politicians of all political parties and the media believe in IAPT, that should make one immediately suspicious! A decade on there is no evidence of:
- economic saving – see this link https://www.academia.edu/39289068/Comparative_public_policy_-_the_economic_policy_failure_of_IAPT_in_the_NHS_improving_access_to_psychological_therapies_ either in terms of a) a reduction in work absenteeism b) number of people helped into work or c) reduction in benefit payments
- psychological recovery – there is no evidence that IAPT clients lose their diagnostic status with treatment, much less that any changes are enduring. When IAPT marks its’ own homework it claims a 50% recovery rate (but without claiming how long this lasts!) but independent assessment suggests only the tip of the iceberg recover
Worryingly the iceberg may be melting with the high stress levels amongst IAPT frontline staff. Its much vaunted ‘low threshold’ for access means that therapists are ‘treating’ clients for problems in living e.g a stressed client forced to commute a long distance for financial reasons complaining of insomnia and tiredness but being treated for depression because of her PHQ9 result! The therapist is stressed by her recovery target, that is unlikely to be met with this client, the client is stressed by the hoops she has had to go through to accommodate appointments in her busy schedule and all to no avail.
No politician wants to admit the wasting of a £1 billion on IAPT in the last decade. The media and politicians are desperate for a good news story, claiming the success of IAPT and the moral highground of being anti stigma and for mental health gives a warm glow in the winter of our discontent.
But if treatment services began with the hospitality that traditionally marks the Christmas season, then actually they would not go far wrong, it’s not that complicated.
Dr Mike Scott