The Improving Access to Psychological Therapies (IAPT) programme aims to provide evidence-based psychological therapies for people with depression and anxiety disorders.
The NHS Information Centre have published the first set of key performance indicators for the programme, which aim to provide the Department of Health, IAPT services, commissioners and members of the public with information on how IAPT services are performing.
The 4-year vision for the programme was set out in February 2011 when the following objectives were set by the Department of Health:
- 3.2 million people will access IAPT, receiving brief advice or a course of therapy for depression or anxiety disorders;
- 2.6 million patients will complete a course of treatment;
- Up to 1.3 million (50 per cent of those treated) will move to measurable recovery.
From April 2011 the following indicators are being used to measure improvement:
- The proportion of people entering treatment against the level of need in the general population;
- The proportion of those entering treatment against the number referred. The level of need in the general adult population is known as the rate of prevalence, defined by the Psychiatric Morbidity Survey.
The NHS Information Centre have published the Q1 results (Apr-Jun 2011) and the key facts are as follows:
- 210,540 people were referred for psychological therapies
- 123,975 entered treatment *
- It is estimated that 6.1 million people suffer from anxiety and depression disorders in England indicating that the access rate of people with anxiety or depression orders to IAPT services is 2.0 per cent
- The recovery rate for England for people who were at caseness (i.e. suffering from depression and/or anxiety disorders) at their first session but not at caseness at their last session was 42.0 per cent
- Recovery rates varied from 7% to 63% between different Primary Care Trusts, which may reflect a lack of qualified staff to provide the psychological therapies
- During the reporting quarter 5,001 people moved off sick pay and benefits
* The number of people who completed treatment in the quarter is not a direct subset of the number of people referred in the same quarter, as some may have been referred for treatment in a previous quarter.
The Information Centre website features various datasets and analysis spreadsheets as well as the report summary itself, for those who are interested in further detail.
Improving Access to Psychological Therapies Key Performance Indicators (IAPT KPIs) Q1 Apr 2011 – Jun 2011. NHS Information Centre, 20 Sep 2011.
So ‘at caseness’ – a new version of the way ‘clinical’ had been used in the past? I can see that practitioners need to think of their cases on their patient list but it will rankle! In this field here language consistency is needed for the patient and they are part of the language constituency but vulnerable outsiders to any ongoing progress of ‘official’ vernacular slang!
There’s a response to this report on the Mental Health Foundation website: http://mentalhealth.org.uk/our-news/news-archive/2011/11-09-20/
Cheers,
The Mental Elf
We posted on WELD, the mental Elf’s sister blog a while ago about the fact that there were no areas listed in IAPT as having a special interest in specifically rolling out psychological therapies to people with learning disabilities (see: http://www.weldblog.net/2011/06/06/access-to-psychological-therapies-for-people-with-learning-disabilities-could-be-improved/)
I am not sure that the performance indicators listed here will help anybody to be clearer about whether this situation is changing or not?
The term “caseness” is this used as people who might not meet the clinical indicators of depression and/or anxiety are also offered treatment?
So “caseness” was what I thought it was – if you answer the questionnaire and are diagnosed surely you are therefore also clinically anxious and/or depressed? This is a side issue taking up a lot of space it would seem but illustrated the point – language is important!
My concern from experience is that the PHQ is not that accurate and hopefully other clinical indicators are used to assess people,otherwise also in my experience from working in primary care mental health is that depression and anxiety are over diagnosed,therefore inflating the numnber of peole requiring treatment.
Good point! And PHQs are quite difficult as a patient! Especially the first one/few – and if you get transferred and entered into several waiting lists – it can echo the pathology in dangerous ways especially in relation to dangers – like with obsessional post-natal depression; cut in deep and offer too little natural hooks for intuitive trust and stabilising! Ill people are not ecologist-data-clerks ready to objectively and without upset do stats on themselves as the first thing they do! Yes you need data but recording should be delivered less obtrusively with less under-supported work for the ill as part of a standardised slick patient experience: it should go hand in hand with comprehensive introductions to the new worlds of psychiatric and psychological care/intervention. The PHQ had intense effects that I can recall like flashbacks. I was caught between wanting to gather clues about the services that fitted in with what I already knew and whether I was safe and turning it back as the questionnaire did; I wanted full introductions based on concerns to all related professionals organisation and theoretical and professional background. I would still say now seek to win trust; not expect it off people scared witless anyway and scared whatever they say could be taken down and used cold out of context in evidence against ! Surely that puts the patient journey into focus – when everything is up for question and you’ve been taken as statutory authority’s ward!
Learning difficulties and specific learning difficulties; not good prospect in juncture with specious world of psychology! Even if I do say so in polysyllabic pastiche!?
I am a stronger supporter of lay-led self-management in mental health and do feel IAPT has medicalised mental health recovery again. I devised a mental health self care course for the Expert Patients Programme and am living proof of the efficacy of self care in terms of positive thinking, planning, activities etc. I live with Bipolar Disorder and work in mental health but myself working in partnership whith my doctor and seeing any setbacks as ‘blips’ really does keep me well.
For those of you interested in the IAPT key performance indicators, the provisional Q2 report is now available on the NHS Information Centre website:
http://www.ic.nhs.uk/statistics-and-data-collections/mental-health/nhs-specialist-mental-health-services/improving-access-to-psychological-therapies-key-performance-indicators-iapt-kpis-q1-2011-12-final-and-q2-2011-12-provisional
Key facts from the report:
214,156 people were referred for psychological therapies
129,096 entered treatment1
It is estimated that 6.1 million people suffer from anxiety and depression disorders in England indicating that the access rate for people with anxiety or depression disorders to IAPT services in the quarter was 2.1 per cent
The recovery rate for England for people who were at caseness at their first session but not at caseness at their last session was 42.2 per cent
During this reporting quarter 6,305 people moved off sick pay and benefits
Cheers,
The Mental Elf