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Deprivation cuts chance of recovering from mental illness

Referral rates for psychological therapy higher, and recovery lower, in deprived areas

Louise Prime

Tuesday, 18 October 2016

Recovery from mental illness following psychological therapy is much less likely in areas of high deprivation than in wealthier areas, according to the latest official figures for England. The report from NHS Digital also revealed considerable variation between clinical commissioning groups (CCGs) in rates of improvement in mental illness and in waiting times to start treatment.

NHS Digital examined activity, waiting times and outcomes for the Improving Access to Psychological Therapies (IAPT) programme. In its report Psychological Therapies: Annual Report on the use of IAPT services, 2015-16, it found that in 2015-16 there were:

  • 1,399,088 new referrals;
  • 953,522 referrals that entered treatment;
  • 537,131 referrals that finished a course of treatment.

The report revealed that more than 200,000 referrals were made by the most deprived 10% of areas, compared with fewer than 92,000 by the least deprived areas.

Outcomes from therapy also varied considerably by deprivation score: the overall recovery rate was 46.3%, but 55% of patients from the least deprived areas recovered, compared with only 35% of those in the most deprived areas. There was huge variation in recovery rates between CCGs: the lowest was 21.4% (NHS Leicester City CCG) and the highest was 63.2% (NHS Bath and North East Somerset CCG).

The IAPT programme has a stated target that at least 75% of new referrals should enter treatment within 6 weeks, and 95% within 18 weeks (based on the waiting time between the referral date and the first attended treatment appointment). Overall in 2015-16, 81.3% of referrals were seen within 6 weeks, and 96.2% were seen within 18 weeks – both above the targets. In fact, the peak number of referrals entered treatment at 7-14 days, and only 3.8% of referrals had to wait more than 18 weeks to enter treatment.

However, there is wide variation across CCGs between in average waiting times; the shortest average wait was 5.9 days (NHS South Tyneside CCG) and the longest was 139.3 days (NHS Wirral CCG). The proportion of referrals meeting the 6-week target also varied enormously, from just 21.2% (NHS Eastern Cheshire CCG) to as high as 99.5% (NHS South Lincolnshire CCG).

This report also includes data for ex-British Armed Forces personnel and their dependents: in 2015-16, the recovery rate for patients who were former services personnel or their dependents was 48.6%, a slight improvement on the 47.1% equivalent rate reported in 2014-15. Again, there was huge variation between CCGs: the lowest recovery rate was 32.6%, in NHS Wirral CCG, and the highest was 81.3%, in NHS Bath and North East Somerset CCG.

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