Outcomes for treatment for anxiety and depression

Published

1. Main facts and figures

  • in every ethnic group, over 60% of patients showed an improvement after treatment for anxiety or depression in 2018 to 2019
  • the highest percentage of patients showing an improvement was in the White British ethnic group at 68.1%
  • the lowest percentage of patients showing an improvement was in the Bangladeshi ethnic group at 60.8%
  • in most ethnic groups, women were more likely to have shown an improvement than men
  • between 2015/16 and 2018/19, the percentage of patients showing an improvement increased in every ethnic group
  • the biggest increase in patients showing an improvement was in the Pakistani ethnic group
Things you need to know

Improving Access to Psychological Therapies (IAPT) is mainly for adults. A small number of patients under 18 years old are also referred for treatment.

IAPT service providers submit data every month to NHS Digital. This includes information about patients' ethnicity.

This analysis only includes patients whose ethnicity was known. The percentage of patients whose ethnicity was known has gone up from around 80% in 2015 to 88% in 2019.

Data is shown for the whole of England. Download the data for local data broken down by clinical commissioning groups. Some local data has been suppressed if a small number of patients made it unreliable.

The definition for ‘no reliable change’ has been revised since the first version of this measure page. The new methodology separates out patient referrals which showed no reliable change from those where it wasn’t possible to assess change due to missing data. All data presented here is now based on the new methodology.

What the data measures

This data shows outcomes for patients who've had treatment for anxiety or depression. The data covers referrals through NHS Improving Access to Psychological Therapies (IAPT) services.

The data is broken down by ethnicity, gender and time. Download the data to see figures showing the change over time for different ethnic groups by gender.

Patients are assessed after treatment and recorded as showing either:

  • improvement
  • no change
  • deterioration

Patients complete a questionnaire before, during and after their treatment. Their responses are used to assess the outcome of their treatment.

The percentage of referrals with an unknown outcome is not shown. For that reason, not all percentages for the 3 outcomes add up to 100%.

To be included in this data, a patient's referral must have ended in the financial year covered. For example, data for 2018 to 2019 includes referrals that ended between April 2018 and March 2019. The patient must have attended at least 2 appointments in the course of the referral.

The ethnic categories used in this data

The 16 ethnic categories used in this data are those listed in the 2001 Census. The categories are broadly the same as the ethnic groups used in the 2011 Census, except that:

  • the 2001 Census categorised Chinese people within ‘Other ethnic group’
  • the 2001 Census did not list Gypsy and Irish Travellers or Arab people

2. By ethnicity

Percentage of patients showing improvement, deterioration or no change following therapy for anxiety or depression, by ethnicity
Ethnicity Reliably improved No Reliable Change Reliably deteriorated
% % %
Asian 63.9 27.5 7.5
Bangladeshi 60.8 28.2 8.8
Indian 66.4 26.0 6.8
Pakistani 63.0 28.3 7.7
Asian other 62.0 28.7 8.1
Black 66.2 25.6 7.0
Black African 66.2 25.3 7.1
Black Caribbean 66.4 25.7 7.0
Black other 65.7 26.0 6.9
Mixed 64.7 27.6 6.7
Mixed White/Asian 63.4 29.2 6.3
Mixed White/Black African 65.6 27.2 6.7
Mixed White/Black Caribbean 64.7 27.4 7.0
Mixed other 65.1 27.1 6.7
White 68.0 25.4 5.5
White British 68.1 25.4 5.5
White Irish 65.5 27.2 6.4
White other 66.9 26.0 6.0
Other inc Chinese 64.0 27.5 7.4
Chinese 66.5 26.5 6.0
Any other 63.4 27.7 7.6

Download table data for ‘By ethnicity’ (CSV) Source data for ‘By ethnicity’ (CSV)

Summary

This data shows that:

  • 68.0% of White patients showed an improvement after therapy, the highest percentage out of the 5 aggregated ethnic groups
  • patients from the Asian (63.9%) and Other (64.0%) ethnic groups were the least likely to show an improvement out of the same 5 groups
  • out of all 16 ethnic groups, White British (68.1%) and White Other (66.9%) patients were the most likely to have improved
  • Bangladeshi (60.8%), Asian Other (62.0%) and Pakistani (63.0%) patients were the least likely to have improved
  • 8.8% of Bangladeshi patients deteriorated, the highest percentage out of all ethnic groups
  • the patients least likely to have deteriorated were from the White British (5.5%), White Other and Chinese (both 6.0%) ethnic groups
  • Mixed White and Asian patients were the most likely to show no change (29.2%)
  • the least likely to show no change were Black African (25.3%) and White British (25.4%) patients

