Congratulations to David Clark and team, whose paper Transparency about the outcomes of mental health services (IAPT approach): an analysis of public data has just been published in The Lancet!
David is one of the architects of the Improving Access to Psychological Therapies (IAPT) program. IAPT services, which deliver NICE recommended psychological treatments for anxiety disorders and depression, are now established in every health region (CCG) in England. A unique session-by-session outcome monitoring system enables the services to record changes in anxiety and depression in 98% of people who have a course of treatment. The Lancet article uses publicly available data to identify characteristics of services with better and worse outcomes. A predictive model is generated from England wide data for 2014-15, and then replicated with 2015-16 data and with changes in outcome between the two years. Five aspects of the organisation of a service predicted better clinical outcomes. These were: shorter waiting times before the start of treatment, a higher average number of treatment sessions, a larger proportion of cases having a problem descriptor identified, less missed appointments and a higher proportion of clinical activity focusing on the delivery of treatment. The social deprivation level of the area where a service was based was a negative predictor of outcome but this effect was partly mitigated by the organisational factors.
Traditionally, efforts to improve mental health outcomes have largely focused on the development of new and more effective treatments. The article suggests that the way in which services are organised could be similarly important. This is important as it opens up additional avenues for improving mental health outcomes.
You can read the paper in full here.