Perspectives on an enhanced 'Improving Access to Psychological Therapies' (IAPT) service addressing the wider determinants of mental health: a qualitative study

Esther Louise Curtin; Katrina d'Apice; Alice Porter; Emily Widnall; Matthew Franklin; Frank de Vocht; Judi Kidger

doi:10.1186/s12913-023-09405-8

Perspectives on an enhanced 'Improving Access to Psychological Therapies' (IAPT) service addressing the wider determinants of mental health: a qualitative study

BMC Health Serv Res. 2023 May 24;23(1):536. doi: 10.1186/s12913-023-09405-8.

Authors

Esther Louise Curtin¹, Katrina d'Apice², Alice Porter³, Emily Widnall³, Matthew Franklin⁴, Frank de Vocht^{3

5}, Judi Kidger³

Affiliations

¹ Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
² Centre for Public Health, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. katrina.dapice@bristol.ac.uk.
³ Centre for Public Health, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
⁴ School for Health and Related Research (ScHARR), University of Sheffield, Regent Court, Sheffield, S1 4DA, UK.
⁵ NIHR Applied Research Collaboration West (NIHR ARC West), Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.

Abstract

Background: A new Health and Wellbeing pathway was introduced into the Improving Access to Psychological Therapies (IAPT) service in one geographical area of the UK in 2021 to address the wider determinants of mental health problems. It comprised assisted signposting to wider services and physical health promotion. This qualitative study aimed to understand stakeholders' experiences of implementing and receiving this new support and the barriers and facilitators to its delivery.

Methods: Forty-seven interviews were conducted, with service developers (n = 6), service deliverers (n = 12), service users (n = 22) and community and clinical partners (n = 7), as part of a larger mixed-methods evaluation. Interviews were recorded, transcribed, and analysed using reflexive thematic analysis.

Results: Three themes spanned all participant groups and represented key aspects of the service: (1) identifying suitability, (2) a holistic service, and (3) moving forward. The sub-themes represent the barriers and facilitators to processes working in practice, lending insight into potential service improvements. These included strengthening the quality of communication during referral and assessment, tailoring the support and delivery mode, and increasing transparency around continued care to drive sustained benefits.

Limitations: Service users may have been selected due to their positive experiences of IAPT and were not demographically representative of the population, although participants' experiences of the service did suggest variation in our sample.

Conclusions: The Health and Wellbeing pathway was perceived as having a positive impact on mental health and could reduce the burden on therapeutic services. However, service- and individual-level barriers need to be addressed to enhance statutory and community support links, manage service users' expectations, and improve accessibility for certain groups.

Keywords: Health promotion; Mental health services; Qualitative; Service user experience; Signposting; Stakeholder perspectives.

MeSH terms

Communication*
Health Promotion
Humans
Mental Health*
Physical Examination
Qualitative Research

Abstract

MeSH terms

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