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Despite the emergence of NICE guidelines regarding the effectiveness and appropriateness of psychological therapies for the majority of common mental health problems, access to these services is still dramatically underdeveloped and uneven. Estimates of untreated problems such as depression and anxiety in primary care signal the extent of these problems and the scale of investment in new services, if these needs are to be adequately met in the future.The Department of Health's and the Care Services Improvement Partnership's (CSIP) Improving Access to Psychological Therapies (IAPT) programme sets out a framework and a series of co‐ordinated actions, including two national demonstration sites, to begin to address these issues in England.This paper examines the origins and policy drivers that have given rise to the IAPT programme, outlines the progress to date and specifically assesses the implications for the mental health workforce of this programme. Issues addressed include the workforce profiles of existing services, career frameworks for psychological therapists, the capacity of training providers to train new and existing staff in psychological therapies and the challenges implicit in devising a workforce delivery plan to support the IAPT programme.

The Improving Access to Psychological Therapies (IAPT) programme was established to treat people with mild to moderate depression and anxiety and bring them to recovery. Although the Positive Practice Guide for people with intellectual disabilities was published in 2009, no geographical areas are listed as having a special interest in specifically rolling out IAPT to people with intellectual disabilities. Issues related to whether current IAPT services can meet the needs of people with intellectual disabilities are considered, along with adaptations that would be needed to ensure the service is accessible and meets the needs of people with intellectual disabilities.

A number of initiatives have been developed to ensure easy access to mental health services for Black and Asian Minority Ethnic (BAME) communities. Improving Access to Psychological Therapies (IAPT) is a service that delivers first line interventions for South Asian women; however, little is known about what makes IAPT accessible for this population. This paper aims to explore South Asian women’s experiences of accessing psychological therapy and whether therapy within IAPT helps individuals to re-frame their experiences within their own cultural context.

A qualitative approach was used. Semi-structured interviews were carried out with South Asian women who accessed an IAPT service. Ten participants took part in the study and interviews were analysed using thematic analysis.

Six themes were identified; access, experience, cultural framework, therapist characteristics, expectations and “sticking with it”. Having a good therapeutic relationship with the therapist was key. While cognitive behavioural therapy (CBT) enabled clients to manage their symptoms, manualised CBT led to a sense of dissatisfaction for some. Clients spoke of having to make a forced choice to either deny their culture or leave their culture at the door to access therapy. Cultural and religious exclusion had a negative impact on therapy particularly for those whose difficulties were related to their cultural or religious context.

Culture and religion continues to be excluded from psychological therapy for South Asian Women. A cultural shift is required from within IAPT services to maintain engagement for this group. Further clinical implications are discussed.

While the experiences of Black and Asian ethnic minority groups accessing secondary mental health services has been explored, this study explores and highlights the experiences of South Asian Women accessing therapy in primary care, and uniquely identifies the processes that enable women to engage in therapy.

Two years ago, we published within this journal a scoping article (Turpin et al, 2006) concerning the urgent need to review and enhance the workforce responsible for delivering psychological therapies to people seeking help for common mental health problems in primary care (London School of Economics, 2006). We estimated that the demand for such interventions, the service models that might deliver increased capacity for psychological treatments, the implications for workforce numbers and the impact that this would have on education and training. Much of the thinking that was adopted within the review was based on current development work around the mental health workforce led by the National Workforce Programme sponsored by the National Institute for Mental Health England (NIMHE) on New Ways of Working (NWW).The current paper reflects on the process and the added value that NWW has contributed to what is a radical new venture, which has been described by the lead evaluator of the pilot Improving Access for Psychological Therapies (IAPT) phase, Professor Glenys Parry, as 'the industrialisation of psychological therapies'. More specifically, it reviews the implementation of a national programme designated as IAPT, which was commissioned on the basis of the NWW work, and the evidence accrued from the IAPT national demonstration sites at Doncaster and Newham, together with the efforts of Lord Layard and the New Savoy Partnership.The first year implementation of IAPT is described, together with the lessons learned from the roll out. As the programme has developed, it has become important to ensure that clients also have a choice of evidence‐based interventions. NWW has provided a means to help practitioners come together from a range of therapeutic orientations and professions to contribute to this more diverse workforce. Finally, it is argued that NWW has been instrumental in helping managers and professions alike think more flexibly about service models and provision, and how to develop a new workforce competent to deliver such an innovative service.

