Stephen Kellett1, Kimberley Webb2, Nic Wilkinson3, Paul Bliss4, Tom Ayers4, Gillian Hardy2. 1. University of Sheffield and Sheffield Health and Social Care Foundation NHS Trust,UK. 2. University of Sheffield,UK. 3. Psychological Services,Sheffield Health and Social Care NHS Foundation Trust,UK. 4. Sheffield Improving Access to Psychological Therapies Service,UK.
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.
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.
Authors: David C Gillespie; Mark Barber; Marian C Brady; Alan Carson; Trudie Chalder; Yvonne Chun; Vera Cvoro; Martin Dennis; Maree Hackett; Euan Haig; Allan House; Steff Lewis; Richard Parker; Fiona Wee; Simiao Wu; Gillian Mead Journal: Pilot Feasibility Stud Date: 2020-06-15