Risk factors for initial appointment non-attendance at Improving Access to Psychological Therapy (IAPT) services: A retrospective analysis

Abstract

Background: Approximately 1.5 million referrals are made to Improving Access to Psychological Therapy (IAPT) services annually. However, treatment is received in less than half of cases due to ineligibility or non-attendance. The aim was to explore risk factors for non-attendance at the initial two IAPT appointments following referral. Methods: An exploratory, retrospective analysis of referral and attendance data from five IAPT services in the North of England. Participants were 97,020 referrals received 2010–2014. Main outcome was attendance at the first two offered appointments (assessment and initial treatment). Results: Based on data from two services, 66% of referrals resulted in assessment attendance. Across all five services 57% of patients who attended for assessment subsequently attended the first treatment appointment. The odds of attending an assessment appointment were more than 3 times higher for self-referrals than for GP referrals (OR 3.46, 95% CI 3.27–3.66, p < 0.001). Factors important to treatment appointment attendance following assessment were the service, referral source, presenting problem, and anxiety severity. Conclusion: Initial appointment non-attendance is a consistent problem for IAPT services. Specific factors that may support IAPT services to improve non-attendance rates are identified. IAPT indicators of success should take account of non-attendance at initial appointments.