A feasibility study of the transferability of Improving Access to Psychological Therapies (IAPT) to emergency medical inpatients within acute medical wards

Previous literature has reported that patients admitted to hospital with an acute medical presentation and comorbidity of depression stayed 2.45 days longer in hospital than patients who did not. Emergency admissions in English hospitals are increasing, impacting bed capacity and safe delivery of care. Identifying and providing interventions to reduce depression is important in reducing the length of stay in hospital. Depression and anxiety assessments are not consistently conducted as part of the emergency admissions process. As such, the prevalence of depression and anxiety is unknown within the acute medical population. In addition, psychological intervention is not routinely provided in medical wards. The feasibility of: a) Collecting data on common mental health conditions on admission. b) Implementation of Improving Access to Psychological Therapy within an acute medical ward. c) Collecting length of stay and readmission rates and linking to outcome measures was conducted to inform a multi-centred random control trial. The study adopted Orsmond and Cohen (2015) feasibility study framework. A mixed methods approach was used. The sample included all patients admitted to medical wards under study. Quantitative data was collected on the sample, Recruitment demographics, Length of Stay and Readmission data. Patients who received intervention completed a structured questionnaire on discharge. A series of staff focus groups tested the feasibility of intervention. The study concluded that it is feasible to collect data on anxiety and depression prevalence. 26.84% of the acute medical admission population displayed signs of anxiety or depression. Patients who received intervention reported that it was acceptable to receive psychological treatment at the bedside. Staff supported the intervention, however, nurses struggled to complete the initial screening tool. This study provides new evidence into the prevalence of common mental health conditions in the acute medical pathway. It demonstrates the feasibility of delivering psychological care at the bedside.