Bridging the Gap: Examining Progress and Disparities in IAPT Talking Therapies Recovery Rates

5 min readJan 23, 2024

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This article is well timed as IAPT goes through it’s new rebrand to Talking Therapies. The NHS Talking Therapies ‘Help Us Help You’ campaign launched on 15th January. The campaign builds on activity promoted in the 2021/22 campaign but has been expanded to highlight the conditions that NHS Talking Therapies can help treat, like depression, social anxiety, and post-traumatic stress, to help reach target audiences.

Significant investment continues to support the growth of NHS Talking Therapies, in particular, activity targeting specific groups such as Black and South Asian communities (as they are underrepresented and can experience greater barriers to access); 30–50 year-olds (who report higher levels of stress); and men (who are less likely to access services in comparison to women).

Help Us Help You - NHS Talking Therapies

Campaign to increase use of NHS Talking Therapies for people experiencing feelings of anxiety or depression

campaignresources.dhsc.gov.uk

The new NHS Talking Therapies for anxiety and depression Workforce Census was published on 12th January by NHS Benchmarking. The census provides a high-level overview of the workforce across England as of 31 March 2023. (see report listed at the end under ‘referenceable reports no.3)

Ethnic Inequalities in Improving Access to Psychological Therapies (IAPT)

Just last year the NHS RHO (Race & Health Observatory) released a landmark independent review of services provided by NHS Talking Therapies, formerly known as Improving Access to Psychological Therapies (IAPT), has been undertaken in partnership with the National Collaborating Centre for Mental Health.

This report informed by 10 years of anonymised patient data, found that whilst there is no evidence that talking therapies are unsuitable or ineffective for ethnic minority groups, people from Black and ethnic minority groups experience worse access to, and outcomes from, NHS talking therapies compared to White British groups.

Using mixed-methods research methodology, the review presented action-focused recommendations and highlighted examples of good practice. (see report listed at the end under ‘referenceable reports no.2)

A Closer Examination

(image of talking therapy from Unsplash)

Mental health therapies, particularly the Improving Access to Psychological Therapies (IAPT) program in England, play a crucial role in supporting individuals towards recovery. However, concerns about equitable access and outcomes linger. This article explores the latest IAPT data through the lens of ethnicity and socioeconomic deprivation, highlighting both progress and persisting disparities.

Progress and Positive Action:

The latest NHS Digital data reveals encouraging trends. Recovery rates have improved for several minoritized ethnic groups, including Black African, Black Caribbean, Asian Indian, and Other Chinese communities, alongside White individuals from other backgrounds. This signifies positive action by IAPT services to bridge the gap in access and outcomes for underserved communities. Notably, the historical disparity between White and Black or Black British populations has closed, showcasing a significant step towards greater equity. (see report listed at the end under ‘referenceable reports no.1)

Screenshot from NHS Digital — Talking Therapies report, released 16th Jan 24' (covering full year 22'-23'). Highlights recovery rates by minority ethnic groups, page 17 (filtered by ‘ethnic groups’)

Persistent Disparities and Emerging Concerns:

Despite these advancements, challenges remain. The data reveals the Bangladeshi community continues to experience substantially lower recovery rates, raising concerns about cultural sensitivity and accessibility within IAPT services. Additionally, individuals from mixed-ethnicity backgrounds, particularly White and Black Caribbean, demonstrate lower service utilization, suggesting potential barriers to engagement.

Deprivation and the Interplay of Factors:

Further analysis by deprivation level paints a compelling picture. The data exposes a “perfect trend” where recovery rates decrease in correlation with increasing deprivation. This trend heavily overlaps with ethnic demographics, as many minoritized communities face disproportionate socioeconomic disadvantage. While this connection is evident, the complex interplay of factors behind the disparities remains unclear.

Screenshot from NHS Digital — Talking Therapies report, released 16th Jan 24' (covering full year 22'-23'). Highlights most deprived segments of society which are mainly minority ethnic groups, page 17 (filtered by ‘Indecise of Deprevation Decile’)

Unveiling the “Why”: A Call for Further Research and Collaboration:

The existing data cannot definitively explain the reasons behind the observed disparities. Factors like cultural sensitivity of services, systemic racism, and socioeconomic status likely play a role, but their relative weight and interaction require further investigation. Statistical analysis controlling for socioeconomic status could shed light on this crucial question.

Towards a More Equitable Future:

Addressing these disparities demands collaborative efforts on multiple levels. IAPT services must prioritize cultural sensitivity and targeted outreach to reach underserved communities. Addressing societal inequalities and structural racism is also essential. Finally, further research, informed by the insights of CBT therapy experts and community voices, is vital to refine interventions and unlock better outcomes for all.

Conclusion:

While the IAPT program demonstrates progress in narrowing the gap in mental health recovery rates for several minoritized groups, significant disparities persist. Understanding the complex interplay of factors like ethnicity, deprivation, and cultural sensitivity is crucial to ensuring equitable access and outcomes for all. Through ongoing research, community collaboration, and a commitment to addressing systemic inequalities, we can move towards a future where everyone has the opportunity to heal and thrive.