The main aim of this paper is to highlight innovative partnership working between voluntary sector General Practitioner's and primary and secondary mental health services to improve access to services. Many clients are turned away from services when they disclose substance use, this paper discusses why clients are excluded and how psychological therapies can engage clients in treatment using an alternative approach to health centres. It identifies the need for agencies to have multiple skills in working with both mental health and substance use to provide access to services.

The improving access to psychological therapies (IAPT) group was developed to work with clients using psychological interventions to create, a more flexible approach to services for substance users with psychological difficulties and so the IAPT group was developed. To ensure group's stability it was thought that consistent staff from both organisations should remain in the programme for its duration. To ensure adequate staffing, two staff from the drug agency and three staff from the IAPT team were identified and had shown a firm commitment to work on the programme, and it was agreed that two staff were present at each meeting. The voluntary sector agency premises were chosen as the venue, due to their proximity to bus routes and the anonymity of the service location. The group convened for a period of six weeks and would be a closed group (start with the same group members and have no changes during the groups duration). This would allow clients to engage, work together and to gain confidence in supporting each other. It also allowed clients to work with existing group dynamics and to set boundaries. Establishing the group it was important that it met in the afternoon to allow clients to arrive. The group started at 1 p.m., and worked through until 4 p.m., starting with coffee and having a break within the afternoon. Time was also allocated at the end to talk to staff or other group members about any concerns. The programme included workbooks and hand outs to help clients continue the process at home. Information packs were given including helpline numbers and service information. The group was based using cognitive behavioural therapy techniques, mindfulness and dialectical behavioural therapy. Some motivational interviewing techniques and harm reduction messages as well as relapse prevention were included.

Half the group reported that they had reduced their drug use, two went on to join group programmes. In total, 100 per cent agreed to continue to meet and support each other in a less formal setting. The group felt strongly that it should remain only about cannabis and not to introduce other drugs into the group. All clients felt the group should be a 12-week programme the staff running the group concurred with this. All participants felt the group was helpful but could have been 12 weeks, that it reduced their symptoms and enabled them to interact with others who understood their needs. Peer support was highlighted as the most useful. Two participants entered other drug programmes after the group. All participants associated their substance use with their mood.

There are no other projects that have worked outside the IAPT model that integrate substance users and voluntary sector agencies. Provides a unique view of multi agency approach using IAPT in a non–General Practitioner setting with clients normally excluded from IAPT services due to drug use. Is about inclusion of a normally excluded group.

The recent focus on improving access to psychological therapies led by Richard Layard has generated wide‐scale debate. This article looks at this debate and the potential long‐term implications of Layard's recommendations.

This study aims to explore whether the cultural competency training in Improving Access to Psychological Therapies (IAPT) services is sufficient to equip Psychological Wellbeing Practitioners (PWP) to support Black, Asian and Minority Ethnic (BAME) service users.

A qualitative design was adopted using semi-structured interviews with six PWP participants. Reflexive thematic analysis using Braun and Clarke’s (2006) six-step process was used in data analysis.

Three themes revealed evaluations of PWP training, factors supporting PWPs’ cultural competency and points of improvement for PWP training. The training briefly and superficially covered cultural competency content; however, it encouraged PWPs to explore potential personal and cultural biases in therapy. PWP training can also be improved by providing more culturally relevant resources and involving BAME service users.

A small sample size (N = 6) was used, impacting the findings’ generalizability.

