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Developing Services for Patients with Depression or Anxiety in the Context of Long-term Physical Health Conditions and Medically Unexplained Symptoms: Evaluation of an IAPT Pathfinder Site

Published online by Cambridge University Press:  20 May 2016

Stephen Kellett ,
Kimberley Webb ,
Nic Wilkinson ,
Paul Bliss ,
Tom Ayers  and
Gillian Hardy
Stephen Kellett*
Affiliation:
University of Sheffield and Sheffield Health and Social Care Foundation NHS Trust, UK
Kimberley Webb
Affiliation:
University of Sheffield, UK
Nic Wilkinson
Affiliation:
Psychological Services, Sheffield Health and Social Care NHS Foundation Trust, UK
Paul Bliss
Affiliation:
Sheffield Improving Access to Psychological Therapies Service, UK
Tom Ayers
Affiliation:
Sheffield Improving Access to Psychological Therapies Service, UK
Gillian Hardy
Affiliation:
University of Sheffield, UK
*
Correspondence to Stephen Kellett, Department of Psychology, University of Sheffield, Sheffield S10 2TN, UK. E-mail: s.kellett@sheffield.ac.uk
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Abstract

Background: There are national policy drivers for mental health services to demonstrate that they are effectively meeting the psychological needs of people with long-term health conditions/medically unexplained symptoms (LTC/MUS). Aims: To evaluate the implementation of a stepped-care service delivery model within an Improving Access to Psychological Therapies (IAPT) service for patients with depression or anxiety in the context of their LTC/MUS. Method: A stepped-care model was designed and implemented. Clinical and organizational impacts were evaluated via analyses of LTC/MUS patient profiles, throughputs and outcomes. Results: The IAPT service treated N = 844 LTC and N = 172 MUS patients, with the majority (81.81%) receiving a low intensity intervention. Dropout across the service steps was low. There were few differences between LTC and MUS outcome rates regardless of step of service, but outcomes were suppressed when compared to generic IAPT patients. Conclusions: The potential contribution of IAPT stepped-care service delivery models in meeting the psychological needs of LTC/MUS patients is debated.

Keywords

IAPTLTCMUSstepped-care
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 44 , Issue 5 , September 2016 , pp. 553 - 567
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2016 

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