• One in four of GP’s patients will need treatment for mental health problems at any time¹⁸
• At least 25 per cent of patients with a physical illness admitted to hospital also have a diagnosable mental health condition
• A further 41 per cent have sub-clinical symptoms of anxiety or depression, with rates rising to 60 per cent for the over-60s¹⁹
• Dementia is also a very important issue (see Dementia Commissioning Pack)²⁰
• Patients with a physical illness are three to four times more likely to develop a mental illness than the rest of the population

A recent study of frequent attenders at emergency departments in Cambridge identified at least three subgroups with mental health-related presentations:

• Moderate frequent attenders (defined as six–20 presentations per year) with unattributed PES (‘MUS’ presenting with abdominal complaints in particular),
• Moderate frequent attenders with undiagnosed mental health and long-term physical health co-morbidities, and
• Extreme frequent attenders (more than 20 presentations per year) with repeated self harm and substance misuse problems.²¹

The common problems acute liaison services address are:^{18 19}

• Mental disorder accounts for around five per cent of A&E attendances, 25% of primary care attendances, 30% of acute inpatient bed occupancy and 30% of acute readmissions
• Self-harm accounts for between 150,000 and 170,000 A&E attendances per year in England
• MUS may account for up to 50% of acute hospital outpatient activity
• 13–20% of all hospital admissions and up to 30% of hospital admissions via A&E at weekends are related to alcohol
• In England, alcohol-related hospital admissions doubled in the 11 years up to 2007, and alcohol-related deaths also doubled in the 15 years to 2006
• One-quarter of all patients admitted to hospital with a physical illness also have a mental health condition that, in most cases, is not treated while the patient is in hospital
• Most patients who frequently re-attend A&E departments do so because of an untreated mental health problem
• Self-harm is the third most common reason for unscheduled medical admission
• Two-thirds of NHS beds are occupied by older people, up to 60% of whom have or will develop a mental disorder during their admission