Common mental health problems affect 1 in 4 people, and IAPT services are currently commissioned to treat 15% of known need.
The recently released ‘Five Year Forward View for Mental Health’ report from the Mental Health Taskforce states that IAPT access targets should be increased from 15 to 25%. That’s another 600,000 individuals each year.
Unsurprisingly, this commendable development has been welcomed by service users, mental health providers and commissioners alike. However, it will not come without challenges.
In the weeks since the report was published, concerns around funding and training have been widely expressed. These issues are of course inextricably linked.
IAPT services are already stretched. Partly this is due to the fact that IAPT is such a high volume service battling high DNA rates, which waste valuable clinical time. Adding further pressure is the fact that staff turnover across IAPT is high, with over 18% of core training posts in psychiatry currently vacant. Psychiatry also has the slowest rate of growth and the highest drop out rate of any clinical specialty. It’s possible that this is due in part to the current working environment; in the recent British Psychological Society and New Savoy Partnership survey, 46% of psychological therapy workers reported experiencing depression themselves. So how will IAPT find the capacity to support an additional 600,000 people each year?
The workforce issues facing IAPT are not easy to resolve. The report has recommended steps to ensure a brighter future for those working in the mental health profession, but these changes will not happen overnight. In the meantime, services will need to find ways to achieve more with the resources they already have—or look at other ways of increasing their capacity.
Individual face to face therapy is staff and time intensive, and in order to cope with increased targets, services may have to rely more on other methods of delivery. Increasing the use of different, equally effective treatment types such as group courses and online therapies for appropriate patients will help to increase the volume of patients that can be treated.
Group therapy has the clear advantage of allowing treatment to be delivered to multiple patients simultaneously. It also has the added benefit of peer support, which can prove highly beneficial to many patients. Online therapies are a treatment option suitable for many. They allow patients to undergo treatment via the internet, supported by a PWP. In some services, this has allowed PWPs to support four patients an hour instead of one, while maintaining recovery rates. Many online therapy providers are also able to provide the therapists to deliver cCBT to patients. This has been an efficient way for services to expand their capacity and therefore treat more patients.
When modifying care pathways, it is important that data is collected and analysed to ensure that outcomes for patients remain consistent, or ideally improve. By analysing the efficacy of different treatment options for certain patient groups, it is possible to build service models that are not only efficient, but which also give patients the best chance at recovery.
For services that are already stretched and understaffed, meeting targets of 25% access will not be easy. Funding must be increased to reflect the new target, but by looking into existing care pathways, redesigning services and resolving inefficiencies, there is much that services themselves can do to help reach more of those in need.
We will be hosting a workshop at the iaptus user conference looking into optimising service care pathways. You can find out more about the conference here.
