Nurses working in acute and critical care areas frequently care for people with an enduring mental illness and/or long-term ailments as they are frequent users of acute hospital services. Mental health and physical health are indistinguishably interwoven, with chronic conditions such as diabetes and cancer associated with high rates of mental illness. Some 70% of NHS spend goes on the treatment of chronic illnesses including the assessment and treatments of psychosocial wellbeing in acute hospitals.¹ Physical illness increases the risk of mental illness, which may be exacerbated by admission into acute care. Mental health conditions account for 30% of acute inpatient bed occupancy and 30% of acute readmissions.² Older people occupy 66% of NHS beds and around 60% will have or develop a mental disorder during their admission.³

Patients admitted to acute care with an existing mental illness are likely to have received poorer quality healthcare prior to admission.⁴ They are less likely to seek medical help, attend screening programmes, register with a GP, or may have difficulties in making and keeping appointments. The presence of a mental disorder may ‘overshadow’ the recognition and treatment of physical health problems. It is essential that acute care nurses are aware of the complexity of exploring patient problems, ensuring that physical problems are not missed in those experiencing mental illness. It is often overlooked how physical conditions can manifest as a deterioration in acute mental health status.