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<p>Over £400 million is being invested in the Improving Access to Psychological Therapy
(IAPT) programme over the spending review period to make a choice of psychological
therapies available for those who need them in all parts of England.</p><p> </p><p>
</p><p> </p><p>We are also investing in improving provision for children and young
people, older people and carers, people with long-term physical health problems and
those with severe mental illness.</p><p> </p><p> </p><p> </p><p>Since 2008 the IAPT
programme has seen over 2.6 million people enter treatment, and over 1.5 million complete
treatment.</p><p> </p><p>In addition, over 1 million patients have reached recovery
and we have seen 90,000 people move off of sick pay and benefits.</p><p> </p><p>The
IAPT programme has worked consistently to increase the numbers of older people accessing
services, and latest figures suggest that numbers are improving.</p><p> </p><p> </p><p>
</p><p>To increase the numbers of older people the IAPT programme has supported an
advertising campaign delivered through Age UK and Carers UK to ensure older people
are aware that IAPT is for them. In addition, a curriculum has been developed and
is being rolled out to train both existing IAPT staff and new IAPT staff to work better
with older people.</p><p> </p><p> </p><p> </p><p>Other innovative approaches to working
with older people include Government support to the Alzheimer’s Society to develop
online cognitive behavioural therapy for carers of people with dementia. The online
resource is in place and ethical approval is being sort prior to clinical trials which
started in 2014.</p><p> </p><p> </p><p> </p><p>The Severe Mental Illness (SMI) workstream
has been added to the IAPT programme to extend the benefits of improved equitable
access to psychological therapies to people with SMI, including those with schizophrenia.</p><p>
</p><p> </p><p> </p><p>This workstream will work closely with secondary care mental
health services, local commissioners and providers to document the benefits of access
to talking therapies for people who have a SMI. They will lead the development of
Patient Reported Outcome Measures for SMI and Personality Disorder who receive talking
therapies, and work with professional organisations to develop more appropriate and
deliverable care pathways, and determine gaps in current approaches.</p><p> </p><p>
</p><p> </p><p>NHS England is also currently carrying out a pilot aimed at improving
access to psychological therapies for people with long term conditions and/or medically
unexplained symptoms including diabetes, chronic obstructive pulmonary disease, stroke
and other illnesses/disorders.</p><p> </p><p> </p><p> </p><p>There is no cap on the
number of IAPT sessions for each person. NHS England expects clinical commissioning
groups (CCGs) and providers to have due regard to the National Institute for Health
and Care Excellence guidelines and in some cases therapy may exceed 20 sessions in
duration.</p><p> </p><p> </p><p> </p><p>No estimate has been made by the Department
of the proportion of adults or children with diabetes, anxiety disorder, depression,
schizophrenia and personality disorder who were untreated in each of the last 10 years.</p><p>
</p><p> </p><p> </p><p>The most recent drug prevalence estimates suggest that there
were 256,153 opiate users in England in 2011-12, of these 62% received treatment in
the same year. The equivalent proportions for the preceding years, where there is
both prevalence and treatment data, are 2006-07 – 49%; 2008-09 – 64%; 2009-10 – 63%;
2010-11 – 64%. This proportion of opiate users being treated is considered a very
high rate internationally – and is a platform for significant public health gains.</p><p>
</p><p> </p><p> </p><p>No estimate has been made of the proportion of adults or children
with alcohol dependency who were untreated in each of the last 10 years. However,
it is estimated that 1.6 million adults show some signs of alcohol dependence; around
250,000 of whom are estimated to be moderately to severely dependent and might benefit
from specialist treatment. Using this later figure, about 44% of these dependent adult
drinkers were in treatment in England in 2013-14. Continued investment in alcohol
treatment by local authorities is essential to make inroads into the alcohol dependent
population and to help more people recover from alcohol problems.</p><p> </p><p> </p><p>
</p><p><em>Achieving Better Access to Mental Health Services by 2020,</em> published
October 2014, articulates our ambition and the immediate actions we will take this
year and next to achieve better access and waiting times in mental health services.
