Patients who come back: Clinical characteristics and service outcome for patients re‐referred to an IAPT service

Aims: Patients who are referred more than once to a Primary Care Mental Health Improving Access to Psychological Therapies (IAPT) Service raise questions about those patients' clinical characteristics, the appropriateness of the interventions offered and their capacity to make use of them. IAPT treatments are based on National Institute for Health and Clinical Excellence (NICE) guidelines for the treatment of common mental health problems. NICE recommendations are based on evidence gained from clinical trials, in particular Randomised Controlled Trials (RCTs), which tend to exclude the sort of patient with complex and co‐morbid conditions who often present in practice. Method: Using data routinely collected from the IAPTus clinical database, re‐referral patterns and level of complexity of 50 patients who were referred on more than one occasion to a Primary Care Mental Health (Improving Access to Psychological Therapies) Team from 2009–2010, were analysed. Results: The evidence presented in this study indicates patients who re‐refer exhibit complex environmental, historical and psychological problems. Implications for practice: Although further research is required to compare the characteristics of this patient group with those who are referred only once, this study provides limited evidence that such patients may be more likely to engage and complete treatments that offer regular, structured and one‐to‐one interventions.