The Torbay Depression and Anxiety Service provides an Improving Access to Psychological Therapies (IAPT) service to adults aged 18 and over who may present with depression or anxiety disorders (including generalised anxiety, obsessive-compulsive disorder, social anxiety, agoraphobia, panic disorder and post-traumatic stress disorder). A sizeable proportion of people seen by this service are women with perinatal mental health problems.
Psychological therapies – Torbay Depression and Anxiety Service (IAPT)
The Torbay Depression and Anxiety Service provides an Improving Access to Psychological Therapies (IAPT) service to adults aged 18 and over who may present with depression or anxiety disorders (including generalised anxiety, obsessive-compulsive disorder, social anxiety, agoraphobia, panic disorder and post-traumatic stress disorder). A sizeable proportion of people seen by this service are women with perinatal mental health problems.
meeting the recommended response time for Pathway 4 with at least 75% of women having started NICE-recommended psychological interventions within 6 weeks.
Women are asked about their emotional wellbeing at each routine antenatal and postnatal contact, in line with NICE quality statement 4.
Referrals for women for psychological interventions treatment within 6 weeks of referral, during pregnancy or the postnatal period start in line with NICE quality statement 6.
Referrals
The service accepts self-referrals (which make up the majority) and referrals from social workers and all health professionals within mental health and generic health services.
Interventions
The service currently meets the recommended response time, with 75% of women starting psychological therapies within 6 weeks of referral. This includes both low- and high-intensity interventions offered via a stepped care model:
Low-intensity interventions, involving up to six 30-minute sessions, including: CBT, guided self-help, behavioural activation, cognitive restructuring and graded exposure
High-intensity interventions, involving up to 16 60-minute sessions, including: CBT, eye movement desensitisation and reprocessing, counselling for depression and a mindfulness group.
This approach also enables people who do not benefit from low-intensity interventions to be stepped up. The service also provides women with information about medication.
To meet the needs of women during the perinatal period, the service:
has established, and continues to maintain, a strong working partnership with the perinatal mental health team
has established a new group to treat postnatal depression
offers adapted assessment sessions
has four 45-minute assessment sessions per week ring-fenced for women in the perinatal period
offers a flexible approach: childcare is arranged or women can attend appointments in a children’s centre with their baby
free crèche facilities are offered by the postnatal depression group.
Monitoring and measurement of outcomes
The service monitors and records outcomes using the IAPT minimum data set, including:
Patient Health Questionnaire
Generalized Anxiety Disorder scale
phobia screening questions
disorder-specific measures
Work and Social Adjustment Scale
employment questions
waiting times and patient experience questionnaires.
Workforce, staff training and supervision
Workforce
(WTE hours and roles)
The Torbay Depression and Anxiety Service consists of:
· high-intensity therapists (9.7 WTE)
· trainee psychological wellbeing practitioners (2 x 1, 1 x 0.8)
· psychological wellbeing practitioners (9 x 1 WTE)
· counsellors (1 x 0.8, 1 x 0.6 WTE)
Note: IAPT = Improving Access to Psychological Therapies; WTE = whole time equivalent.
Training and supervision is offered to all staff. Supervision for staff delivering the postnatal depression group is provided by a clinical psychologist.