3. By ethnicity over time

Percentage of patients showing improvement, deterioration or no change following therapy for anxiety or depression, by ethnicity over time
Reliably improved (%) No Reliable Change (%) Reliably deteriorated (%)
Ethnicity Reliably improved (%) 2015/16 Reliably improved (%) 2016/17 Reliably improved (%) 2017/18 Reliably improved (%) 2018/19 No Reliable Change (%) 2015/16 No Reliable Change (%) 2016/17 No Reliable Change (%) 2017/18 No Reliable Change (%) 2018/19 Reliably deteriorated (%) 2015/16 Reliably deteriorated (%) 2016/17 Reliably deteriorated (%) 2017/18 Reliably deteriorated (%) 2018/19
Asian 56.7 61.1 62.7 63.9 31.7 29.6 28.4 27.5 8.4 7.8 7.5 7.5
Bangladeshi 53.9 58.9 61.7 60.8 32.0 29.7 28.1 28.2 10.7 10.1 8.6 8.8
Indian 59.2 64.0 65.3 66.4 30.7 28.1 27.1 26.0 7.4 6.7 6.4 6.8
Pakistani 54.9 59.1 61.3 63.0 32.5 30.8 29.1 28.3 9.1 8.3 8.3 7.7
Asian other 55.2 59.1 60.4 62.0 32.3 30.8 30.0 28.7 8.7 8.2 8.1 8.1
Black 59.8 62.5 63.9 66.2 29.4 28.7 27.3 25.6 8.2 7.4 7.3 7.0
Black African 58.8 61.7 63.1 66.2 29.6 28.9 27.9 25.3 8.5 7.8 7.5 7.1
Black Caribbean 60.8 63.3 64.5 66.4 29.1 28.5 26.9 25.7 7.7 7.1 7.3 7.0
Black other 58.6 61.8 64.2 65.7 30.0 29.2 27.1 26.0 8.7 7.5 7.2 6.9
Mixed 58.6 62.4 63.2 64.7 30.9 29.1 28.3 27.6 7.3 6.7 7.2 6.7
Mixed White/Asian 58.2 63.5 62.7 63.4 31.5 28.8 28.8 29.2 7.4 6.0 7.2 6.3
Mixed White/Black African 60.8 61.0 64.1 65.6 28.4 30.5 26.8 27.2 7.8 6.5 7.9 6.7
Mixed White/Black Caribbean 58.8 61.5 63.7 64.7 31.2 30.2 27.9 27.4 7.0 6.8 7.3 7.0
Mixed other 58.0 62.9 62.8 65.1 30.9 27.9 28.7 27.1 7.5 7.0 6.9 6.7
White 63.5 66.0 67.2 68.0 28.3 26.9 26.2 25.4 6.0 5.8 5.7 5.5
White British 63.6 66.1 67.3 68.1 28.2 26.9 26.2 25.4 5.9 5.8 5.7 5.5
White Irish 63.8 65.2 65.8 65.5 27.6 26.9 26.7 27.2 5.9 6.5 6.6 6.4
White other 61.9 63.7 65.6 66.9 28.8 28.2 27.0 26.0 6.8 6.7 6.3 6.0
Other inc Chinese 56.4 59.0 61.7 64.0 30.8 30.5 28.8 27.5 8.1 8.6 8.0 7.4
Chinese 60.6 64.5 65.4 66.5 29.4 26.9 27.7 26.5 6.6 7.4 5.9 6.0
Any other 55.7 57.9 61.0 63.4 31.1 31.2 29.0 27.7 8.4 8.8 8.4 7.6

Download table data for ‘By ethnicity over time’ (CSV) Source data for ‘By ethnicity over time’ (CSV)

Summary

This data shows that, between 2015/16 and 2018/19:

  • the percentage of patients who improved after therapy increased in every ethnic group
  • out of all 16 ethnic groups, the biggest increase in patients showing an improvement was in the Pakistani ethnic group, from 54.9% to 63.0%
  • the smallest increase was in the White Irish ethnic group, from 63.8% to 65.5%
  • out of the 5 aggregated ethnic groups, the biggest increase in patients improving was among Asian patients, from 56.7% to 63.9%
  • the smallest increase was among White patients, from 63.5% to 68.0%
  • the gap between White and Asian patients in the percentage showing an improvement went down from 6.8 to 4.1 percentage points
  • the gap between White patients and those from the Other ethnic group in the percentage showing an improvement went down from 7.1 to 4.0 percentage points

