What IAPT services can learn from those who do not attend

Area of Science:

• Mental Health Services Research
• Healthcare Access and Equity
• Psychological Therapies

Background:

• Non-attendance rates in Improving Access to Psychological Therapies (IAPT) services range from 45-48%.
• Patient, staff, and service implications arise from high non-attendance.
• Identifying modifiable factors is crucial for service improvement.

Purpose of the Study:

• To identify service-related factors contributing to patient non-attendance in IAPT.
• To explore patient perspectives on barriers to attending psychological therapy.

Main Methods:

• Qualitative interviews were conducted with 14 patients who did not attend or minimally engaged with IAPT services.
• Semi-structured interviews were performed face-to-face or via telephone.
• Thematic analysis was employed using data mapping sheets for iterative analysis.

Main Results:

• Five key themes emerged: the waiting process, IAPT-GP relationships, patient expectations, service rigidity, and practitioner-patient relationship dynamics.
• The waiting process and perceived service rigidity were significant factors influencing non-attendance.
• Interpersonal dynamics and clarity of expectations impacted engagement.

Conclusions:

• Service-related adjustments can mitigate non-attendance in IAPT.
• Future research should explore collaborative care models and treatment protocolization.
• Optimizing the patient journey and therapeutic alliance is essential for improving access and adherence.