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Lord Layard and Professor Clark will be well known to most readers of the Journal for their leadership of the Improving Access to Psychological Therapies (IAPT) programme in England since 2005. They have pushed for this improved access and a
rigorous basis for selecting therapies within the programme for a decade and this book is an opportunity for them to step back and review the state of the nation.
Reading the book I can see why ministers were persuaded to support the IAPT programme as the authors present a logical and compelling argument. The logic starts with a section on defining the problem - the morbidity, cost to the nation, suffering and disability caused by mental health disorders, and includes a persuasive section on the impact of depression on medical disorders, and then turns to the developmental trajectory of children.
The closely argued account pushes the right buttons for policy makers to take psychological therapies seriously. This leads naturally into an account of the development of effective therapies, ‘what works for whom’, and leads on to the experiences in the first phase of the improved access programme.
The final chapters cover parity of esteem from the perspective of physical treatments and psychological treatments, arguing that provision of treatments should be on the basis of the best evidence rather than who can lobby the loudest, suggesting that pharmaceutical companies have big purses but often fly in the face of the high-quality evidence about psychological therapies.
Throughout the book there are frequent diagrams and graphs to back up the argument, and there are extensive references and notes to provide follow-up reading.
The authors address some of the criticisms of IAPT - its monoculture (at least in the early days), the highly variable provision across the country, wide variations in response rates, and they point out that its purpose is not to return people to work, but that ability to work is an important justification for invest