Guest blog by Andy Bell, Deputy Chief Executive, Centre for Mental Health
Having a musculoskeletal condition increases your risk of having a mental health problem, and people with a mental health condition are more likely to have a range of MSK problems. Yet the way services for both are organised and the ways professionals in each are trained offers little recognition of the overlaps between them.
Mental health and MSK conditions share some common traits and challenges. Both are complex and diverse. Many are poorly understood. And neither has traditionally been afforded priority status within the NHS.
Nonetheless, both are finally gaining recognition by policymakers as causes of long-lasting distress, pain, poverty and disability. The NHS Long Term Plan, for example, includes a welcome focus on improving mental health support, including an extension of psychological therapy provision for people with long-term physical conditions. And a new five-year MSK strategy sets out a range of actions that statutory bodies such as Public Health England and charities including Versus Arthritis and ARMA will take to prevent MSK conditions and improve support for those living with them.
The MSK strategy specifically notes the links with mental health, citing a fourfold higher risk of depression among people living with chronic pain and a 50% higher risk of back pain among people with depression . It goes on to note that integrated working may therefore help to support people with co-occurring needs more effectively, though gives little detail about what that might mean in practice.
Centre for Mental Health is now working with partners in both mental and physical health to highlight the often neglected physical health needs of people living with long-term mental health conditions such as schizophrenia, bipolar disorder or personality disorders through a collaborative called Equally Well . Having a severe mental illness is known to cut short life expectancy by 15-20 years. But for many it also comes with chronic pain and disability. And too often people’s physical symptoms are ignored or overshadowed by their mental illness.
We want to change that by ensuring that people working in and using mental health services have a bigger focus on physical health, and that those working in physical health can work equally well with someone who has a mental health diagnosis as they can with someone who does not. For MSK professionals, this may mean being more aware of the nature and impact of mental health conditions, and being able to work in trauma-informed ways . Building links with mental health professionals and service users can help to ensure people get timely help where possible to prevent MSK problems and whenever necessary to offer the right help and support to people who need it.
Some services, for example Sussex MSK Partnership , understand the importance of ‘no health without mental health’ (one of its three core values) and the value of people who use services being recognised as equal partners in designing and delivering this sort of support .
It is vital that people living with long-term mental health conditions get the same recognition for their physical health needs, with MSK professionals available to meet their needs in ways that they find helpful and convenient (including for those who may be in hospital for their mental health).
Achieving equal health for people with mental health conditions requires the whole health and care system to work differently. But ultimately, it is about the interactions professionals have with people day to day. And through Equally Well we hope to work with ARMA and colleagues across the MSK sector to enable people to bring about change at every level of the system and to ensure no one is left without the support they need for their physical and mental health.