Living with Mental and Physical Multimorbidity

We want to give people living with both mental and physical health issues, their families, and the health and social care professionals who treat and support them, a voice in deciding the most important questions to be answered by future research.

Research Priority Setting

Working together to shape our future research

Improving the health of people with mental and physical health issues - what are the questions you would like to see be answered by research?

We want to give people living with both mental and physical health issues, their families, and the health and social care professionals who treat and support them, a voice in deciding the most important questions to be answered by future research. To do this, we have undertaken a research priority setting exercise.

Our aim was to identify unanswered questions about what would help people with mental health conditions look after their physical health, and what treatments and services, if examined by research could make a real difference to peoples’ lives. We have been working with communities and partner organisations from across Yorkshire and Humber, to prioritise those issues that are the most important for research to address and plan how we might respond to them.

Surveys

Over 100 people living with mental and physical health problems, informal caregivers, and health and social care professionals, responded to our first survey. They suggested a wide range of topics that were important to them.

We turned those responses into a long list of questions which, if examined by research, could make a real difference to peoples’ lives. In the second survey we asked people to tell us which 20 questions they think are the most important.

Again over 100 people responded to our second survey, giving us the top 20 research priorities. We were pleased to see respondents from a range of backgrounds agreeing on the top 20 priorities.

Workshop

We have completed a research priority setting workshop via zoom, which had 23 attendees including people with lived experience, carers, clinicians, and researchers. The results of the second survey were presented and discussions took place to refine these priorities into a top 10.

Priorities

From the workshop the priority research topics and questions that were identified were:

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 reduced 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)?

Our priority setting Steering Group, which includes people with experience of mental health problems and clinicians, continues to provide excellent guidance throughout the priority setting process.



LEAP

We are in the process of setting up a Lived Experience Advisory Panel.

Other areas of interest

We are also working to develop a network of applied health researchers working in mental health, with a specific interest in the complexities that face those who deliver care and receive it. Our areas of interest include (but are not limited to):

  • Mental health economics

  • The prevention and management of diabetes in people with serious mental illness

  • Mental physical multimorbidity in older people (including frailty)

  • Knowledge transfer and implementation science

  • Sexual health for people with serious mental illness

  • The health and safety of inpatient mental health environments


OWLS

BASIL