The Australian version of IAPT: clinical outcomes of the multi-site cohort study of NewAccess

Abstract

Background

The United Kingdom IAPT (Improving Access to Psychological Therapies) approach of delivering low intensity therapies for symptoms of depression and anxiety was adapted for Australia and named NewAccess. Clinical outcomes of the service were evaluated in three sites between October 2013 and 2016.

Aims

This paper describes the clinical outcomes in the Australian health setting.

Methods

Prospective cohort study with repeated measures. Both intent-to-treat and per protocol analyses were conducted for primary outcomes measures Patient Health Questionnaire-9 (nine item), and Generalised Anxiety Disorder (seven item). Secondary measures were Phobia Scale and Work and Social Adjustment Scale.

Results

Three thousand nine hundred and forty-six individuals were assessed, and 3269 attended at least two treatment sessions. Forty percent were males. There was a clinically meaningful reduction (improvement) shown by reliable recovery rates in both depression and anxiety symptoms at post-treatment assessment (68%; 95% CI: 66–70%) with large effect sizes (1.23 for depression and 1.25 for anxiety). Outcomes in PHQ-9 and GAD-7 were not influenced by age or sex, but recovery rates were significantly reduced by relationship status (single or separated). Unemployment reduced PHQ-9 outcomes but not GAD-7 outcomes.

Conclusion

NewAccess demonstrated positive clinical outcomes in Australia, that compared favourably with international studies with the same methodology.

Keywords:

• IAPT
• anxiety
• depression
• CBT
• NewAccess
• Step 2 mental health care

Acknowledgements

The authors thank Dr Clare Shann for her major contribution to the project, Professor James Bennett Levy and who had significant input into the design and implementation of early stages of the trial, and Ernst Young who completed a mid-way evaluation (early clinical and economic outcomes) in November 2015. From Beyond Blue, the Honorable Jeffrey Kennett, Ms Susan Anderson, Ms Bronwyn Hall and CEOs, past and present through their hard work in stewardship and faith in the model, ensured the completion of the NewAccess trial. We also gratefully acknowledge the coaches and participants in this trial.

Disclosure statement

MBai is one of the Board of Directors of Beyond Blue and AM is an employee. MBat, SL and PR provided training, supervision and/or clinical governance of NewAccess under a grant from Beyond Blue. Authors had full access to data, conducted the analysis and interpreted the data. There were no other conflicting interests with respect to this article.

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

The NewAccess trial was fully funded by Beyond Blue with significant input from Movember.