The Improving Access to Psychological Therapies (IAPT) programme is designed to support the NHS in delivering evidence-based psychological therapies for people with depression and anxiety disorders in England.
The previous 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 rise so that atleast 600,000 more adults with depression and/or anxiety will be able to access IAPT services each year, by 2020/21.
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 1,434,000 referrals in 2017/18 (a 62% increase). The number of referrals starting treatment increased by 89%, from 533,550 in 2011/12 to 1,009,072 in 2017/18. The 2015 access target has been met, but the number of people starting IAPT treatment must still increase considerably if the 2020/21 target is to be reached. In order to achieve the 1.5 million target, an extra 164,000 people must gain access to IAPT services each year.
Successfully 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 69% between Q1 2012/13 and Q2 2016/17, but since then improvement has stalled. In Q1 2018/18, 147,229 people finished a course of IAPT treatment, which is slightly less than it was two years ago. This observation is worrying, since the number of people starting treatment has gone up but those finishing treatment has remained the same. It could indicate an overstretched system in which people start a course of IAPT treatment but are unable to schedule regular appointments due to a lack of capacity.
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 below the clinical threshold.
The recovery rate has increased over time, from 46.1% in Q1 2012/13 to 52.4% in Q1 2018/19. The target recovery rate of 50% was first achieved in Q4 2016/17, and has been met since then.