The Psychological Therapies Health Integration Team (HIT) is a team of academics, commissioners, psychologists and other experts, working together to improve the uptake of, access to, and outcomes for psychological therapies.
Most common mental health problems, such as anxiety and depression, are managed in primary care (general practice) and Bristol has recently re-organised its primary care mental health services. This is an opportunity to improve the access to, and outcomes of, psychological therapies that are known to be effective in the treatment of these problems. At the same time, more and more people are online and using smart mobile devices. Now is the time to develop and use high quality online materials to support the work of low and high intensity psychotherapists.
Although services were established to increase access to psychological therapies, such as cognitive behavioural therapy (CBT), many patients do not engage with the service and outcomes are not as good as they could be. In Bristol in 2013/14, more than 40 per cent of patients referred to Improving Access to Psychological Therapies (IAPT) services did not engage with the service and most patients received ‘low intensity’ interventions such as guided self help or groups. Demand for ‘high intensity’ one to one CBT greatly exceeds supply. The proportion of patients who ‘recover’ is lower for Bristol than the national average, around 30 per cent rather than the average of 50 per cent.
The Psychological Therapies HIT is also known as InPsyTe, which stands for Improvement and Innovation in Psychological Therapies in primary care.
Aims and objectives
The aim the Psychological Therapies HIT is to improve uptake of, access to, and outcomes for effective psychological therapies. This will be achieved through:
- Using existing evidence, and undertaking new studies, to inform service improvement and redesign
- Examining the use of CBT-based computerised interventions (cCBT), and assessing the balance between these treatments and face to face time with a therapist
- Assessing existing, and developing new and effective online treatment
- Providing education for therapists, GPs and others to improve referral to and engagement with psychological therapies
- Improving reporting systems for uptake, process and outcomes of psychological therapy services
- Developing new treatment for patients with anxiety and depression
How patients and the public are involved
The HIT management team includes two service user representatives. The team will also work with other user groups through the local Clinical Research Network and the User Development Co-ordinator at the CCG. Research has found that there are substantial barriers to the uptake of, and engagement in, both computerised and face to face CBT. It is important that there is service user involvement in designing and implementing changes to the these services.
The team has already discussed their ideas and proposed projects at various user groups, including the University of Bristol’s Elizabeth Blackwell Institute Public Advisory Group (PAG). This group includes service users and representatives of a wide range of community groups providing services for those with mental health problems. Initial feedback stressed the importance of proactive relationship building with service users, and embedding an approach to reducing inequalities into the research strategy.
They have also engaged with the Knowle West Media Centre (KWMC), a community organisation whose brief is to develop and deliver innovative digital inclusion projects that have social, cultural and economic benefit and encourage wider participation in decision making. They have agreed to run workshops involving service users from one of the most deprived areas of Bristol in the development of this novel intervention.
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InPsyTe at the HIT conference
The InPsyTe HIT presented this poster (PDF) at the 2018 Bristol Health Partners Health Integration Team conference.