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Cited by 37Mental Health Treatment and AccessPsychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Improving access to psychological therapies and older people: Findings from the Eastern Region

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Matthew Prina, A., Marioni, Riccardo E., Hammond, Geoffrey C., Jones, Peter B., Brayne, Carol, Dening, Tom·2014·Behaviour Research and Therapy
DOI 10.1016/j.brat.2014.03.008PMC PMC4007011
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Abstract

BACKGROUND: Evaluations of the Improving Access to Psychological Therapies (IAPT) scheme have not yet focused on minority subgroups. This paper aims to evaluate accessibility, waiting times and clinical outcomes of IAPT for older adults. METHODS: All referrals from six Primary Care Trusts (PCT) in the East of England were used in this analysis. During each session, the therapist recorded information on anxiety symptoms using the Generalised Anxiety Disorder Questionnaire (GAD-7) and depressive symptoms with the Patient Health Questionnaire (PHQ-9). Waiting times, type of referrals and reliable recovery rates were investigated. RESULTS: Older adults accounted for only 4% of all the IAPT referrals made between September 2008 and July 2010 in the Eastern Region. Waiting times for both IAPT assessment and treatment were slightly lower for older adult. In all centres, reliable recovery rates were higher in older adults compared to younger adults post-treatment, however these differences were not significant, with the exception of a difference in anxiety scores (χ(2)(1) = 18.6, p < 0.001). In multivariate analyses, being an older adult was associated with recovery for depression (OR = 1.30, 95% CI 1.10-1.53), anxiety (OR = 1.42, 95% CI 1.21-1.66), and overall recovery (OR = 1.31, 95% CI 1.10-1.54) after adjustment for gender, PCT region, baseline score, maximum treatment step during treatment, dropping out, and number of sessions. CONCLUSIONS: The IAPT services were shown to be beneficial to older patients, however, access to these services in later life has been lower than expected. The service pathway for older populations needs to be better researched in order to eliminate possible obstacles in accessing services.

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  • Anti-depressants may not be an acceptable option for older people, concordance may be poor, and evidence repeatedly suggests that older people are not referred for 'talking treatments'.

    “In terms of current treatments, anti-depressants may not be an acceptable option for older people, concordance may be poor [27], and evidence repeatedly suggests that older people are not referred for ‘talking treatments’ [28].”

    From Can support workers from AgeUK deliver an intervention to support older people with anxiety and depression? A qualitative evaluation (2019) · cites this paper as [28]

    For citation [28], the Discussion reports that adults over 65 were less likely than working-age adults to be referred by GPs to psychological therapy services. The Results (Referrals) nevertheless record 1,227 referrals of people over 65, so the paper supports under-referral, not a categorical claim that older people are not referred. The antidepressant and concordance clauses are attached to citation [27], not this source. (LLM, conf=0.86)

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  • Significantly more older adults aged 65-85 years (54%) completed treatment compared to younger adults aged 18-64 years (37%).

    “they found that significantly more of the older adults aged 65–85 years (54%) completed treatment compared to younger adults aged 18–64 years (37%).”

    From Barriers to treatment for older adults seeking psychological therapy (2015) · cites this paper as Prina et al., 2014

    The Results > Referrals passage reports significantly higher treatment completion among older adults: 53.6% versus 36.3% for adults of working age (p < 0.01). It describes the age groups as over 65 and 18–65, not 65–85 and 18–64; 36.3% also does not round to the claimed 37%. No page number is available in our copy. (LLM, conf=0.90)

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  • Based on expected prevalence, the rate of access to the scheme in older people should have been closer to 12.7% rather than the 4% found.

    “Based on the expected prevalence of mental health issues in older adults in that region, the rate of access to the scheme in older people should have been closer to 12.7% rather than the 4% found.”

    From Barriers to treatment for older adults seeking psychological therapy (2015) · cites this paper as Prina et al., 2014

  • In the Improving Access to Psychological Services scheme in the East of England between 2008 and 2010, only 4% of referrals were for adults aged over 65 years, with 95% being for adults aged 18-65 years.

    “They found that only 4% of the referrals made under this scheme were for adults aged over 65 years, with 95% being for adults aged 18–65 years.”

    From Barriers to treatment for older adults seeking psychological therapy (2015) · cites this paper as Prina et al., 2014

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1 of the 42 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Royal Voluntary Service (WRVS) Valuing the socio-economic contribution of older people in the UK. A literature review 2011 Cardiff, UK

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Authors
Matthew Prina, A., Marioni, R. E., Hammond, G. C., Jones, P. B., Brayne, C., & Dening, T.
Affiliations
  • University of Cambridge (GB)
  • University of Nottingham (GB)
ORCID
Venue
Behaviour Research and Therapy
Publisher
Elsevier BV
Published
2014-05
Volume
56
Pages
75-81
ISSN
0005-7967 (ISSN-L)
DOI
10.1016/j.brat.2014.03.008
PMC
PMC4007011
OpenAlex
W2034648172
Cited by
37
References
42
Citations by year
2026: 1 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 5 · 2021: 1 · 2020: 4 · 2019: 8 · 2018: 2 · 2017: 2 · 2016: 4 · 2015: 3 · 2014: 1
FWCI
4.93
Type
journal article
Language
en
Open access
Licence
Locations
  • Behaviour Research and Therapy (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (publishedVersion, other-oa)
  • Repository@Nottingham (University of Nottingham) (publishedVersion, other-oa)
  • Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
Funders
  • NIHR Collaboration for Leadership in Applied Health Research & Care for Cambridgeshire & Peterborough
  • Matthew Prina was supported by the Medical Research Council (grant number RG56433)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
Improving Access to Psychological Therapies, older adults, access to psychotherapy, waiting time, treatment recovery, depression, anxiety, primary care referral, access to services
MeSH terms
Adolescent, Adult, Age Factors, Aged, Aging, Anxiety, Depression, England, Female, Health Services Accessibility, Humans, Male, Mental Health Services, Middle Aged, Outcome and Process Assessment, Health Care, Psychotherapy, Referral and Consultation, Time Factors, Young Adult

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