Outcomes for treatment for anxiety and depression
Published
Last updated 4 March 2018 - see all updates
There is a new version of this page. View the latest version.
- 1. Navigate to Main facts and figures section
- 2. Navigate toOutcomes of referrals following psychological therapy by ethnicity section
- 3. Navigate toOutcomes of referrals following psychological therapy by ethnicity and gender section
- 4. Navigate to Methodology section
- 5. Navigate to Data sources section
- 6. Navigate to Download the data section
1. Main facts and figures
-
for each ethnic group, the majority of referrals through Improving Access to Psychological Therapies (IAPT) for a course of treatment or therapy showed an improvement on completion, rather than a deterioration or no change
-
IAPT referrals for White patients were more likely to have shown an improvement compared with other broad ethnic groups, and those for patients from the Asian or Other ethnic groups were the least likely to – this was found for both men and women
-
among the specific ethnic groups, the highest percentage of IAPT referrals that showed improvement were for patients who were White British, White Irish or who identified as ‘Other White’ (for both men and women)
-
IAPT referrals for patients in the Bangladeshi, Pakistani, Other Asian or Other ethnic groups were the least likely to have shown improvement (for both men and women)
-
women’s IAPT referrals were more likely to have shown improvement than men’s, with the exception of women of mixed White and Asian background and Bangladeshi women (for the latter, the rates of improvement were very similar to those of men)
Things you need to know
About 900,000 people get treatment each year through Improving Access to Psychological Therapies (IAPT) services. IAPT is an adult service, but contains a small amount of referrals for patients who are under 18.
IAPT data is based on monthly submissions to NHS Digital by providers of these services and providers are required to record the ethnicity of patients. The proportion of IAPT patients with a recorded ethnicity has risen gradually, from about 80% in April 2015 to about 85% in March 2016. This analysis only includes referrals for which a valid ethnicity was recorded.
The data presented here is at the national level. The ‘download the data’ section contains data at the local level by clinical commissioning groups (CCGs). These are the NHS bodies that in 2013 replaced primary care trusts in their role of planning and commissioning health care services at the local level. In 2015/16 there were 209 CCGs and 2 commissioning hubs. In many CCG areas, however, the number of patients in some ethnic groups was too small to be reliable and has been suppressed.
What the data measures
This data measures outcomes for all referrals for treatment for anxiety or depression made through the NHS’s Improving Access to Psychological Therapies (IAPT) services. The data is broken down by ethnicity.
IAPT is a wide-ranging initiative providing evidence-based psychological therapies to people in England with anxiety disorders and depression. The outcomes for referrals are assessed as showing either:
- improvement – where there is a significant improvement in the patient’s condition
- no change – where there is no significant change in the patient’s condition (neither improvement nor deterioration)
- deterioration – where there is significant deterioration in the patient’s condition
Outcomes are assessed using the responses patients made to questionnaires that were tailored to their health condition and measured their depression and anxiety over the course of their treatment. These give a clinically reliable basis for determining patients’ outcomes.
A referral must have ended in the financial year 2015/16 and the patient must have attended at least 2 appointments in the course of the referral.
The ethnic categories used in this data
The 16 categories used in this data are those listed in the 2001 Census. The categories are broadly the same as those used in the 2011 Census, with the following exceptions:
- the 2001 Census categorised Chinese people within 'Other ethnic group'
- the 2001 Census did not list Gypsy and Irish Travellers or Arab people
The 2001 categories are therefore as follows:
White:
- English/Welsh/Scottish/Northern Irish/British
- Irish
- Any Other White background
Mixed/Multiple ethnic groups:
- White and Black Caribbean
- White and Black African
