The Economic and Mental Health Impact of IAPT: Pragmatic Trial in Three English Regions

Abstract

Abstract Background Improving Access to Psychological Therapies (IAPT) programme is the English’s major initiative for treating anxiety and depression, currently provided to over 1 million people. We tested whether IAPT could reduce healthcare costs and improve employment in persons with long-term chronic conditions. Methods Stepped-wedge design of two cohorts covering 560 patients each with depression and/or anxiety and comorbid long-term physical health conditions, namely diabetes, chronic obstructive pulmonary disease (COPD) and cardio-vascular disease (CVD) from three areas in Thames Valley (Berkshire, Oxfordshire and Buckinghamshire) for the period March 2017 - August 2017. Panels were balanced. Difference-in-difference models were used and intention-to-treat analysis. Results Based on the step-wedge modelling, IAPT treatment decreased costs by £497 (95% CI: -£770 to -£224) total per person (pp) (from £1266 pp before starting the treatment to £768 pp since the treatment started)in the first 3 months. Results also showed a decrease by about 5.55 [95% CI: -6.35, -4.75] (-4.18 [95%CI: -4.91, -3.45]) points per person in the PHQ9 (GAD7). Our results show that IAPT increased the probability to an employment for those who were unemployment by about 7.92% (95% CI: 0.94% to 14.9%). Conclusions IAPT treatment significantly reduced healthcare utilization and costs among persons with chronic conditions. It also significantly increased the probability of employment. Key messages IAPT treatment significantly reduced healthcare utilization and costs among persons with chronic conditions. IAPT was significantly associated with increased probability to find employment for those unemployed.