The Improving Access to Psychological Therapies (IAPT) programme is 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.
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 (1.88 million in total).
The number of referrals to IAPT and the number of referrals starting treatment have both increased over time. In 2011/12 there were 887,452 referrals to IAPT, and this increased to 1,676,985 referrals in 2019/20 but then fell to 1,440,183 in 2020/21 (a 62% increase from 2011/12). The number of referrals starting treatment almost doubled, from 533,550 in 2011/12 to 1,025,210 in 2020/21. The 2015 access target of 900,000 was met, however IAPT fell short of the 2020/21 target by 32%, with 474,790 more people needing to start treatment to reach the target. The number of people starting IAPT treatment must increase considerably if the 2023/24 target of 1.88 million starting treatment is to be reached.
As well as looking at annual numbers of referrals to IAPT, we can also examine monthly data for detail of more recent changes. In 2019, the number of referrals to IAPT fluctuated at around 140,000 each month and the number of referrals starting treatment remained at around 100,000 each month. Both fell in December 2019 but recovered in January 2020.
Between February and April 2020, the number of referrals to IAPT more than halved, following the onset of the Covid-19 pandemic. This may be due to reductions in the number of patients presenting at GP surgeries during the lockdown period. The number of referrals starting treatment fell by 34% over the same time period. Since then, both the number of referrals and the number starting treatment increased to levels that are slightly higher than before the pandemic.
Finishing a course of treatment is only one outcome for those referred to IAPT. Other outcomes include: declining or dropping out of treatment, being referred to another service, not being suitable for IAPT treatment or dying before they reach an outcome.
The number of people successfully finishing a course of treatment increased by 93% between Q1 2012/13 and Q1 2021/22, from 88,162 to 170,572 - the highest number on record. In Q3 2021/22, 160,679 people successfully finished a course of treatment, a 6% decrease from the previous quarter.
When patients begin treatment through the IAPT programme they are clinically assessed for scores of anxiety and depression; those who score highly are considered a clinical case. When reassessed at the end of treatment, people who no longer score as highly 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 recovery rate increased gradually between Q1 2012/13 and Q4 2018/19, from 46.1% to 53.0%. Since then, it has decreased to 49.0% in Q3 2021/22. The target recovery rate of 50% was first achieved in Q4 2016/17. Since then, the recovery rate has fallen below target in Q4 2019/20, Q1 2020/21 and Q3 2021/22.
NHS Digital notes that while the number of organisations that submit data for IAPT has not changed throughout the Covid-19 pandemic, there has been a significant change in the rate of recovery since the pre-Covid-19 period.
About this data
Improving Access to Psychological Therapies (IAPT) is an NHS 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.
A patient referred to IAPT has moved to recovery if they were defined as a clinical case at the start of their treatment and are no longer defined as a clinical case at the end of their treatment. This is measured by scores from questionnaires tailored to their specific condition. The Government target is that 50% of eligible referrals to IAPT services should move to recovery.
Between Q2 2020/21 and Q2 2021/22, data for each quarter was calculated from monthly publications. For example, data for Q4 2020/21 was calculated by summing the monthly data for January, February and March in 2021. Quarterly data was reinstated in Q3 2021/22 and we will use this data going forward.
In December 2021, revised data was published for the months between September 2020 and May 2021, and these historic figures have been updated in our charts accordingly.
For more information about the data, please see the NHS Digital website.