title: Predictors of patient non-attendance at Improving Access to Psychological Therapy services demonstration sites.
abstract: BACKGROUND
  Improving Access to Psychological Therapy (IAPT) services have increased the number of people with common mental health disorders receiving psychological therapy in England, but concerns remain about how equitably these services are accessed.
  
  
  METHODS
  Using cohort patient data (N=363) collected as part of the independent evaluation of the two demonstration sites, logistic regression was utilised to identify socio-demographic, clinical and service factors predictive of IAPT non-attendance.
  
  
  RESULTS
  Significant predictors of IAPT first session non-attendance by patients were: lower non-risk score on the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM); more frequent thoughts of "being better off dead" (derived from the CORE-OM); either a very recent onset of common mental health disorder (1 month or less) or a long term condition (more than 2 years); and site.
  
  
  CONCLUSIONS
  The small sample and low response rate are limitations, as the sample may not be representative of all those referred to IAPT services. The predictive power of the logistic regression model is limited and suggests other variables not available in the dataset may also be important predictors.
  
  
  CONCLUSIONS
  The clinical characteristics of risk to self, severity of emotional distress, and illness duration, along with site, were more predictive of IAPT non-attendance than socio-demographic characteristics. Further testing of the relationship between these variables and IAPT non-attendance is recommended. Clinicians should monitor IAPT uptake in those they refer and implement strategies to increase their engagement with services, particularly when referring people presenting with suicidal ideation or more chronic illness.
authors.affiliation: School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, South Yorkshire, Sheffield S1 4DA, UK. Electronic address: l.dibona@sheffield.ac.uk.
authors.forename: Laura
authors.initials: L
authors.lastname: Di Bona
authors.affiliation: School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, South Yorkshire, Sheffield S1 4DA, UK.
authors.forename: David
authors.initials: D
authors.lastname: Saxon
authors.affiliation: Centre for Psychological Services Research, University of Sheffield, Sheffield S1 4DA, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Barkham
authors.affiliation: Department of Psychology, University of Hull, Hull HU6 7RX. Previously, School of Health and Related Research, University of Sheffield, Sheffield S1 4DA.
authors.forename: Kim
authors.initials: K
authors.lastname: Dent-Brown
authors.affiliation: School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, South Yorkshire, Sheffield S1 4DA, UK; Centre for Psychological Services Research, University of Sheffield, Sheffield S1 4DA, UK.
authors.forename: Glenys
authors.initials: G
authors.lastname: Parry
mesh_terms: D000328:Adult; D004739:England; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D011613:Psychotherapy
keywords: Access; Improving Access to Psychological Therapy (IAPT) services; Non-attendance; Personal characteristics; Psychotherapy; Risk