PWP training does not sufficiently equip PWPs to support BAME service users. PWPs’ reflection of their own ethnic identity and personal experiences, when combined with training, can improve cultural competency. IAPT training should focus on cultural awareness, knowledge and skills to enhance therapeutic experience. Moreover, PWPs should reflect on their identity, personal biases and experiences when working with diverse communities.

This is one of the few qualitative studies evaluating the cultural competencies of PWPs in IAPT.

The purpose of this paper is to explore the importance of equal access to Improving Access to Psychological Therapies (IAPT) for people with intellectual disabilities.

The paper identifies barriers to access and shows how a reference group can work to solve the barriers and increase access.

The paper evaluates the authors’ progress to date and how the authors plan to continue to take the work forward.

The paper highlights some of the factors responsible for the authors’ success and gives information that will be helpful to other areas who are interested in facilitating equal access.

The paper demonstrates how the focus of a reference group can drive improvements across services to improve access for people with intellectual disabilities to IAPT services.

In Scotland, individuals referred for NHS psychological therapies are expected to commence “treatment” within 18 weeks of receipt of referral. With high demand, high non-attendance rates and limited capacity, this can be a challenging goal. The service discussed here was keen to develop a way of seeing individuals referred sooner and improving the efficiency of the assessment process. The purpose of this paper is to look at the impact of introducing assessment (“Signpost”) appointments on waiting times, attendance, and treatment planning.

Signpost appointments were offered to all existing, and any new referrals, to an adult psychological therapies team (PTT) in NHS Lanarkshire. Clinicians kept a record of the outcomes of these appointments over a six month period. Waiting times and attendance figures were compared before and after the introduction of the Signpost system.

Following the introduction of Signpost appointments, individuals were seen sooner for both assessment and therapy. Attendance at first appointments improved and Signpost appointments helped inform treatment planning. Although alternatives were discussed, the majority of clients were still offered individual therapy. Service user and staff satisfaction was high.

The results from this study led to assessment (“Signpost”) appointments being rolled out across other adult PTTs in NHS Lanarkshire.

There is little research looking at the impact of assessment/signpost appointments on adult mental health services in the UK. In the current climate of public service cuts, this study provides an innovative way of reducing waiting times and maintaining service user satisfaction, without requiring more resources.

The purpose of this paper is to identify barriers for people with psychotic spectrum disorders accessing CBTp in NHS Lothian. Despite national guidelines recommending CBT for the treatment of schizophrenia (National Institute for Health and Care Excellence Guidelines 2014) and (Scottish Intercollegiate Guidelines Network Guidelines 2013), levels of access to CBTp remain low. The overall goal of the study is to uncover emergent themes regarding barriers to access to CBT for patients with psychosis. In addition, the influence of psychosocial skills intervention (PSI) training for psychosis (Brooker and Brabban, 2006) will be explored and if completion of this training effects referral behaviours and attitudes to CBTp.

This study is a quantitative service evaluation project which uses a questionnaire design to explore the factors that influence a clinician’s decision to refer a patient for CBTp. Three qualitative questions are included for thematic analysis to allow the respondents to elaborate on their views on potential barriers. All appropriate Community Mental Health Team (CMHT) staff in adult mental health in NHS Lothian were invited to participate in the study.

CMHT staff in NHS Lothian hold favourable views of CBTp and would support an increase in access for patients with psychosis. Key barriers to access for CBTp identified in this study comprise of, little or no access to CBTp, lack of integration of services and unclear referral pathways. Further themes emerging from the study also included, improving multi-disciplinary communication and increasing CMHT staff knowledge and confidence in CBTp. PSI training was shown to have a significant effect on referral rates. Further research would be warranted to explore the influence of PSI training on CMHT staff confidence and knowledge in CBTp.

This is the first paper of its kind to investigate the potential barriers to access to CBTp in Scotland. The paper has highlighted some key barriers and potential strategies to overcome the barriers identified will be discussed.