What is the adult Improving Access to Psychological Therapies programme?

The Improving Access to Psychological Therapies programme began in 2008 and has transformed the treatment of adult anxiety disorders and depression in England

Improving Access to Psychological Therapies (IAPT) is widely-recognised as the most ambitious programme of talking therapies in the world – and, in the past year alone, more than one million people accessed IAPT services for help to overcome their depression and anxiety, and better manage their mental health.

Plans set out in the NHS Long Term Plan build on the ambitions of the Five Year Forward View for Mental Health, and will see the number of people with anxiety disorders or depression who can access talking therapies through IAPT increase by an additional 380,000 per year to reach 1.9m by 2023/24. Details of local IAPT services are available on the NHS website.

The NHS Mental Health Implementation Plan 2019/20 – 2023/24 provides a new framework to ensure delivery, at the local level, on the commitment to pursue the most ambitious transformation of mental health care in England. IAPT services are characterised by three things:

1. Evidenced-based psychological therapies, with the therapy delivered by fully-trained and accredited practitioners, matched to the mental health problem and its intensity and duration, designed to optimise outcomes. From April 2018 all clinical commissioning groups are required to offer IAPT services integrated with physical healthcare pathways. The IAPT Pathway for People with Long-term Physical Health Conditions and Medically Unexplained Symptoms guidance is intended to help with implementation and sets out the ideal pathway for IAPT services.
2. Routine outcome monitoring, so that the person having therapy, and the clinician offering it, have up-to-date information on an individual’s progress. This supports the development of a positive and shared approach to the goals of therapy and, as this data is anonymised and published, this promotes transparency in service performance encouraging improvement.
3. Regular and outcomes-focused supervision so practitioners are supported to continuously improve and deliver high quality care.

The priorities for service development are:

• Expanding services so that 1.9m adults access treatment each year by 2024.
• Focusing on people with long term conditions. Two-thirds of people with a common mental health problem also have a long-term physical health problem, greatly increasing the cost of their care by an average of 45% more than those without a mental health problem. By integrating IAPT services with physical health services the NHS can provide better support to this group of people and achieve better outcomes.
• Supporting people to find or stay in work. Good work contributes to good mental health, and IAPT services can better contribute to improved employment outcomes.
• Improving quality and people’s experience of services. Improving the numbers of people who recover, reducing geographic variation between services, and reducing inequalities in access and outcomes for particular population groups are all important aspects of the development of IAPT services.

Guidance on co-locating mental health therapists in primary care

This guidance document has been created by NHS England to assist GPs, practice managers and commissioners who are integrating mental health therapists into primary care pathways.