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Postcode lottery in quality of talking therapies for depression

Talking therapy services provided as part of the Government's flagship Improving Access to Psychological Therapies programme are falling woefully short of ‘recovery rate' targets for treating depression and anxiety in some parts of England, NHS figures reveal.

The first set of data on IAPT published by the NHS Information Centre shows that three quarters of the 145 PCTs providing the services fell short of the Government's 50% ‘recovery rate' target – with some reporting success rates as low as 5.6%.

The IAPT programme, which is being backed by £400m of Government money over the next four years, delivered a national average ‘recovery rate' of 42% in the first quarter of 2011. But five PCTs reported recovery rates of less than 20%, with NHS Blackpool achieving just 5.6%, while top performing areas included Sandwell (66.7%), Gloucestershire (62.8%) and Sefton (62.3%).

The figures also expose difficulties with patient access to IAPT, despite the Government claiming that over half of the population are now covered by talking therapy services. Just 2% of people with depression and anxiety used IAPT services, while four in 10 patients referred by GPs had to wait more than four weeks for treatment.

GP leaders and mental health experts warned that the gulf between recovery rates in different areas could reflect a lack of qualified staff providing IAPT services in some areas.

Dr Clare Gerada, chair of the RCGP and a GP in Kennington, south London, said: ‘I am not surprised that there's a postcode lottery - in my experience the quality of IAPT is variable.'

‘We used to have on-site counsellors with mental health backgrounds dealing with these issues but now, under IAPT, it can be midwives offering treatment.'

‘GP consortia should look at reintroducing practice-based counselling. I worry that the explosion of IAPT risks us offering CBT as the only model.'

Dr David Smart, a GP in Northampton, said his local IAPT service had been well received by GPs, but warned that mental health provision remained patchy.

‘This data does show there is a huge variation in outcomes,' he said. ‘Plans to withdraw depression indicators from the QOF framework risk increasing the disparity in mental health provision in different areas.'

Paul Burstow, the care services minister, said: ‘Not every service has reached the goal of a 50% success rate yet. But I am confident that as the programme continues to roll out, those services will catch up with the best performing services.'


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