Rapid Psychological Help: Preliminary Results from the Evaluation of the Norwegian Version of Improved Access to Psychological Therapies

Introduction: “Rapid Psychological Help” (RPH) is a pilot project implemented across Norway by the Norwegian Directorate of Health and is the Norwegian version of British Improving Access to Psychological Therapies (IAPT). RPH represents an innovative strategy to improve access to mental-health care in Norway, advertising broad, quick, and low-threshold access to evidence-based treatment for anxiety and depression. Key characteristics of RPH’s new approach are that (a) patients can directly contact RPH, while contact with standard mental health services requires a referral from a general practitioner, (b) RPH aims to provide access to mental health treatment within 48 hours, while standard waiting lists are often up to 12 weeks, and (c) by including less therapist contact per patient through focused and brief treatment and so-called “low-intensity treatments” (i.e., less costly treatments, instead of “high-intensity” individual therapy) more patients can receive treatment. Thus, RPH is a novel mental health model to alleviate individual and societal costs related to the burden of anxiety and depression in Norway. This abstract reports the initial results from the evaluation of RPH.

Methods: The evaluation used an observational cohort study design. To determine treatment effectiveness, pre-and post-treatment scores were compared to benchmarks from the IAPT project in England. Patients were asked to fill out a set of questionnaires before, under and after treatment. The Patient Health Questionnaire (PHQ), Generalized Anxiety Disorder (GAD) scale, and the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) were used to measure depressive symptoms, anxiety and quality of life, respectively.

Results: Of the 289 patients that had started treatment, 248 (85.8%) had completed the baseline questionnaire and at least one follow-up questionnaire. 183 (63.3%) had completed the questionnaire at the end of treatment. In case data at the end of treatment was missing, the last-observation-carried-forward method was used. Paired t-tests indicated a large reduction in both symptoms of depression (t₂₄₇=18.3; p<.001, d = 1.16) and anxiety (t₂₄₇=17.4; p<.001, d = 1.10), together with a large increase in self-reported quality of life (t₂₄₇= -15.1; p<.001, d = -.96).

Conclusion: Preliminary results from the evaluation were promising with regard to symptom relief after treatment. The derived effect sizes were comparable with those found in the initial evaluation of the IAPT project. Inclusion of more patients is necessary to carry out more detailed analysis and to provide more accurate estimates of the effect sizes associated with the changes in depression, anxiety and quality of life before and after treatment.