It includes the Improving Access to Psychological Therapies commitment of treatment
within six weeks for 75% of people with 95% of people being treated within 18 weeks.</p><p>
</p><p> </p><p> </p><p>For the year 2013-14 the mean waiting time for IAPT services
was 40 (days) and the median was 21 (days). Information on the number of referrals
waiting more than 28, 90 and 180 days for IAPT services, for each CCG, for the year
2013-14, is attached.</p><p> </p><p> </p><p> </p><p>No estimate has been made of the
proportion of time general practitioners (GPs) spend with patients who have a mental
illness.</p><p> </p><p> </p><p> </p><p>From September 2014, over 800,000 people with
the most complex health and care needs (including mental health conditions) will benefit
from the Proactive Care Programme, receiving personalised, joined-up care and support,
tailored to their needs. This is being delivered through an enhanced service to the
GP contract.</p><p> </p><p>NHS England is working with commissioners to make mental
health a bigger priority, with better integration of physical and mental health care.</p><p>
</p><p>Improving the diagnosis of mental illness is one of four national goals for
2014-15 – where providers will be rewarded for better assessing and treating the mental
and physical needs of their service users, through the Commissioning for Quality and
Innovation framework.</p><p> </p><p> </p><p> </p><p>We do not centrally hold information
on the proportion of patients with a mental illness that receive drug, talking or
mindfulness therapy.</p><p> </p><p><strong> </strong></p><p> </p><p>The table below
shows information on the number of referrals received, entering treatment and finishing
a course of treatment, within IAPT services for 2013-14.</p><p> </p><p><strong> </strong></p><p>
</p><table><tbody><tr><td><p>Referrals received</p><p> </p></td><td><p>Referrals entering
treatment</p></td><td><p>Referrals with a finished course of treatment.</p></td></tr><tr><td><p>1,118,990</p></td><td><p>709,117</p></td><td><p>364,343</p></td></tr></tbody></table><p>
</p><p> </p><p> </p><table><tbody><tr><td><p>Data source: Improving Access to Psychological
Therapies (IAPT) Dataset</p></td></tr></tbody></table><p> </p><p><strong> </strong></p><p>
</p><p>There were 53,326.6 prescription items written in the United Kingdom and dispensed
in the community, in England, for medicines classified as anti-depressants in British
National Formulary (BNF) section 4.3 <em>Antidepressant drugs</em>, for the calendar
year 2013.</p><p> </p><p> </p><p> </p><p>The Department has not estimated the proportion
or number of the people estimated to experience a mental illness who are being treated
by the National Health Service.</p><p> </p><p> </p><p> </p><p>No estimate has been
made by the Department of the proportion of patients with mental illness who prefer
to be treated by drug therapy or talking therapies.</p><p> </p><p> </p><p> </p><p>The
Department’s 2014-15 Mandate to NHS England makes clear that ‘everyone who needs it
should have timely access to evidence based services’. The Mandate sets a clear objective
for NHS England to deliver the key objectives of the IAPT programme – providing access
to therapies to 15% of those eligible (around 900,000 people), with a recovery rate
of 50%.</p><p> </p><p> </p><p> </p><p>The Outcomes Framework for the NHS in England
clearly states that the NHS should carry on expanding access to psychological services
as part of the IAPT programme.</p><p> </p><p> </p><p> </p><p>The Government holds
the NHS to account by setting objectives in the NHS England Mandate and monitoring
their delivery through the NHS Outcomes Framework.</p><p> </p><p> </p><p> </p><p>If
NHS England is failing to deliver against its objectives, Ministers can ask NHS England
to report on what action it has taken, or to set out a plan for improvement.</p><p>
</p><p> </p><p> </p><p>CCG commissioning plans, including for mental health, should
be informed by the content of their local Joint Strategic Needs Assessments and Joint
Health and Wellbeing Strategy, which should address the needs of their local population.
In addition, Health and Wellbeing Boards must include local Healthwatch as part of
their core membership, Healthwatch represent the concerns and interests of local people-
in their role as champions of the population.</p><p> </p>
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