IMPARTS: Integrating mental and physical healthcare

Around 30 per cent of people with long-term physical health conditions, such as diabetes and arthritis, have a diagnosable psychiatric disorder – commonly depression and anxiety.

When this happens, the outcomes for the physical disorder are worse – people experience more symptoms, poorer quality of life, and are more likely to die. However, mental and physical healthcare services are often disconnected and physical healthcare staff such as general hospital doctors/nurses are not usually trained to help with mental health so patients’ difficulties often go unnoticed.

The National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre, supported by King’s Health Partners, pioneered IMPARTS (Integrating Mental and Physical Healthcare; Research, Training and Services). IMPARTS was co-developed by clinicians and patients to support better mental healthcare in general hospitals.

Digital questionnaire on physical health

It includes staff training, identifying mental healthcare pathways and supports research studies. At its heart is a digital questionnaire that patients attending general hospital appointments complete about their physical health, smoking, quality-of-life, depression and anxiety.

Responses are uploaded directly into patients’ electronic health records, available immediately to their physical healthcare professional. Any mental health difficulties are therefore detected and rapidly acted upon, with self-management materials and/or referral to mental health services.

Patients can now receive a notification to complete the questionnaires at home on their own smartphone or tablet, so that the results are available at the up-coming appointment, whether in the hospital or by telephone/online.

 IMPARTS has assisted over 100,000 patient visits

IMPARTS is now used in 75 physical healthcare services across two large hospital trusts (King’s College Hospital/Guy’s & St Thomas’ Hospital) and has assisted 102,546 patient visits. It has been well-received by clinicians and patients. 

One clinician stated: “Without IMPARTS, sometimes you’d get a feeling about a patient but nothing you could put your finger on…Whereas with a questionnaire patients will disclose things they wouldn’t have otherwise done.”

A patient said: “It was wonderful that mental health issues were addressed during the consultation. I feel stress exacerbates my symptoms and it is not a separate issue.”

IMPARTS research can provide crucial insights into interactions between mental and physical symptoms. For example, we showed that differences between patient and doctor assessments of psoriasis severity were associated with patients’ mental health status.

We plan to support NHS trusts to develop an approach to identify mind and body needs, and to aid selection of patients for studies testing novel treatments aimed at improving the lives of people with comorbid mental and physical disorders. 

IMPACT AREAS:

Whole Person Care | Data and Analytics to Drive Healthcare | National and International Collaboration | Improving Access and Uptake