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Psychological therapy: big differences in recovery rates across England

24 November 2015: Recovery rates(2) for patients treated for mental health disorders are published today by the Health and Social Care Information Centre (HSCIC), highlighting markedly different outcomes across the country(3).

*HSCIC must be quoted as the source of these figures

*Data are available at CCG level within this report

Psychological Therapies: Annual Report on the use of Improving Access to Psychological Therapies (IAPT) 4 services, England, 2014/15 looks at referrals received and outcomes5 from therapies such psychotherapy, cognitive behavioural therapy, counselling, couples therapy and other treatments6. The report shows there was a total of 1,267,193 referrals received in 2014-157.

The percentages of patients recorded as having recovered from a mental health disorder8 after completing a course of treatment under the (IAPT) programme ranged from 18.8 to 69.4 across CCGs in England. The report shows:

  • The England mean average recovery rate was 44.8 per cent (189,152 of 421,744 referrals).
  • Patients suffering from a range of anxiety and stress-related disorders9 have a slightly higher recovery rate at 47.8 per cent (80,608 of 168,718 referrals) than for patients suffering from depression10 at 44.6 per cent (38,509 of 86,268 referrals).
  • The CCGs with the highest recovery rates were NHS Cannock Chase CCG at 69.4 per cent (470 of 68011 referrals), NHS Stafford and Surrounds CCG at 67.3 per cent (415 of 620 referrals) and NHS Chiltern CCG at 61.6 per cent (1,230 of 1,995 referrals).
  • The CCGs with the lowest recovery rates were NHS Heywood, Middleton and Rochdale CCG at 18.8 per cent (265 of 1,405 referrals), NHS East Staffordshire CCG at 20.9 per cent (70 of 340 referrals) and NHS Blackburn with Darwen CCG at 29.9 per cent (425 of 1,415 referrals)

For referrals entering treatment in 2014/15:

  • The mean average waiting time was 32.0 days from referral to the first treatment appointment. The CCG with the shortest mean average waiting time was NHS Dudley CCG at 6.712 days.
  • The CCG with the longest mean average waiting time from referral to the first treatment appointment was NHS Blackpool CCG at 124.1 days.

Today's report also includes new analysis on the number of IAPT referrals and recovery rates for ex-British armed forces personnel. In 2014-15:

  • 18,579 ex-British armed forces personnel were referred to IAPT services.
  • 8,111 referrals finished a course of treatment in the year and started treatment at caseness2, with almost half of these (47.1 per cent, or 3,824) moving to recovery.
  • For this particular group, the recovery rate was 2.3 percentage points higher than the England average.

Responsible Statistician Dominic Gair said: "Today's report highlights regional differences in recovery rates and waiting times, providing useful information about the characteristics of people accessing services.

"This report will enable commissioners and care providers to review access to psychological therapies in their areas, which should be useful when planning services for patients in the future."

You can view the full report here: http://www.hscic.gov.uk/pubs/psycther1415

ENDS


Notes to editors

  1. The Health and Social Care Information Centre (HSCIC) was established on April 1 2013 as an Executive Non Departmental Public Body (ENDPB). It is England's trusted data source, delivering high quality information and IT systems to drive better patient services, care and outcomes. Its work includes publishing more than 260 statistical publications annually; providing a range of specialist data services; managing informatics projects and programmes and developing and assuring national systems against appropriate contractual, clinical safety and information standards.
  2. The numerator for the recovery rate is the number of referrals moving to recovery, i.e. those with a finished course of treatment in the year who were at "caseness" on entering treatment and not at "caseness" on completing treatment. Caseness is the term used when a referral is assessed as being a clinical case, determined by the scores recorded on anxiety and depression measures. If patients score above the clinical/non-clinical cut-off on either anxiety, depression or both, they are classified as clinical cases and at "caseness". For a referral to be considered recovered, the patient needs to score below the clinical threshold on BOTH anxiety and depression scores at the end of treatment, to ensure that recovery is measured by looking at the welfare of the individual rather than one specific symptom. The denominator for the recovery rate is the number of referrals with a finished course of treatment in the year which were initially at caseness.
  3. Data are broken down by Clinical Commissioning Group (CCG) level.
  4. The IAPT programme is designed to provide services for those suffering from anxiety and depression disorders and the purpose of the IAPT dataset is to support reporting on the treatment of these individuals, although locally, some IAPT services may have expanded to treat other psychological disorders.
  5. Referral received date and finishing treatment dates are not necessarily in the same year.
  6. Within IAPT reporting, analysis is presented by the following types of therapy. Because of changes to the types of therapy recorded in the dataset during the year, some therapy types have been grouped for consistency across the year: (a) Behaviour Activation (b) Brief psychodynamic psychotherapy (c) Cognitive Behavioural Therapy (CBT) (d) Computerised Cognitive Behavioural Therapy (CCBT) (e) Counselling (f) Couples Therapy (g) Employment Support (h) Guided Self Help (i) Interpersonal Psychotherapy (IPT) (j) Psychoeducational peer support (k) Pure Self Help (l) Other.
  7. Referrals cannot be compared to the previous year because the data do not support like for like comparisons with the previous year. This is because of changes to the IAPT data set (from version 1 to 1.5) and the change in the number of organisations providing services during the year.
  8. Percentages are rounded to one decimal point.
  9. The problem descriptors recorded by clinicians for the patients they are treating have been grouped as follows for reporting purposes: (a) Depression (b) Anxiety and stress related disorders: (i) Agoraphobia (ii) Generalised anxiety disorder (iii) Mixed anxiety and depressive disorder (iv) Obsessive-compulsive disorder (v) Other anxiety or stress related disorder (vi) Panic disorder (episodic paroxysmal anxiety) (vii) Post-traumatic stress disorder (viii) Social phobias (ix) Specific (isolated) phobias (c) Other Mental Health problems.
  10. There are three categories that conditions are separated into: depression; anxiety and stress-related disorders; other mental health problems.
  11. Numbers are rounded to nearest 5 for sub-national geographies.
  12. Average waiting times and recovery rates are affected by the quality of data supplied by providers. Factors which vary include data volumes, outliers and local recording practices.
  13. For media enquiries please contact media@hscic.gov.uk or call 0300 30 33 888.

Map A - showing the total number of referrals to IAPT services by CCG

IAPT Referrals by CCG

Map B - showing the recovery rate by CCG

IAPT Recovery rate by CCG

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