A pioneering five year programme led by Camden and Islington NHS Foundation Trust is on track to save the equivalent of more than 10,000 years* lost to premature death among people with psychosis.
On average, people with serious mental illness die 15 to 25 years earlier than the rest of the population. This new approach – innovative in mental health services – works by coordinating and treating the physical and mental needs of people with psychosis in a proactive manner, led by the mental health trust.
The first phase of the five year project has seen almost 400 out of an initial target number of 800 individuals successfully assessed ahead of starting a comprehensive treatment plan aimed at increasing their life expectancy.
Its key targets include:
reducing the suicide rate among psychosis patients by 20% by 2022
cutting the percentage of those smoking by two per cent per year by 2020
widespread screening for diabetes to determine full prevalence up to 2020, before then reducing to stabilise at 18% or lower by 2022, reversing the national trend
The project will achieve these targets by providing:
Physical health training for mental health staff to cover conditions such as diabetes and lung disease, as well as training to help patients stop smoking
More rigorous physical health screening for every psychosis patient throughout their treatment both in hospital or in the community
Wellbeing clinics* led by psychosis teams
The Trust’s plan – being delivered through an “Integrated Practice Unit for Psychosis” (IPU) – covers service users at C&I with diagnosed psychosis and those registered with local GPs.
Dr Ian Prenelle, Lead Consultant Psychiatrist on the programme, said: “For too long, people with serious mental illness have struggled to get proper scrutiny and support for their physical health issues such as diabetes, lung disease, weight gain, and smoking and drinking.
“As a result, they suffer a significant reduction in life expectation. By treating the complex physical health needs of our service users at the same time as we treat their mental health condition, we will enable them to live, longer, healthier and happier lives.”
Typically, psychosis patients are:
two to three times more likely to have Type 2 diabetes
up to three times more likely to die from cancer than the general population
twice as likely to die from heart disease and
more than three times likelier to smoke than the general population
The Integrated Practice Unit for Psychosis being funded by Camden and Islington Clinical Commissioning Groups embodies all ten pledges in C&I’s new Clinical Strategy*.
Notes to Editors
C&I’s partnership with Camden and Islington local authorities, GPs, acute trusts and community health services, targets 18 specific improvement outcomes addressing both mental and physical health, as well as wellbeing and quality of life.
For physical health outcomes the focus particularly is on diabetes and Chronic Obstructive Pulmonary Disease (COPD), and an emphasis on encouraging people to quit smoking.
*10,000 lost years: This figure has been calculated on the basis of C&I’s 15% target reduction of the gap between average mortality in people with serious mental illness (SMI) and that of the general population – for the SMI population it is on average 15 to 25 years earlier. A 15% reduction of this gap is equivalent to 1.5 years, and for the estimated 7,000 potential SMI group in Camden and Islington this would be a total 10,500 hours.
*Wellbeing clinics: Wellbeing clinics provide expertise and help for people to improve their physical and mental health, and consequently their sense of wellbeing.
The aim is to build people’s sense of enjoyment, contentment and engagement with others and boost their self-confidence and self esteem.
Support is provided on a range of different issues that can impact on physical and mental health such as sleep, alcohol intake, healthy diet, activities, building relationships, learning and “mindfulness” – being aware of the present moment, including your thoughts and feelings.
* Our Clinical Strategy
At the heart of everything we do are the guiding principles contained in our new Clinical Strategy launched in March 2016. The ethos behind the Integrated Practice Unit for Psychosis reflects the following pledges from the Clinical Strategy:
we will co-produce with our service users and carers their treatment and support
we will work in a recovery-orientated way
we will offer evidence-based interventions
we will choose outcomes that measure things that matter to service users and carers and use these to shape our services
we will integrate with other services so that service users have their mental, physical and social needs met in a coherent way
We will prevent mental illness deteriorating or relapsing in all our service users and we will contribute to initiatives that prevent mental health problems in children and young people
we will equip all our clinical staff to address drug and alcohol problems
we will improve access to our services for everyone regardless of gender, race, ethnicity, disability, sexual orientation and other protected characteristics
We will choose a quality improvement methodology and implement it
We will grow our already strong interest in research
We provide mental health and substance misuse services to people living in Camden and Islington, and a substance misuse and psychological therapies service to residents in Kingston.
We have two inpatient facilities, at Highgate Mental Health Centre and St Pancras Hospital, as well as community based services throughout the London boroughs of Camden and Islington. Our Trust is also a member of University College London Partners (UCLP), one of the world’s leading academic health science partnerships.
We provide services for adults of working age, adults with learning difficulties, and older people in the London area either in a community or inpatient setting.
Our income for 2015/16 was £138 million and we have approximately 1,700 staff. Our staff work in multi-disciplinary teams providing a holistic approach to recovery. This means that we often work with partner agencies and the voluntary sector.
Camden and Islington Mental Health and Social Care Trust was established in 2002. In March 2008 we became the first Care Trust to achieve Foundation Trust status and are licensed by NHS Improvement.