Abstract
This commentary examines publicly available information on 2017–2018 outcomes in the UK government’s Improving Access to Psychological Therapies (IAPT) programme, a National Health Service (NHS) primary care mental health programme in England. In that year there were 1.4 million referrals into IAPT and over 500,000 people completed a course of treatment. The IAPT database collects routine session-by-session outcome monitoring data for this population, including outcomes for depression and anxiety in a stepped care model which includes a range of psychological therapies, among them Cognitive Behavioural Therapy (CBT) and Person-centred Experiential Therapy, known in the IAPT programme as Counselling for Depression (CfD).In 2017–18, 32% of all referrals were for anxiety and stress disorders, 26% for depression, and 35% were unspecified. The definition of treatment completion is receipt of 2 sessions or more and on this basis 60% of all referrals in 2017–18 did not complete treatment, predominantly because they failed to attend the initial appointment, or ended after only one session. Four years of data on outcomes for CBT and CfD suggests these therapies are broadly comparable in terms of both recovery rate and average number of sessions, though the number of referrals to each therapy varied widely. Data on treatment choice and satisfaction was favourable but there were issues with low return rates and invalid data. Information on outcomes for ethnicity, sexual orientation, disability and religion, as well as a measure of local economic deprivation, indicate lower outcomes for a number of patient groups. Data on employment status outcomes suggest little overall change, including for the category of those on benefits payments.The data published alongside the annual IAPT reports mean there is an increasing amount of information in the public domain about IAPT performance, but it is time consuming to extract and evaluate. This report highlights a number of points of concern which suggest the need for improvement on multiple axes. We suggest that improved researcher access to the huge IAPT dataset can allow for more detailed evaluations of IAPT that can inform policy/decision-making to improve outcomes for clients.
Highlights
Most common presenting issues In 2017–18, out of the 1,439,957 referrals, 35% (N = 498, 060) were unspecified (“not stated, not known, invalid”), 26% (N = 375,001) were for depression and 32% (N = 467,911) for anxiety and stress disorders, a category that included Generalised Anxiety Disorder (GAD), mixed anxiety and depression, Agoraphobia, Obsessive Compulsive Disorder, Panic Disorder, Post-Traumatic Stress Disorder, Social and specific phobias and other anxiety or stress related disorders [3]
Conclusions there is an increasing amount of information in the public domain about Improving Access to Psychological Therapies (IAPT) performance in the annual reports, there is a considerable burden on the reader to extract and construct a report such as detailed in this Commentary
The data indicates that 60% of those referred to IAPT do not complete the initial 2 appointments; given the low threshold for ‘completing treatment’, the dropout rate is potentially significantly higher
Summary
This article delves into publicly available information on the Improving Access to Psychological Therapies (IAPT) programme to examine IAPT performance [1]. The UK government’s IAPT initiative is a funded programme for England aimed at delivering evidence-based psychological therapies – primarily CBT – for depression and. Moller et al BMC Psychiatry (2019) 19:252 presented for the first time through an interactive dashboard. The IAPT programme has been described as “England’s mental health experiment” [8] and it is important to consider the outcomes of this experiment since 2012. The current article focuses on key results from 2017 to 2018 but includes, where relevant, results from the prior three IAPT reports
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
