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Ask How I Am

This project sought to understand the relationships between living with a long-term condition and people’s emotional and mental wellbeing to help identify ways of improving people’s experiences and outcomes.

  • COVID-19
  • Person-centred care
  • Primary care
  • Communication and administration

The relationship between mental and physical health

Our report, Ask How I Am: Supporting emotional health among people living with long-term conditions was coproduced by National Voices and Centre for Mental Health, with support from a range of long-term conditions charities. 

We know that mental and physical health are closely related. People who live with long-term physical conditions are twice as likely to have poor mental health as those who do not.  

During the COVID-19 pandemic, we spoke with people living with long-term conditions, their family members and the healthcare professionals who work with them, to understand the relationships between having a long-term illness and people’s emotional and mental wellbeing, and to identify ways of improving people’s experiences and outcomes. 

Our report shows the impact long-term conditions can have on people, their relationships and jobs; what helps; what support is already available and works; and what needs to change to better emotionally support people living with long-term physical ill-health. We are aware that in many places clinicians are supporting people with their mental health, but it is not always the case that emotional wellbeing is brought up.

Recommendations and resources

This work produced one overarching call to action for all healthcare practitioners and services working with people living with long-term physical conditions to show care and compassion in all their interactions and to take every opportunity to ask about emotional wellbeing.  

We have set out six practical tips for healthcare workers to help them to do this routinely. We know, however, that this needs to be facilitated by significant system change. Short appointment times, inadequate training and patchy availability of mental health services make it more difficult for healthcare practitioners to support people’s emotional wellbeing.  

We have therefore defined ten recommendations for system change, both nationally and locally, which we believe will enable significant improvements to be made.  

We also developed information for people with long-term conditions and a model of whole person care for people living with long-term physical health conditions.

#AskHowIAm campaign

Upon launching our report, we initiated our #AskHowIAm campaign, asking every healthcare provider to meaningfully ask people how they are feeling to encourage compassionate conversations at all points of contact between healthcare professionals and people living with long-term conditions. 

We also asked system leaders to make the necessary service changes to enable these vital conversations to take place, as well as to equip healthcare professionals with the skills and knowledge they need to effectively support the range of emotional and mental health needs those living with long-term conditions may experience. 


This report was sensitively researched by Jo Wilton, and faithfully written by Andy Bell, both at Centre for Mental Health. Dr Charlotte Augst, Chief Executive at National Voices, first had the idea to explore the long and porous line between physical and mental ill health. The whole National Voices team supported the development of the report from inception to launch. We are grateful to Kate Fitch, Freelance Consultant, who managed the project, expertly liaising between project partners and funders.

Special thanks to the following, without whose financial support, and more importantly, thoughtful input throughout the project, this work would not have been possible:

Heather Baumohl-Johnson and Sarah Gudgin from Arthritis Action

Jessica D’Cruz and Leila Reyburn from Mind

Samual Dick from the British Heart Foundation

George Holley-Moore, from Macmillan Cancer Support

Nikki Joule from Diabetes UK

Ian McCreath, from Dementia Change Action Network

Chit Selvarajah and Phil Mawhinney from Independent Age

Jen Taylor-Watt, Impact on Urban Health, part of Guy’s and St. Thomas’ Foundation.

Finally, we would especially like to thank people who took part in the surveys, interviews and stakeholder events, who gave us their time, their experiences and their reflections.