NHS Talking Therapies: Year-on-Year Trends in Recovery and Completion Rates for Minoritized Groups

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The latest NHS Talking Therapies Annual Report (2023–24) highlights ongoing disparities in recovery and completion rates among ethnic groups. Despite a slight overall improvement in recovery rates, completion rates have declined, raising concerns about barriers to sustained engagement. In this blog, we analyse year-on-year trends, explore possible contributing factors, and discuss implications for policy and service improvements.

Accessing NHS Talking Therapies Data

Follow these steps to locate the latest report and analyse key statistics:

1. Visit: NHS Digital Talking Therapies Annual Report (2023–24) or search “NHS Digital Talking Therapies Anxiety & Depression Annual Report 2023–24”.
2. Scroll to the bottom of the page and click on ‘Annual Interactive Dashboard’.
3. Open the dashboard menu.
4. Navigate to Page 7 — ‘Key Activity by Variable, England’ for Completion Rates.
5. Navigate to Page 17 — ‘Outcome Status by Rates’ for Recovery Rates.
6. Select the variable section and deselect all options.
7. Tick the ‘Ethnic Group’ box.
8. Under the ‘Recovery Rates’ column, click the sorting arrow to arrange data from highest to lowest rates.

Recovery and Completion Rates: A Year-on-Year Comparison

Recovery Rates (compared to the national target of 50%)

• White (all): 50.8% (2022–23) → 51.2% (2023–24)
• Black (all): 49.1% → 49.5%
• Asian (all): 45.4% → 45.2%
• Mixed (all): 45% → 45.8%
• Other Ethnic Groups: 43.7% → 43.8%

While there are marginal increases, particularly among Mixed and White ethnic groups, the overall trend suggests that existing disparities remain largely unchanged.

Completion Rates

• White (all): 42.0% → 39.7%
• Black (all): 36.0% → 34.0%
• Asian (all): 35.0% → 34.5%
• Mixed (all): 35.3% → 34.5%
• Other Ethnic Groups: 34.9% → 32.8%

The most concerning trend is the decrease in completion rates across all ethnic groups, indicating challenges in ensuring sustained participation in therapy.

Key Talking Points

1. Lack of Culturally Sensitive Training

• Current training is mandatory for new starters (i.e. those completing LI or HI CBT training using the updated curriculums) but not for existing staff, who make up much of the workforce.
• Many services have provided additional training and have audited their own service data (for example using the IAPT BAME Positive Practice Guide), but this is currently optional.
• Therefore, upskilling will require buy-in from Service Leads and Commissioners, along with potential funding if external trainers are required.
• While NHS Talking Therapies has made significant strides in promoting cultural competence, there remains a need for consistent implementation and support to ensure all staff are adequately trained across all services.

2. Deprivation and Structural Inequality

• Recovery rates are assessed without accounting for deprivation levels, making it difficult to analyse disparities effectively.
• Many minoritized communities face additional socioeconomic barriers (plus structural racism) that may impact access, engagement, and outcome.
• These findings underscore the need for mental health services to consider socioeconomic factors and structural inequalities when assessing recovery rates and developing interventions to improve engagement among minoritized communities.

3. Gaps in Reporting Ethnic Group Data

• The current reporting system lacks granular breakdowns for specific minoritized groups, limiting the ability to identify specific trends and needs.
• These limitations hinder the development of targeted interventions to improve engagement and outcomes for specific communities within minoritized populations.

4. Shifting NHS Targets: From Recovery to Reliable Recovery

• The national recovery target has been set at 50%, but a revised 53% Reliable Recovery target is expected to be introduced by 2028–29.
• This target would require expanded funding to be achievable, but planned expansion did not occur for many services in Year 1.

5. Impact of Increased Waiting Times

• Longer wait times have been shown to negatively impact both recovery and completion rates.
• Policy interventions should focus on reducing these delays to improve access and engagement.
• These findings underscore the importance of policy interventions focused on reducing waiting times to improve access, engagement, and overall outcomes in mental health services.

Policy and Service Recommendations

✅ Expand culturally competent training programs for all staff, not just newly qualified staff.
✅ Improve data reporting mechanisms to allow for a more detailed breakdown of ethnic group disparities.
✅ Address socioeconomic barriers by integrating community-led mental health support.
✅ Prioritize funding and resource allocation to meet the upcoming Reliable Recovery target.
✅ Reduce waiting times to ensure early intervention and better retention in therapy services.

Conclusion

This year’s NHS Talking Therapies report highlights persistent disparities that must be addressed through targeted policy changes and service improvements. The decline in completion rates across all groups suggests that systemic barriers remain, particularly for Black and Asian clients. As new recovery targets and reporting frameworks are introduced, it is essential to ensure that these changes lead to meaningful improvements in accessibility and outcomes.

Further Reading & References

📌 NHS Talking Therapies Annual Report 2023–24
📌 NICE Guidelines on Depression and Anxiety Treatment
📌 Reports on Ethnic Disparities in Mental Health — Race Equality Foundation
📌 Advancing Ethnic Equalities in NHS Talking Therapies
📌 NHS Talking Therapies Review Identifies Barriers in Accessing Care
📌 Outcomes in NHS Talking Therapies During the Cost-of-Living Crisis
📌 Reliable Recovery Scorecard
📌 NHS Talking Therapies Monthly Statistics — January 2024

This blog was co-authored by Chris Frederick and Richard Thwaites and is published on Medium. It will be shared across social media and ResearchGate to encourage discussion and awareness.