This month marks an important milestone in our project evaluating an NHS England funded programme known as IAPT for SMI, as the reports on our findings have been launched, both a full report and summary – the culmination of 10 months’ intensive work here at McPin!
‘IAPT for SMI’ is an extension of Improving Access to Psychological Therapies (IAPT), a national programme which aims to allow more people with mental health difficulties to access talking therapies. In 2011, the government made a commitment to expand this programme to people with ‘severe mental illness’ (SMI), including psychosis, bipolar disorder and personality disorders. NHS England identified six demonstration sites which, building on existing provision of psychological treatments in these sites, have been piloting IAPT for SMI services since 2012.NHS England has been evaluating whether these IAPT for SMI services are effective in a number of ways. While it is important to know about the clinical results for people receiving talking therapies, it is also essential to understand people’s experiences of using them – which is why the McPin Foundation was commissioned to find out about the experiences of people accessing talking therapies in these sites. We wanted to understand what they felt helped or didn’t help them, and what they liked or didn’t like about using IAPT for SMI services. We also wanted to hear from people who had been referred to the service, but had not gone on to receive talking therapy, so that we could understand why they didn’t feel it was suitable for them, or what prevented them from accessing it.
We invited people who had used (or been referred to) IAPT for SMI services to complete a survey questionnaire about their experience. We then invited 61 of the survey respondents with a range of experiences to take part in an interview with the researchers. The interviews allowed us to ask more detail about their views and feelings about the therapy, or about why they did not end up receiving therapy.
The reports on our findings come at the same time as information from the mental health task force is published based on a survey of 20,000 people. This survey asked people how they would like things to be different in mental health services by 2020. The number one change people said they would like to see is improvements in access – followed by choice of treatments, prevention and quality of provision. Our evaluation of the IAPT for SMI pilot supports these findings – and also suggests how to achieve improvements in this area.
Overall, our research found that people were very positive about their experiences of the therapy – although some aspects of the service were experienced more negatively than others, notably waiting times, but also the process of exiting from the service. We made a number of recommendations including:
- Simplification of the referral process
- Reduction in waiting times and provision of clear information about waiting times from outset
- Good communication, information and support from IAPT services and others during the waiting period
- Clear information about what to expect from therapy and choices on offer
- Flexibility and accommodation of individual needs
Central to our evaluation methodology was the involvement of ‘peer’ researchers with lived experience of mental health problems. The research team consisted of three peer researchers based in different parts of the country who worked closely alongside researchers at the McPin Foundation during all the different phases of the project – the design of the research materials, data collection, analysis of the data, and reporting. They were also able to liaise directly with the demonstration sites in their respective localities, to support them with promoting and distributing the survey and, at a later stage, disseminating the evaluation findings. Crucially, all of the interviews were carried out by the peer researchers on the team, as the shared experience helped build rapport with interview participants. This collaborative approach ensured that the evaluation really prioritised the views of people who have used mental health services.
This month has seen not only the publication of the final reports, but also the presentation of the research findings at two conferences. Earlier this month, Julie Billsborough and Lisa Couperthwaite, who worked on the project, presented the evaluation findings at the Lancashire Care demonstration site, and in a couple of weeks, Vanessa Pinfold will be speaking at the IAPT for SMI networking National Conference in Birmingham.
It’s not quite over yet, though, as we have also been working on an in depth analysis of the interview data and are planning to write it up as a peer review publication – allowing us to address some of the key research findings in more detail – watch this space!
Agnes Hann, Senior Researcher, The McPin Foundation.