TY - JOUR T1 - Are the gates to be thrown open? JF - British Journal of General Practice JO - Br J Gen Pract SP - 317 LP - 318 DO - 10.3399/bjgp10X484138 VL - 60 IS - 574 AU - Nigel Mathers AU - Caroline Mitchell Y1 - 2010/05/01 UR - http://bjgp.org/content/60/574/317.abstract N2 - The Improving Access to Psychological Therapies (IAPT) programme is the largest investment ever made in primary care mental health.1 One of its intentions is to improve access to talking therapies to a wider population including vulnerable groups such as young people, older adults, and members of ethnic minority communities.2An article in this month's Journal3 reports observational data derived from the evaluations of two IAPT demonstration sites and an evaluation of psychoeducational sessions elsewhere. It compares the characteristics of patients who self-refer to IAPT with those referred from primary care, although no outcome data are provided. The authors pose the question whether a self-referral system helps improve access to psychological therapies. They conclude that such a system ‘could work out extremely well and improve access for those who have not been able to get access before as well as those who have never thought of counselling’. Is this conclusion really justified?There is no doubt that many people with high levels of mental distress are disadvantaged either due to problems of access or that their care does not meet their needs.4 Successful psycho-educational workshops have been reported to attract a wide range of self-referred clients, including members of ethnic minority groups, with anxiety and depression scores well above average, implying appropriate referral.5 Psycho-education workshops, however are not IAPT.Another article6 reported no difference in symptom severity between self-referrers and GP referrals to a pilot IAPT demonstration site. In addition, those who referred themselves to the IAPT … ER -