More needs to be done to speed implementation and improve effectiveness of IAPT

Recent figures have shown that the Improving Access to Psychological Therapies (IAPT) programme is effective for the majority of people who have accessed talking therapies through it, but the programme has the potential to help many more people.

When the Health and Social Care Information Centre (HSCIC) released its first figures on how the IAPT programme is faring, it told people in the sector pretty much what they already knew: talking therapies can be effective but the programme could still do much better.

One headline figure was that, of the 144,000 referrals for talking therapies that resulted in people having at least two sessions, 57% showed improvement in their mental health. This strengthens the existing evidence base for talking therapy and again shows their undoubted value.

But this only tells a fraction of the story. Other figures are more worrying.

For instance, while 884,000 referrals were made for talking therapies only around half resulted in people entering treatment and in 269,000 cases people dropped out or declined the treatment that was offered to them.

This is a high attrition rate and the reasons for this happening need to be closely investigated. 

Vicki Nash, head of policy and campaigns at mental health charity Mind, speculated that this could in part be down to a lack of choice in the therapies offered, and this seems a sound theory. IAPT only offers therapies recommended by the National Institute for Health and Care Excellence and there have been calls for the programme to offer the full range of psychological therapies to patients so they can choose the one they believe is right for them.

Additionally, the time that people have to wait to access therapy urgently needs to be reduced. The HSCIC reported that of those referred who entered treatment in 2012-13, 63 in every 100 attended their first appointment within 28 days, with 92 in every 100 attending within 90 days.

That’s still a significant minority who have to wait for more than 3 months to access therapy. It is also a significant minority who face a greater risk of becoming more unwell as they wait and who may therefore require more intensive treatment further down the line. This can have a devastating effect on the person concerned, as well as costing the state more in the long run.

But the proposal in the government’s recent mental health action plan to introduce waiting time standards for mental health – giving mental health patients the same rights as someone with a physical health problem – from April 2015, should hopefully start to address some of these problems. Targets and deadlines tend to focus the mind, although it depends on what the penalties for non-compliance are, which haven’t as yet been made clear.

The HSCIC figures show that IAPT is working, but the programme must do better. The mental health action plan committed the government to expand the service to 300,000 more people, which is welcome, but the problems highlighted by the HSCIC need to be investigated and addressed quickly – for the benefit of all concerned.