- White and Asian
- Any Other Mixed/Multiple ethnic background
Asian/Asian British:
- Indian
- Pakistani
- Bangladeshi
- Any Other Asian background
Black/African/Caribbean/Black British:
- African
- Caribbean
- Any Other Black/ African/ Caribbean background
Other ethnic group:
- Chinese
- Any Other ethnic group
2. Outcomes of referrals following psychological therapy by ethnicity
| Ethnicity | Reliably improved | No Reliable Change | Reliably deteriorated |
|---|---|---|---|
| % | % | % | |
| Asian | 56.7 | 34.9 | 8.4 |
| Bangladeshi | 53.9 | 35.4 | 10.7 |
| Indian | 59.2 | 33.5 | 7.4 |
| Pakistani | 54.9 | 36.0 | 9.1 |
| Asian other | 55.2 | 36.1 | 8.7 |
| Black | 59.8 | 32.1 | 8.2 |
| Black African | 58.8 | 32.7 | 8.5 |
| Black Caribbean | 60.8 | 31.5 | 7.7 |
| Black other | 58.6 | 32.7 | 8.7 |
| Mixed | 58.6 | 34.1 | 7.3 |
| Mixed White/Asian | 58.2 | 34.4 | 7.4 |
| Mixed White/Black African | 60.8 | 31.4 | 7.8 |
| Mixed White/Black Caribbean | 58.8 | 34.2 | 7.0 |
| Mixed other | 58.0 | 34.6 | 7.5 |
| White | 63.5 | 30.6 | 6.0 |
| White British | 63.6 | 30.5 | 5.9 |
| White Irish | 63.8 | 30.4 | 5.9 |
| White other | 61.9 | 31.4 | 6.8 |
| Other | 56.4 | 35.5 | 8.1 |
| Other - Any Other | 55.7 | 35.9 | 8.4 |
| Other - Chinese | 60.6 | 32.8 | 6.6 |
Download table data for ‘Outcomes of referrals following psychological therapy by ethnicity’ (CSV) Source data for ‘Outcomes of referrals following psychological therapy by ethnicity’ (CSV)
Summary of Outcomes for treatment for anxiety and depression Outcomes of referrals following psychological therapy by ethnicity Summary
This data shows that for IAPT services in 2015/16:
- referrals for White adults were more likely to show improvement following therapy (63.5%) than for other ethnic groups
- the referrals least likely to show improvement were for the Asian (56.7%) and Other (56.4%) broad ethnic groups
- for specific ethnic groups, referrals for the White British and the White Irish ethnic groups were the most likely to show improvement (63.6% and 63.8% respectively) and also the least likely to show deterioration (5.9% in both groups) or no change (slightly over 30% each)
- the Asian ethnic groups for whom referrals were least likely to show improvement were Bangladeshi (53.9%), Pakistani (54.9%) and Other Asian (55.2%), compared with referrals for Indian patients (59.2%)
- 10.7% of referrals for Bangladeshi patients showed deterioration – the highest percentage for any ethnic group
- referrals for patients from the Other Asian or Pakistani specific ethnic groups were the most likely to show no change (around 36% for both groups)
3. Outcomes of referrals following psychological therapy by ethnicity and gender
| Reliably improved | No Reliable Change | Reliably deteriorated | ||||
|---|---|---|---|---|---|---|
| Ethnicity | Reliably improved Men (%) | Reliably improved Women (%) | No Reliable Change Men (%) | No Reliable Change Women (%) | Reliably deteriorated Men (%) | Reliably deteriorated Women (%) |
| Asian | 54.7 | 57.8 | 36.5 | 34.0 | 8.8 | 8.2 |
| Bangladeshi | 54.1 | 53.9 | 35.1 | 35.4 | 10.8 | 10.7 |
| Indian | 57.3 | 60.1 | 35.7 | 32.3 | 7.0 | 7.6 |
| Pakistani | 52.3 | 56.5 | 37.2 | 35.2 | 10.5 | 8.3 |
| Asian other | 53.6 | 56.4 | 37.3 | 35.3 | 9.1 | 8.4 |
| Black | 57.1 | 60.9 | 34.9 | 30.8 | 8.0 | 8.2 |
| Black African | 55.7 | 60.2 | 35.8 | 31.2 | 8.4 | 8.6 |
| Black Caribbean | 59.0 | 61.5 | 33.3 | 30.7 | 7.7 | 7.8 |
| Black other | 54.5 | 60.5 | 37.4 | 30.5 | 8.1 | 9.0 |
| Mixed | 57.0 | 59.3 | 36.3 | 33.1 | 6.7 | 7.6 |
| Mixed White/Asian | 59.4 | 57.7 | 34.3 | 34.3 | 6.3 | 7.9 |
| Mixed White/Black African | 58.9 | 61.6 | 35.0 | 29.8 | 6.1 | 8.6 |
| Mixed White/Black Caribbean | 55.7 | 60.1 | 37.6 | 32.8 | 6.6 | 7.1 |
| Mixed other | 56.6 | 58.6 | 36.3 | 33.8 | 7.2 | 7.6 |
| White | 62.5 | 64.1 | 31.7 | 29.9 | 5.9 | 6.0 |
| White British | 62.6 | 64.1 | 31.6 | 29.9 | 5.8 | 5.9 |
| White Irish | 61.9 | 65.0 | 32.6 | 28.9 | 5.5 | 6.1 |
| White other | 60.0 | 62.7 | 33.2 | 30.6 | 6.9 | 6.7 |
| Other | 53.3 | 58.0 | 38.7 | 33.9 | 8.1 | 8.1 |
| Other - Any Other | 52.9 | 57.2 | 38.9 | 34.4 | 8.2 | 8.4 |
| Other - Chinese | 55.8 | 62.3 | 37.0 | 31.3 | 7.2 | 6.4 |
Download table data for ‘Outcomes of referrals following psychological therapy by ethnicity and gender’ (CSV) Source data for ‘Outcomes of referrals following psychological therapy by ethnicity and gender’ (CSV)
