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Hospital admissions ‘reduced by access to psychological therapies’

By Gareth Iacobucci

Exclusive: The Government's Improving Access to Psychological Therapies programme is not only reducing rates of depression and anxiety but also driving down hospital admissions for physical illness, new evidence suggests.

An early analysis linking data from IAPT to GP records has found the programme is reducing hospital admissions, length of stay, outpatient activity and attendance at casualty.

A further analysis of a project in Liverpool has demonstrated a 40% reduction in admissions for angina in patients who received group CBT, according to Dr Alan Cohen, an adviser to the Department of Health on IAPT.

Dr Cohen, a GP in Wimbledon, told an RCGP debate on the programme that the ‘extraordinary' findings so far suggested CBT could have a major impact in helping to step the increase in hospital activity.

He said GPs needed to be proactive in commissioning IAPT services and offering them to patients with physical illness.

‘GPs understand the relationship between diabetes and depression, or ischaemic heart disease and depression. For that reason the commissioning of a psychological therapy service needs to be done or advised very strongly by GPs.'

Dr Cohen said two trusts in London had been able make major savings by offering CBT to people with COPD, avoiding costs of up to £23,000 a day following hospital admission.

‘What they found in Merton and in Hillingdon was that for every pound invested in a psychologist, they saved £3 in acute admission rates.'

The evidence is a welcome boost for the programme, which has been criticised in some quarters for sucking money from other parts of mental health budgets.

Lord Richard Layard, the influential researcher whose work underpins the programme, told the debate that although IAPT was having an impact, access needs to be accelerated by whoever forms the next government, particularly for children.

‘For depression, you have under a third of people in treatment. This has got to be changed. For adults, we want a commitment to see it through by training an extra 1,000 therapists every year for another three years. For children, we need a similar programme of training, perhaps of 200 extra therapists a year.'

Dr Paquita de Zulueta, a GP in Westminster, Central London, said GPs themselves needed to receive CBT training.

‘It's about training GPs in helping them to refer people to CBT appropriately, because not everyone can work in the CBT model. It is quite demanding of clients and patients.'

Dr Alan Cohen Dr Alan Cohen: 'The results are extraordinary'


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