Abstract
ObjectivesPrompt Mental Health Care (PMHC) is the Norwegian version of the England’s Improving Access to Psychological Therapies (IAPT). Both programs have been associated with substantial symptom reductions from pre- to post-treatment. The present study extends these findings by investigating symptom levels at 12 months post-treatment, as well as treatment outcome in relation to low- vs. high-intensity treatment forms.Design and Outcome MeasuresA prospective cohort design was used. All participants (n = 1530) were asked to complete the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 questionnaire (GAD-7) at baseline, before each session during treatment, at final treatment, and at 12 months post-treatment. Cohen’s d was used as effect size measure. Sensitivity analyses were conducted to examine the impact of the high missing data rates at post-treatment (≈44%) and 12 months post-treatment (≈58%).ResultsA large symptom reduction was seen from baseline to 12 months post-treatment for both PHQ (d = −0.98) and GAD (d = −0.94). Improvements observed at post-treatment were largely maintained at 12 months post-treatment (PHQ (Δd = 0.10) and GAD (Δd = 0.09). Recovery rates decreased only slightly from 49.5% at post-treatment to 45.0% at follow-up. Both low- and high-intensity treatment forms were associated with substantial and lasting symptoms reductions (−1.26 ≤ d ≤ −0.73). Sensitivity analyses did not substantially alter the main results.ConclusionThe findings suggest long-lasting effects of the PMHC program and encourage the use of low-intensity treatment forms in PMHC like settings.
Highlights
In 2006, “The depression report, A New Deal for Depression and Anxiety Disorders” by The Centre for Economic Performance’s Mental Health Policy Group gave compelling reasoning for upscaling the offer of evidence-based psychological therapy for individuals with anxiety and depression in England (Layard et al, 2006)
Improving Access to Psychological Therapies” (IAPT) provides treatment based on National Institute for Health and Care Excellence (NICE) guidelines, and utilizes both low intensity and high intensity [e.g., individual cognitive behavioral therapy (CBT)] treatment forms (Clark et al, 2009; Chan and Adams, 2014; Clark, 2018)
The present study aimed to investigate how symptoms of anxiety and depression developed from baseline to 12 months post-treatment among clients from the first 12 prompt mental health care (PMHC) pilot sites
Summary
In 2006, “The depression report, A New Deal for Depression and Anxiety Disorders” by The Centre for Economic Performance’s Mental Health Policy Group gave compelling reasoning for upscaling the offer of evidence-based psychological therapy for individuals with anxiety and depression in England (Layard et al, 2006). The program has been established in virtually all Clinical Commissioning Groups in England, and the latest annual report showed that more than a million people are seen each year with an average recovery rate of 50.8% (NHS Digital, 2018). Clients reported their gender (male, female), age (18–24, 25– 44, 45–67, > 67), education (primary school, high school, university/university college), job status (working, working and receiving benefits, not working with or without benefits), marital status (living alone, not living alone) and immigrant background (yes, no). The proportion of missing data at baseline, final treatment and 12 months was 1.04%, 43.5 and 57.9%, respectively, for PHQ, and 1.04, 43.7, and 59.1%, respectively, for GAD
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