The challenge of developing person-centred services to manage comorbid mental and physical illness

Abstract

This chapter considers the difficulties posed by the direction in which healthcare has developed across the world, in particular problems arising from fragmentation and specialisation of care provision. There has been an increasing recognition of the need for improved systems of primary care; however, there is no universal model of provision, and barriers to the management of physical and mental comorbidity can be identified in primary care settings. Models of collaborative care which derive from the Chronic Care Model have shown some promise in management of comorbidity. In order to improve outcomes for people who present with comorbid and multimorbid health problems, healthcare professionals in all settings will need to acquire a range of specific skills. These include being able to explore the impact of physical and mental health problems on the patient, and the negotiation of patient-centred goals.