Perspectives on an enhanced ‘Improving Access to Psychological Therapies’ (IAPT) service addressing the wider determinants of mental health: a qualitative study

Esther Louise Curtin, Katrina d'Apice, Alice Porter, Emily Widnall, Matthew Franklin, Frank de Vocht , Judi L Kidger

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)


Background A new Health and Wellbeing pathway was introduced into the Improving Access to Psychological
Therapies (IAPT) service in one geographical area of the UK in 2021 to address the wider determinants of mental
health problems. It comprised assisted signposting to wider services and physical health promotion. This qualitative
study aimed to understand stakeholders’ experiences of implementing and receiving this new support and the
barriers and facilitators to its delivery.
Methods Forty-seven interviews were conducted, with service developers (n = 6), service deliverers (n = 12), service
users (n = 22) and community and clinical partners (n = 7), as part of a larger mixed-methods evaluation. Interviews
were recorded, transcribed, and analysed using reflexive thematic analysis.
Results Three themes spanned all participant groups and represented key aspects of the service: (1) identifying
suitability, (2) a holistic service, and (3) moving forward. The sub-themes represent the barriers and facilitators to
processes working in practice, lending insight into potential service improvements. These included strengthening the
quality of communication during referral and assessment, tailoring the support and delivery mode, and increasing
transparency around continued care to drive sustained benefits.
Limitations Service users may have been selected due to their positive experiences of IAPT and were not
demographically representative of the population, although participants’ experiences of the service did suggest
variation in our sample.
Conclusions The Health and Wellbeing pathway was perceived as having a positive impact on mental health
and could reduce the burden on therapeutic services. However, service- and individual-level barriers need to be
addressed to enhance statutory and community support links, manage service users’ expectations, and improve
accessibility for certain groups.
Original languageEnglish
Article number536
Number of pages13
JournalBMC Health Services Research
Issue number1
Publication statusPublished - 24 May 2023

Bibliographical note

Funding Information:
This research was funded by the National Institute for Health and Care Research (NIHR) School for Public Health Research (SPHR), Grant Reference Number SPHR-PHPES004-IAP. The funders took no part in the design of the study and collection, analysis, and interpretation of data and in writing this manuscript. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Publisher Copyright:
© 2023, The Author(s).


  • Mental health services, Signposting, Health promotion, Stakeholder perspectives, Service user experience, Qualitative


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