The leading lights in the development of the Improving Access to Psychological Therapies service Layard and Clark (2015) have claimed that it costs nothing, due to savings on welfare benefits and physical healthcare costs. But there has been no independent verification of this claim.
Last year the amount spent on IAPT for 47 providers was £547.2 million according to Government figures with 4 million appointments. But only 5% of IAPT clients are on long term sickness benefit and in the last year, by the end of treatment, only 5% of these were no longer on benefit, amounting to 1783 clients. Using the figure of £650 furnished by Layard and Clark (2015) as the amount the State saves in a month by getting a person off benefit, the total saving that would accrue from IAPTs ministration in getting the 1783 clients off benefits would be £1.16million. This doesn’t even begin to compare with the totality of IAPT’s cost. Even were one to assume these clients were all off benefit for a year, a saving of approx £15million, the impact on the total cost of IAPT is miniscule, there is no way that IAPT pays for itself!
I could find no published data that compares the proportion of people IAPT gets off benefits with the proportion of people who would have come off benefits before the inception of IAPT. One can imagine that if one tracked a population of Citizens Advice Bureaux attendees a proportion of them would move off benefits, but would this be any more or less than those going through IAPT?
There is a lack of clarity on the specifics and unique way in which IAPT gets clients off benefits.
There is no independent evidence of the effectiveness of IAPT with depression and anxiety disorders in the context of an established physical disorder. Layard and Clark (2015) appeal to CBT studies conducted in in this population, but there is no evidence that IAPT staff have followed such protocols. IAPT does not employ measures of treatment integrity. Nor is there any documented evidence of savings in physical healthcare costs as a result of IAPT’s ministrations.
The National Audit Office has perpetuated the IAPT myth by steadfastly failing to investigate the Services claims. Friends in high places. But each IAPT appointment costs £136, last year, if at each appointment the client was given this sum for their heating/ living expenses it would I believe make a much greater contribution to the common good. I have just seen on TV a single mum with 3 young children from the North East, as she attends a foodbank, in tears as she battles with heating and food costs.
Dr Mike Scott
4 replies on “The Myth That IAPT Costs Nothing – it takes money away from where there is real need ”
Your link for the cost of IAPT this year doesn’t seem to be working. Where did you get your figure from? I take the figure for the total cost of IAPT from the mental health dash board, which is giving a 2022/3 total of £816m. I’ll check for 2021/2. Have you looked at the “prevalencec” scam they are running?
Thanks Paul, I think I have fixed the link. I was referring to 2021/22 not 2022/23 I don’t have a reference for the latter., if u could let me have it. I am not aware of the ‘prevalencec’ scam if you could let us know about this that would be great. Have a good Christmas.
MH dashboard – https://www.england.nhs.uk/publication/nhs-mental-health-dashboard/ – gives IAPT CCG spend as £711million
I’m working on the prevalence issue at the moment and will probably publish something soon. I’d be happy to have an email exchange with you about it. Have a good Christmas yourself. Paul