Trial By Error: My First Post on the IAPT Program
10 OCTOBER 2018
By David Tuller, DrPH
Since 2008, the English arm of the National Health Service has been rolling out a program called
Improving Access to Psychological Therapies, or IAPT. More than 900,000 people now receive IAPT services annually. This program arose out of the notion that many people were suffering from untreated depression, anxiety and other psychiatric disorders, and that a more streamlined system was needed to ensure that they received appropriate psychological therapies. In parallel with that, it was further suggested that the program should be expanded to people with long term conditions (LTCs), such as diabetes and cancer, as well as those suffering from so-called “medically unexplained symptoms” (MUS). The main but not the only therapeutic intervention offered through IAPT is cognitive behavior therapy.
The assumption behind the expansion was that IAPT, by reducing the medical demands of those suffering from LTCs and MUS, would generate significant savings in the overall health care budget—enough, in fact, to cover costs associated with the IAPT program itself. This prediction was based on the idea that psychological issues can exacerbate the health and medical problems of people with LTCs and actually generate the symptoms experienced by people identified as having MUS. Providing these patients with CBT or other psychological modalities would presumably then reduce their need to seek out expensive medical care for their physical complaints.
