Imagine the would-be driving instructor for your son/daughter, has on public record, that for every person attending 2 or more lessons there is one person who attends just once. Warning lights would flash . But the latest IAPT data, for September last, https://digital.nhs.uk/data-and-information/publications/statistical/psychological-therapies-report-on-the-use-of-iapt-services/september-2021-final-including-reports-on-the-iapt-pilots-and-quarter-2-data-2021-22 show just such poor engagement, with 39,734 having only one treatment appointment and 56,972 having two or more treatment sessions. Further, just as many people fail to follow up their referral (self or GP) , 43,258 as have one or two or more treatment sessions. This suggests that IAPT is not high in the public credibility stakes. The driving instructor may claim a 50% pass (recovery) rate but would you believe them without independent verification? IAPT’s self-proclamation of such a recovery rate lacks credibility.
IAPT claims 7.9 sessions of treatment per referral, but can this be regarded as sufficiently potent when NICE recommended treatments are typically twice this length? On December 9th 2021 NHS Digital proclaimed that the ‘Improving Access to Psychological Therapies (IAPT) is run by the NHS in England and offers NICE-approved therapies for treating people with depression or anxiety’. Yet neither NICE nor IAPT have provided any evidence of treatment fidelity. Both display what the Chair of the Hillsborough Independent Panel has termed ‘the patronising disposition of unaccountable power’ [ ‘Justice for Christ’s Sake’ by James Jones SPCK (2021)]. The Panel also highlighted 3 necessities for further public enquiries, empathy, equality and candour. It would be empathetic to ask IAPT clients ‘are you back to your old self with the treatment you have received or alternatively are you back to your best?’. Equality would mean giving precedence to the client’s definition of their situation, and not an organisational device {PHQ9 and GAD7) administered in such a way as to protect the reputation of the Service. Candour would be allowing IAPT therapists to tell it as it is, no longer too fearful to speak out or having to use such measured tones that the central meaning of what they have to say is lost.
Dr Mike Scott