Initial Results of Prompt Mental Health Care, the Norwegian Version of Improving Access to Psychological Therapies

Smith, Otto Robert Frans; Knapstad, Marit; Alves, Daniele Evelin; Aarø, Leif Edvard

doi:10.1159/000477668

Cited by 11 publications

(19 citation statements)

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“…If we indeed intend to sustainably lower the burden of anxiety and depression, we need, however, also to stress the degree to which an intervention succeed in restoring or improving the individuals' capability to function in their ordinary, daily lives. Symptomatic improvement following the PMCH treatment is previously reported [41,58]. The current study adds to this knowledge by showing that PMHC treatment is also associated with a substantial and lasting improvement in daily life functioning.…”

Section: Resultssupporting

confidence: 65%

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Prompt Mental Health Care (PMHC): work participation and functional status at 12 months post-treatment

Knapstad

Sæther

Hensing

et al. 2020

BMC Health Serv Res

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Background: Anxiety and depression are associated with substantial functional impairment. Prompt Mental Health Care (PMHC), the Norwegian adaptation of IAPT is currently piloted across Norway, as a means to improve access to evidence-based care for adults with anxiety disorders (including subthreshold cases) and minor to moderate depression. The aims of the current paper were to examine the change in work status and functional status from pre-to post-treatment and 12 months post-treatment among clients at the first 12 PMHC pilot sites, and whether degree of change differed across sociodemographic characteristics. Methods: A prospective cohort design was used, including working age clients receiving treatment between October 2014 and December 2016 (n = 1446, participation rate = 61%). Work status and functional status were selfreported, the latter by the Work and Social Adjustment Scale (WSAS). Changes in work status and WSAS score were examined through multilevel models based on maximum likelihood estimation. Likelihood ratio tests were performed to determine whether the interaction between time and the respective background variables were statistically significant. Results: A substantial increase in regular work participation was observed from pre-to post-treatment, which further had increased at 12 months post-treatment. The increase was driven by a corresponding reduction in proportion of clients working and receiving benefits (OR 0.38 [0.29-0.50] baseline to final treatment, OR = 0.19 [0.12-0.32] final treatment to 12-months post-treatment), while no statistically significant change was observed in proportion out of work. Large improvement (ES = − 0.89) in WSAS score was observed from pre-to post treatment. WSAS score at 12 months post-treatment remained at the post-treatment level. Conclusions: Previous research has shown substantial symptom improvement among clients receiving treatment in PMHC. The current findings indicate that PMHC might also be able to aid adults struggling with mild to moderate anxiety and depression in returning to usual level of functioning. The degree to which the observed improvements are attributable to the treatment need nonetheless to be confirmed in a trial including a control group and with more complete follow-up data from registries.

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Section: Resultssupporting

confidence: 65%

“…Previous research has found a substantial improvement in symptoms of anxiety and depression during PMHC treatment [41,58]. The current study shows that PMHC is also associated with substantial improvement in work and functional status from pre-to post-treatment and 12 months post-treatment.…”

Section: Discussionsupporting

confidence: 62%

Prompt Mental Health Care (PMHC): work participation and functional status at 12 months post-treatment

Knapstad

Sæther

Hensing

et al. 2020

BMC Health Serv Res

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“…In summary, the present paper extends findings from a report in Norwegian [ 35 ] and a research letter in ‘Psychotherapy and Psychosomatics’ [ 15 ], and has the following objectives: 1) To describe the general characteristics of PMHC. 2) To elaborate on the main findings with regard to effect sizes of clinical improvement and recovery rates from pre- to post- treatment.…”

Section: Introductionmentioning

confidence: 57%

“…The Norwegian Ministry of Health and Care Services initiated PMHC as a pilot project at 12 sites in 2012, with the aim to increase access to evidence-based primary care treatment for adults with mild to moderate anxiety and depression [ 14 ]. As previously described [ 15 ], PMHC and IAPT share key characteristics by offering a free of charge, low-threshold service, aiming for short waiting times, and allowing for access without referral from the GP. In PMHC cognitive behavioural therapy (CBT) is provided, both as low- (guided self-help and group-based psychoeducation) and high-intensity (face-to-face) treatment.…”

Section: Introductionmentioning

confidence: 99%

“…PMHC is evaluated using the same main outcome measures as in IAPT, more specifically the Patient Health Questionnaire Depression Scale (PHQ-9, [ 17 ]) and the Generalized Anxiety Disorder scale (GAD-7, [ 18 ]), to allow for cross-country comparisons. Initial results, presented in a research letter in “Psychotherapy and Psychosomatics” [ 15 ], show a recovery rate of 57%, reliable recovery rate of 52% and promising effect sizes (0.8–1.2) for pre-post improvement in symptoms of both anxiety and depression among the 12 first pilot sites.…”

Section: Introductionmentioning

confidence: 99%

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Prompt mental health care, the Norwegian version of IAPT: clinical outcomes and predictors of change in a multicenter cohort study

2018

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BackgroundPrompt mental health care (PMHC) is a Norwegian initiative, inspired by the English ‘Improving Access to Psychological Therapy’ (IAPT), aimed to provide low-threshold access to primary care treatment for persons with symptoms of anxiety and depression. The objectives of the present study are to describe the PMHC service, to examine changes in symptoms of anxiety and depression following treatment and to identify predictors of change, using data from the 12 first pilot sites.MethodsA prospective cohort design was used. All participants were asked to complete questionnaires at baseline, before each treatment session and at the end of treatment. Effect sizes (ES) for pre-post changes and recovery rates were calculated based on the Patient Health Questionnaire and the Generalized Anxiety Disorder scale. Multiple imputation (MI) was used in order to handle missing data. We examined predictors through latent difference score models and reported the contribution of each predictor level in terms of ES.ResultsIn total, N = 2512 clients received treatment at PMHC between October 2014 and December 2016, whereof 61% consented to participate. The changes from pre- to post-treatment were large for symptoms of both depression (ES = 1.1) and anxiety (ES = 1.0), with an MI-based reliable recovery rate of 58%. The reliable recovery rate comparable to IAPT based on last-observation-carried-forward was 48%. The strongest predictors for less improvement were having immigrant background (ES change depression − 0.27, ES change anxiety − 0.26), being out of work at baseline (ES change depression − 0.18, ES change anxiety − 0.35), taking antidepressants (ES change anxiety − 0.36) and reporting bullying as cause of problems (ES change depression − 0.29). Taking sleep medication did on the other hand predict more improvement (ES change depression 0.23, ES change anxiety 0.45).ConclusionsResults in terms of clinical outcomes were promising, compared to both the IAPT pilots and other benchmark samples. Though all groups of clients showed substantial improvements, having immigrant background, being out of work, taking antidepressant medication and reporting bullying as cause stood out as predictors of poorer treatment response. Altogether, PMHC was successfully implemented in Norway. Areas for improvement of the service are discussed.

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Long-term outcomes of Prompt Mental Health Care: A randomized controlled trial

Sæther

Knapstad

Grey

et al. 2020

Behaviour Research and Therapy

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Initial Results of Prompt Mental Health Care, the Norwegian Version of Improving Access to Psychological Therapies

Cited by 11 publications

References 3 publications

Prompt Mental Health Care (PMHC): work participation and functional status at 12 months post-treatment

Prompt Mental Health Care (PMHC): work participation and functional status at 12 months post-treatment

Prompt mental health care, the Norwegian version of IAPT: clinical outcomes and predictors of change in a multicenter cohort study

Long-term outcomes of Prompt Mental Health Care: A randomized controlled trial

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