The Economic and Mental Health Impact of IAPT: Pragmatic Trial in Three English Regions

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Improving Access to Psychological Therapies (IAPT) programme is the English’s major initiative for treating anxiety and depression, currently provided to over 1 million people. We tested whether IAPT could reduce healthcare costs and improve employment in persons with long-term chronic conditions.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Stepped-wedge design of two cohorts covering 560 patients each with depression and/or anxiety and comorbid long-term physical health conditions, namely diabetes, chronic obstructive pulmonary disease (COPD) and cardio-vascular disease (CVD) from three areas in Thames Valley (Berkshire, Oxfordshire and Buckinghamshire) for the period March 2017 - August 2017. Panels were balanced. Difference-in-difference models were used and intention-to-treat analysis.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Based on the step-wedge modelling, IAPT treatment decreased costs by £497 (95% CI: -£770 to -£224) total per person (pp) (from £1266 pp before starting the treatment to £768 pp since the treatment started)in the first 3 months. Results also showed a decrease by about 5.55 [95% CI: -6.35, -4.75] (-4.18 [95%CI: -4.91, -3.45]) points per person in the PHQ9 (GAD7). Our results show that IAPT increased the probability to an employment for those who were unemployment by about 7.92% (95% CI: 0.94% to 14.9%).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>IAPT treatment significantly reduced healthcare utilization and costs among persons with chronic conditions. It also significantly increased the probability of employment.</jats:p> </jats:sec> <jats:sec> <jats:title>Key messages</jats:title> <jats:p>IAPT treatment significantly reduced healthcare utilization and costs among persons with chronic conditions. IAPT was significantly associated with increased probability to find employment for those unemployed.</jats:p> </jats:sec>