggestions! 
  • Reduced them to 54 and sent them as part of our second survey asking people to select their top 20. 

All of which could not have completed without the help from our steering group of people with lived experience, carers, clinicians, and researchers. 

Which brings us to now, we have just had our research priority setting workshop to refine and discuss the top 20 from the last survey. 

The Workshop

In preparation for the workshop welcome packs were posted out to each attendee. 

We hosted a workshop via zoom which had 23 attendees from Scotland, Leeds, Manchester, York and Sheffield all of who had a great deal of knowledge about living with both physical and mental health problems either from their personal experience, being a carer or health care professional or maybe even all of these.  The workshop was extremely thought provoking and inspiring for the future of research! We had a great mix of guests attend offering their insight and experiences, reflected by a lovely comment we received from one of the workshop attendees – “I enjoyed listening to the lived experience of others and felt really listened to when I shared mine, I’m excited for the future of this as I feel valued and that the patient voice has been heard”.

Together the priority research topics and questions that were identified were defined as:

Coordination of Care and Access to Services 

1. Some people are living with mental health issues and long-term physical health conditions. How can:

  • Mental and physical health services best work together to coordinate their care and support?
  • The challenges of navigating several different health services e.g. dealing with multiple appointments and information requests, be reduced or made easier?
  • Their conditions be cared for and treated together rather than each one being addressed separately?

2. How can people with mental and physical health issues, including people in vulnerable groups (e.g. those who are homeless, those in disadvantaged communities), be supported to look after their mental and physical health when they face high levels of deprivation and poor access to services?

3. Would specialist services for people living with severe mental health ill health and long-term physical health conditions make a difference to their overall health? What can we learn from current ‘best practice’ about how to organise and deliver specialist services?

Understanding the Link Between Mental and Physical Health

4. How can a better understanding of mental health issues be created in physical health services and a better understanding of physical health problems be created in mental health services?

5. How can conversations between GP’s and people living with mental health issues (including annual Health Checks) be improved when discussing their physical heath? 

6. How can patients and their friends or family carers be supported in their understanding of how mental health issues can impact physical health issues and how physical health issues can impact mental health issues?

7. Can effective pain management improve peoples’ mental health?

Managing Medication

8. The side effects of medications and the interaction between medications are a major concern for people living with mental health issues and long-term physical health conditions. How can:

  • Side effects linked to mental health medication (e.g. weight gain, dry mouth/dental problems) be reduce or avoided?
  • Over-prescribing of medications and prescribing medications that react negatively with one another be reduced or eliminated?

Health Promotion

9. Can providing healthy meals (e.g. meals on wheels) and/or supporting people to cook healthy meals (e.g. cooking coaching; access to low cost cooking equipment) help people with severe mental illness manage their weight and related physical health conditions (e.g. diabetes) in the long term?

10. People living with mental and physical health issues often find it hard to keep physically active. How can we:

  • Better understand the barriers to people using schemes to help with physical health issues (e.g. leisure cards, social prescribing, gym prescriptions)?
  • Identify the most effective and ongoing ways to support people to be more active (e.g. support from a health and wellbeing coach, peer support and group sessions, making use of green spaces)?

For the next steps we are working with our steering group and fellow researchers to codesign and address some of the priorities. We are also presenting an infographic of the priorities that can be shared widely, alongside a web page. As well as preparing a research paper and presentation for other researchers to draw.   

We are very appreciative of the steering group and workshop attendees and excited to continue the collaborative journey for these research priorities!

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