IAPT in the NHS in Lambeth

The last government noticed that depression and anxiety disorders were costing them money as people with these conditions are often unable to work. Accordingly, a programme called IAPT (Improved Access to Psychological Therapies) was set up. This aimed to teach some NHS staff how to deliver CBT, and the programme is now well under way.

IAPT has a layered model - if you are managing your anxiety disorder or depression quite well and are only mildly affected, you might be given Computerised CBT (CCBT) or given some suggested reading. If you have moderate depression or an anxiety disorder you might get to have a few sessions with a nurse trained in basic CBT. If your condition is more serious, then you might get to see a psychologist or other trained person for CBT.

While I approve of IAPT, and any provision of mental health services, I share other people's impressions that the service has been set up to provide the minimum quantity of care for the minimum amount of money and I provide an alternative to IAPT.

You might want to wait for therapy on the NHS, but the omens aren't that good. In Lambeth, in the quarter to June 2011, NHS figures were that 44,168 people in Lambeth had anxiety or depression and of these, 1,323 were referred by their GPs for treatment by IAPT. The method for testing for improvement isn't very rigorous: you fill out a questionnaire and above a certain number you are deemed to be in the "clinical" population, below the number, in the "general" population. You need to be in the clinical population to be offered treatment, and you will be considered to be a success if your score drops into the general population, even if the change is just one point. Lambeth has a recovery rate of 51%, that is, half the people given CBT improve, but as only 3% of those with anxiety disorders or depression get to see a therapist, only 1½% of Lambeth residents are seeing an improvement in their condition through the NHS. I don't have figures for their waiting list. If you are depressed or anxious and want to be referred to IAPT, go and see your GP. GPs vary in their desire and ability to deal with mental health issues so you may need to be persistent (which may be difficult and especially so because you are anxious or depressed).

Source: Health and Social Care Information Centre, Community and Mental Health Team, analysis by Barry McInnes.