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Socio-Demographic Differences in Access to the Improving Access to Psychological Therapies Programme: A National Cohort Study
22 Pages Posted: 8 Jul 2022
More...Abstract
Background: Since 2008, the Improving Access to Psychological Therapies (IAPT) programme has offered adults in England evidence-based talking therapies for common mental disorders (CMDs) such as depression and anxiety disorders. However, inequalities in access have not been explored nationally.
Methods: Using a unique individual patient dataset that linked 2011 Census for England and Wales information to national IAPT data collected between April 2017 to March 2018, we estimated the rate of access by a wide range of socio-demographic characteristics that are not routinely available. A large household survey was used to estimate the prevalence of probable CMDs by these socio-demographic characteristics. We estimated the probability of access to IAPT amongst people with CMDs by comparing the rates of access from IAPT data and the estimates of prevalence of CMDs from the household survey. Both unadjusted and adjusted (for important patient characteristics) access rates were estimated in logistic regression models.
Findings: As a proportion of those with a probable CMD, access to IAPT varied markedly by socio-demographic characteristics. Older adults, males, people born outside of the UK, people with religious beliefs, people from Asian ethnic backgrounds, people reporting a disability and those without any academic or professional qualifications were underrepresented in IAPT services nationally, in adjusted models.
Interpretation: The identification of patients who may be underrepresented in IAPT highlights the need for services to improve outreach and engagement with these groups. Further understanding of barriers to access should help increase equity in access.
Funding Information: This project was funded by the Office for National Statistics.
Declaration of Interests: No conflict of interest.
Ethics Approval Statement: Ethical approval was obtained from the National Statistician's Data Ethics Advisory Committee (NSDEC(18)20).
Keywords: mental health, therapy, IAPT, inequality
Suggested Citation: Suggested Citation