Background
The NHS Talking Therapies programme (re-branded from Improving Access to Psychological Therapies in January 2023) was designed to support the NHS in delivering evidence-based talking therapies for people with common mental health problems, such as depression and anxiety disorders, in England. We explore how access and outcomes for the programme have changed over time.
Access to NHS Talking Therapies
The 2015 access standard for IAPT services was to provide timely access to treatment for at least 15% of the community prevalence of depression and anxiety disorders (900,000 people). The Five Year Forward View for Mental Health set out that this should increase to reach 25% of need so that at least 600,000 more adults with common mental health problems can access IAPT services each year by 2020/21 (1.5 million in total). The NHS Long Term Plan then increased this target to an additional 380,000 adults accessing IAPT services by 2023/24 (1.9 million in total). This target was missed.
The number of referrals to IAPT and the number of referrals starting treatment have concurrently increased over time. In 2012/13 there were 883,968 referrals to IAPT, which nearly doubled to 1,694,740 by 2019/20. Despite a fall in 2020/21, the number of referrals grew to 1.8 million in 2021/22 – the highest yet on record. In 2022/23, this fell to 1.7 million. Given that people can self-refer into every NHS Talking Therapies service, the slight drop in the number of referrals might be due to the recent re-branding of the programme.
The number of referrals starting treatment also doubled from 2012/13 to 2019/20, surpassing one million by 2017/18. The 2015 access target of 900,000 was almost met, however IAPT fell short of the 2020/21 target by 32%, with 475,986 more people needing to start treatment to reach the target for that year. Despite efforts to increase the number of referrals, in 2023/24, 1.3 million people started treatment, 0.6 million referrals short of the target.
Finishing a course of treatment is defined as having two or more attended treatment care contacts between the date when the referral was received and the date when it ended. The number of referrals completing a course of treatment grew from 144,210 in 2012/13 to 671,648 in 2023/24. Following additional funding towards the digitisation and expansion of the programme in late 2023, the new target for referrals finishing a course of treatment has increased to 700,00 (end date unspecified). Worryingly, however, since 2016/17, the growth in the number of completed referrals has plateaued, unlike the trend in referrals received and those starting treatment. A closer investigation into attrition in the NHS Talking Therapies service can be found here.
Recovery after treatment completion by deprivation
The NHS has set a target recovery rate of 50%. Although the average recovery rate in 2023/24 was 47%, this obscures the difference in recovery rates between individuals of different deprivation levels. In 2023/24, 52% of those who completed a course of treatment from the least deprived decile recovered, compared with 40% from the most deprived decile. In addition, in 2022/23 there were 16,986 more individuals on average who completed a course of treatment from the average of the 3 most deprived deciles when compared to the average of the 3 least deprived ones (data not shown). Thus, even though a larger number of patients from the most deprived deciles complete treatment provided by the NHS Talking Therapies programme, they are less likely to recover than their least deprived counterparts. This pattern is similar to that observed in 2016, where analysis of NHS Talking Therapies data led researchers to a similar conclusion that individuals who live in deprived areas are more likely to need mental healthcare but less likely to recover following treatment.
Deprivation and mental health are inextricably linked. Poor housing conditions, unemployment and income insecurity are all factors for poor mental health. Often, mental healthcare alone cannot improve mental health without changes in wider factors that can give rise to and exacerbate mental health conditions.
About this data
NHS Talking Therapies (previously known as Improving Access to Psychological Therapies, or IAPT) is an NHS-funded programme in England that offers interventions approved by the National Institute for Health and Care Excellence (NICE) for treating people with common mental health problems, such as OCD, depression and anxiety.
When patients begin treatment through the NHS Talking Therapies programme, they are clinically assessed on their experience of anxiety and depression. Those who score above a certain threshold are considered a clinical case. When reassessed at the end of treatment, people who no longer score above the clinical threshold for anxiety and depression (so are no longer a clinical case), are considered recovered. The recovery rate is the proportion of people who start treatment with a high score, and complete treatment having reduced their score to below the clinical threshold. The government target is that 50% of eligible referrals to NHS Talking Therapies services should move to recovery.
From 2022/23, the Improving Access to Psychological Therapy (IAPT) annual report series has been superseded by the "NHS Talking Therapies Annual Statistics" series.
For more information about the data, please see the NHS Digital website.