Summary of Outcomes for treatment for anxiety and depression Outcomes of referrals following psychological therapy by ethnicity and gender Summary
This data shows that for IAPT services in 2015/16:
- for referrals for women, the White ethnic group had the highest rate of improvement amongst the broad ethnic groups, at 64.1%, while the Asian and Other ethnic groups had the lowest rates of improvement, at 57.8% and 58.0% respectively
- for referrals for men, the White ethnic group had the highest rate of improvement amongst the broad ethnic groups, at 62.5%, while the Asian and Other ethnic groups had the lowest rates of improvement, at 54.7% and 53.3% respectively
- women’s referrals were more likely to show improvement than men’s in each ethnic group, with the exception of the mixed White and Asian group (59.4% of men’s referrals compared to 57.7% of women’s) and the Bangladeshi group (54.1% of men’s, 53.9% of women’s)
- for both women’s and men's referrals, the specific ethnic groups most likely to show improvement were White Irish (65% of women’s, 61.9% of men’s) and White British (64.1% of women’s, 62.6% of men’s)
- for men’s referrals, the specific ethnic groups most likely to show deterioration were Bangladeshi (10.8%) and Pakistani (10.5%)
- for women’s referrals, the specific ethnic groups most likely to show deterioration were Bangladeshi (10.7%) and Other Black (9.0%)
4. Methodology
Data is submitted by providers of Improving Access to Psychological Therapies (IAPT) services on a monthly basis. This means that information about referrals is updated each month. Providers have 2 opportunities to submit a month's data, known as primary and refresh windows. Published data will always be based on a refresh submission unless it was not provided, in which case the primary submission is used.
Ethnic group is a required field in the IAPT dataset. This means that wherever providers hold or collect this information about a person, it should be included in their submission to NHS Digital.
For all referrals, a Patient Health Questionnaire (PHQ-9) is used, alongside either a Generalised Anxiety Disorder (GAD7) questionnaire or an Anxiety Disorder Specific Measure (ADSM), depending on the recorded diagnosis. ADSMs are questionnaires that are sensitive measures of the severity of particular anxiety disorders. The IAPT Data Handbook recommends relevant ADSMs for:
- obsessive-compulsive disorder
- generalised anxiety disorder
- social phobia
- health anxiety
- agoraphobia
- panic disorder
- post-traumatic stress disorder
If one of these conditions is recorded, the relevant ADSM should be used to measure change in anxiety during treatment. If the relevant ADSM has not been given at least twice during a course of treatment, or if the condition recorded is not one of those specified in the above list, the GAD7 (IAPT’s generic anxiety measure) is used to assess change in anxiety.
The patient’s first and last scores are compared for both the PHQ-9 and the relevant anxiety questionnaire. A referral has shown reliable improvement if there is a reliable decrease on one or both of the scores on these questionnaires, and no reliable increase in either of them.
A reliable change is defined as either a PHQ-9 change of 6 points or more, or one of the following, depending on which questionnaire is asked:
- GAD7 - a change of 4 points or more
- Agoraphobia Mobility Inventory - a change of 0.73 or more
- Social Phobia Inventory - a change of 10 points or more
- Panic Disorder Severity Scale does not have an agreed threshold so GAD7 is used
- Obsessive Compulsive Inventory - a change of 32 points or more
- Impact of Events Scale - a change of 9 points or more
- Health Anxiety Inventory (Short Week) - a change of 4 points or more
Rounding
Figures have been rounded to 1 decimal point.
Related publications
Adult improving access to psychological therapies programme
Quality and methodology information
Further technical information
For more information, see Appendix 3 of the 2015-16 IAPT annual publication.
5. Data sources
Source
Improving Access to Psychological Therapies (IAPT) dataset
Type of data
Administrative data
Type of statistic
Official statistics
Publisher
NHS Digital
Publication frequency
Yearly
Purpose of data source
The data is used to to monitor and improve the provision of talking therapies services for the treatment of people with anxiety and/or depression.
6. Download the data
This file contains the following: ethnicity, geography, gender, outcome, value, denominator, numerator