4. By ethnicity and gender

Percentage of referrals showing improvement, deterioration or no change following a course of 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 62.8 64.5 28.3 27.1 7.8 7.4
Bangladeshi 56.6 63.4 30.4 27.0 10.1 8.0
Indian 66.5 66.4 26.2 25.9 6.6 6.8
Pakistani 63.0 63.0 28.1 28.4 7.9 7.6
Asian other 59.0 63.6 31.1 27.4 8.5 7.8
Black 64.6 66.9 27.2 25.0 6.9 7.0
Black African 64.6 66.9 27.2 24.5 6.7 7.2
Black Caribbean 65.0 67.0 26.5 25.3 7.4 6.8
Black other 63.4 66.6 28.9 24.8 6.2 7.2
Mixed 63.9 65.1 28.0 27.4 6.8 6.7
Mixed White/Asian 64.2 63.1 27.6 29.9 7.3 5.9
Mixed White/Black African 61.4 67.4 30.3 25.9 8.0 6.1
Mixed White/Black Caribbean 63.7 65.1 28.5 27.0 6.2 7.3
Mixed other 64.5 65.4 27.2 27.0 6.7 6.7
White 67.3 68.4 26.0 25.1 5.5 5.6
White British 67.5 68.5 25.9 25.1 5.5 5.5
White Irish 65.3 65.7 27.6 26.9 6.1 6.7
White other 65.0 67.5 27.5 25.5 6.1 6.0
Other inc Chinese 63.8 64.1 27.6 27.4 7.4 7.4
Chinese 71.5 64.8 22.6 27.9 5.1 6.3
Any other 62.5 63.9 28.4 27.3 7.7 7.6

Download table data for ‘By ethnicity and gender’ (CSV) Source data for ‘By ethnicity and gender’ (CSV)

Summary

This data shows that:

  • in most ethnic groups, women were more likely than men to show an improvement after therapy
  • the exceptions were the Indian, Mixed White and Asian, and Chinese ethnic groups
  • among women, patients from the White British (68.5%) ethnic group were the most likely out of all ethnic groups to have improved after therapy
  • women from the Bangladeshi (8.0%) and Asian Other (7.8%) ethnic groups were the most likely to have deteriorated
  • among men, patients from the Chinese (71.5%) ethnic group were most likely to have improved after therapy
  • men from the Bangladeshi (10.1%) and Asian Other (8.5%) ethnic groups were the most likely to have deteriorated

5. Methodology

Improving Access to Psychological Therapies (IAPT) service providers submit data every month.

Every patient completes a Patient Health Questionnaire (PHQ-9).

They also complete either:

  • a Generalised Anxiety Disorder (GAD7) questionnaire
  • an Anxiety Disorder Specific Measure (ADSM)

Patients complete the relevant ADSM during treatment if they have:

  • obsessive-compulsive disorder
  • generalised anxiety disorder
  • social phobia
  • health anxiety
  • agoraphobia
  • panic disorder
  • post-traumatic stress disorder

If they're not being treated for one of these conditions, they complete the GAD-7 questionnaire. They also use the GAD-7 to measure changes during treatment if they haven't completed at least 2 ADSMs.

The patient’s first and last scores are compared for both the PHQ-9 and the relevant anxiety questionnaire.

A patient has shown 'reliable improvement' if there is both:

  • a reliable decrease in one or both of the scores
  • no reliable increase in either of them

A reliable change is at least the following number of points:

  • PHQ-9: 6 points
  • GAD-7: 4 points
  • Agoraphobia Mobility Inventory: 0.73 points
  • Social Phobia Inventory: 10 points
  • Panic Disorder Severity Scale: no agreed threshold, so GAD-7 is used
  • Obsessive Compulsive Inventory: 32 points
  • Impact of Events Scale: 9 points
  • Health Anxiety Inventory (Short Week): 4 points

Suppression rules and disclosure control

Figures based on fewer than 5 patients are not shown here. This is to make sure individual patients can’t be identified.

Rounding

Totals for clinical commissioning groups are rounded to the nearest 5.

Percentages are based on unrounded numbers. They are rounded to:

  • 1 decimal point in figures for the whole of England
  • whole numbers in figures for clinical commissioning groups

Related publications

Adult improving access to psychological therapies programme.

Quality and methodology information

6. Data sources

Source

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 monitor and improve the provision of talking therapies services for the treatment of people with anxiety, depression or both.

7. Download the data

Outcomes for treatment for anxiety and depression - Spreadsheet (csv) 33 MB

Measure, Time, Time_type, Geography, Geography_type, Ethnicity_type, Ethnicity, Outcome, Outcome_type, Gender, Gender_type, Value, Value_type, Denominator, Numerator