Psychological Therapies in Primary Care HIT looks back at 2017-18

Dr Nicola Wiles and Dr David Kessler, Directors of the Psychological Therapies in Primary Care Health Integration Team (InPsyTe HIT), give an update on the HIT’s work in 2016-17.

Our HIT aims to improve the delivery of psychological care to patients with depression, anxiety and other common mental disorders. These disorders are a major cause of disability, and patients express a preference for psychological therapies. We also want to innovate, and one of our major themes is the development of online technology to improve access to psychological treatments.

Working with commissioners, academics, clinicians and service leads, our main focus this year has been to continue our work on improving patient access and engagement with the local IAPT (Improving Access to Psychological Therapies) service. We have worked closely with IAPT services on two projects. The first is an evaluation of an online therapist supported therapy package, SilverCloud, within the IAPT service. IAPT have purchased 500 licenses and piloted the service, with therapists offering Silvercloud to suitable clients.

In total 114 took up the offer of online therapy and their outcomes were compared to 304 comparable clients who received conventional low intensity cognitive behavioural therapy (CBT). The initial analysis is encouraging, and on this basis IAPT will continue the Silvercloud pilot. We will continue our work as further data accrues and will deliver a more comprehensive analysis later this year.

The second project, which has been funded by Bristol Health Partners, is an initiative to reach out to members of the black and minority ethnic community, who are seriously under-represented in psychological services. Once again this has involved a close collaboration between Bristol Health Partners, IAPT and the University of Bristol. The initial outreach sessions offering information and psycho-education have been reasonably successful. We hope to continue and develop this initiative in the coming year.

The University of Bristol-led INTERACT programme grant is progressing. The aims of the programme are to develop a therapist integrated online CBT intervention for depression, which will be followed by a randomised control trial evaluating the clinical and cost-effectiveness of the novel intervention. We have built an online therapy platform and are currently testing this with a small group of participants with a view to setting up a large randomised trial in early 2019.

We have established a pool of primary care service-user representatives to help inform academics in their psychological research and clinical and service staff in service-improvement. This group has been helpful in informing the development of the outreach service. We will continue to work with service users.