Last updated:

Achieving parity of outcomes for those with mental health problems and intellectual disabilities

For too long there has been an acceptance in society, and even in the medical profession, that people with mental health problems and intellectual disability will live shorter lives and will suffer because of unmet health needs.

In the vast majority of cases, there is no good reason for this. But the voice of these vulnerable groups often goes unheard, and the status quo remains unchallenged.

The aim of this report is to start to identify what actions need to be taken to support doctors and the medical profession in changing the status quo in the UK.

I cannot promise that it has all the answers, but it does set out a range of core actions that need to be collectively implemented, and adequately funded, to ensure that each vulnerable patient receives ‘whole person’ care.

Professor Sheila the Baroness Hollins, Chair of BMA Board of Science


  • Recommendations

    Joined up care

    The BMA recommends:

    • The integration of intellectual disability, mental health and physical healthcare should be improved
    • NICE and the UK health departments should explore the wider use of NICE’s collaborative care model for people with moderate to severe depression and a chronic health problem
    • Generalists in and outside of hospitals should act as the responsible clinician leading a multi-professional team to strengthen collaborative care
    • A liaison psychiatry service, including paediatric liaison services and intellectual disability liaison services, should be made available in hospitals
    • Mental health trusts should appoint a liaison physician to support the physical health needs of hospitalised people with mental health conditions
    • Health professionals who commission services should ensure they place equal value on mental and physical health when setting priorities
    • Commissioners should have accurate, accessible information on the physical, mental and intellectual disability needs of the population they are serving
    • Equality of access to mental health and intellectual disability services must be made a reality.


    Promoting prevention

    The BMA recommends: 

    • A national mortality review of mental health problems should be implemented across the UK for people with intellectual disabilities and those with a mental illness.
    • Reducing the prevalence of mental health problems and promoting good public mental health should be a priority for Directors of Public Health throughout the UK.
    • Public health intervention programmes should specifically consider how people with intellectual disability or mental health problems will be reached.
    • Mental health literacy and public awareness should be encouraged.


    Training and workforce planning

    The BMA recommends:

    • Undergraduate and postgraduate medical training should shift from teaching mental health separately toward integrating it into the core curriculum
    • There should be adequate workforce planning to ensure that every F1 and F2 doctors has a placement in psychiatry
    • Psychiatrists should be offered teaching on common physical health problems experienced by people with intellectual disabilities and mental health problems as part of their specialty training
    • Training in intellectual disability that explicitly tackles diagnostic overshadowing and unequal treatment should be integrated at all training levels
    • All health professionals should undertake mental health and intellectual disability awareness training
    • Doctors should have the opportunity to work with liaison psychiatrists in primary and secondary care
    • Mental health literacy in the workplace should be improved and support made available to people who are seeking employment
    • Doctors should received specific training on how to communicate to people with intellectual disability.
  • Download the full report

    Recognising the importance of physical health in mental health and intellectual disability: Achieving parity of outcomes - May 2014

    Download the PDF

  • Discussion with Norman Lamb

    BMA Board of Science chair Professor Sheila the Baroness Hollins met with the Minister for Care and Support the Rt Hon Norman Lamb MP to discuss the BMA report. See what happened below. 


    Watch the video in full


    Or watch by topic

    National Mortality Review

    The BMA report calls for a National Mortality Review for people with learning disabilities. Watch the minister give an update on progress in the review.

    Watch this discussion


    Integration of services and improved commissioning approaches

    The Minister for Care Services and Baroness Hollins discuss how commissioning can be improved and better service integration achieved to improve outcomes for patients with mental illness.

    Watch this discussion


    Achieving better access to mental health services

    Watch this discussion


    Improving mental health literacy among health professionals

    Reducing the stigma surrounding mental health and up-skilling clinicians and commissioners is vital to achieving parity of outcomes. Watch the discussion about how mental health literacy among health professionals can be improved.

    Watch this discussion


    Access to mental health care for vulnerable groups

    There is unmet need within vulnerable groups, such as those with an intellectual disability, in mental healthcare. Watch the discussion about tackling this problem.

    Watch this discussion


    Reducing mental health stigma

    There is still stigma and discrimination experienced by people with mental health problems and intellectual disability in the provision of mental healthcare services. The Minister for Care and Support highlights action to tackle this, including the Government’s support for the Time to Change campaign confirming continued Government funding for the campaign.

    Watch this discussion


    Funding for mental health

    Baroness Hollins and Norman Lamb talk about the funding commitments needed to achieve parity of outcomes between mental and physical health.

    Watch this discussion


    Capitalising on recent success

    There has been a greater debate about the state of mental health care in recent months, highlighted by a number of campaigns and a greater openness, especially among MPs, to talking about mental health issues. Baroness Hollins and Norman Lamb discuss how to capitalise on the heightened focus on mental health services.

    Watch this discussion

  • Useful resources