The Increasing Access to Psychological Therapies (IAPT) programme was sold as a cost-effective investment to help people to remain in, or get into work. It would help keep the welfare bill down by reducing reliance on out of work benefits. So is it working? Today’s Annual Report from the Health and Social Care Information Centre presents a mixed picture. Of the 468,881 referrals finishing a course of treatment in 2014/15, 98,313 (21.0%) started ‘unemployed and seeking work; or long term sick or disabled, or in receipt of benefit payments’. Of these, 22.1% (21,775) were ‘employed or not actively seeking work’ by the end of their course of treatment. This sounds positive. Nearly 22,000 referrals now in work or at least not actively needing to look for work. However, this does potentially include people who would be better off in work but are not actively seeking work.

Looking at those who started their treatment in employment, moreover, it is clear that there has also been a shift in the other direction. In fact, 21,176 referrals who started treatment in work (or not actively seeking work) ended their course unemployed or on long term sickness or benefit payments. That is almost exactly the same number (if not proportion) of referrals moving into unemployment as those moving into employment.

It is also very difficult to tell the full story and to understand the proportional shift because of the high number of referrals whose employment history is recorded as ‘invalid or not stated’ (53,870 referrals or 12% of the total at end of treatment).

Evidence based psychological therapies have demonstrable benefits in improved health and wellbeing. Nevertheless, for the IAPT programme to continue to make its case to the Treasury for sustained and increased investment it will be vital to demonstrate its impact on employment outcomes. For starters, every referral needs to include a proper assessment of employment outcomes at the beginning and end of treatment. More research is needed to study the impact of the programme on individual cases to draw a causal link between intervention and employment outcomes. Finally, the services themselves need to develop a better focus on employment support. Partnerships with voluntary sector providers, local authorities and jobcentres can make a real difference in future employment outcomes and recovery rates. This good practice must become much more widespread as the IAPT programme develops.