Introduction

Welcome to the Common Mental Health Disorders Profiling Tool. It has been developed to support an intelligence driven approach to understanding and meeting need. It collates and analyses a wide range of publically available data on prevalence, risk, prevention, early intervention, assessment, treatment, outcomes and service costs. It provides commissioners, service providers, clinicians, services users and their families with the means to benchmark their area against similar populations and gain intelligence about what works.

Tool structure - data are presented under the headings Risk and Related Factors, Prevalence, Services, Quality and Outcomes, and Finance. Within this they are grouped by geography (Clinical Commissioning Group, Sustainability and Transformation Partnership or local authority) and then ordered by topic (e.g. primary care followed by secondary care).

Tool content - data are drawn from many sources and vary by time period, population and presentation of values. Care should be taken with interpretation. Detailed meta data and any caveats are set out in the Definitions section.

Data quality - indicators are included if viewed as robust, of sufficient quality, or they offer an important element that could not be otherwise gained. Each indicator has been assessed and labelled with its quality rank.

 

Common Mental Health Disorder Pathway

The Common Mental Health Disorder Care Pathway is a high level summary using key indicators to help commissioners assess and benchmark how they manage this important condition. The aim is to ensure that this approach is consistent with and linked to the Commissioning for Value packs published by NHS England.

 

Supporting Documents

Recent updates

November 2017

Opportunity for feedback: We are very interested in any feedback on the downloadable outputs which are available from the download section of the tool.

Please complete the survey by clicking here

11 monthly IAPT indicators with data from April 2017 – June 2017 

Four of the IAPT indicators below also appear in the CMHD Pathway domain

Services domain one indicator

  • Access to IAPT services

Quality and Outcomes domain ten indicators

  • IAPT recovery
  • IAPT DNAs: % of IAPT appointments
  • Paired data completeness
  • Waiting < 6 weeks to enter treatment (supporting waiting time measure)
  • Waiting < 18 weeks to enter treatment (supporting waiting time measure)
  • Waiting < 6 weeks for treatment (waiting time standard measure)
  • Waiting < 18 weeks for treatment (waiting time standard measure)
  • Average wait to enter IAPT treatment: Mean wait(in month) for first treatment (Days)
  • Average IAPT treatment dosage
  • Maximum IAPT treatment dosage

Two indicators updated in finance domain with Q1 2017 -18 data.

  • Cost of GP prescribing for hypnotics and anxiolytics
  • Cost of GP prescribing for antidepressant drug

October 2017

Opportunity for feedback: We are very interested in any feedback on the downloadable outputs which are available from the download section of the tool.

Please complete the survey by clicking here


Two indicators updated:

Quality and Outcomes domain one indicator

  • Employment of people with mental illness or learning disability: % of those with a mental illness or learning disability

Risk and related factors domain one indicator

  • Migrant GP registrations: rate per 1,000 population

In addition, STP geography has been added for a number of indicators that are available at CCG level.

September 2017

Twelve indicators updated:

6 Quarterly IAPT indicators Quarter 4 – 2016/17:

Services domain five indicators

  • IAPT referrals
  • IAPT ethnic group coding completeness
  • IAPT use by BME groups
  • Entering IAPT treatment
  • Completion of IAPT treatment

Quality and Outcomes domain one indicator

  • IAPT reliable improvement

Risk and related factors domain one indicator

  • Supported asylum seekers updated to Q1 2017

Prevalence domain two indicators

  • Long-term mental health problems (GP Patient Survey)
  • Depression and anxiety prevalence (GP Patient Survey)

Quality and Outcomes domain one indicator

  • Gap in employment: % gap between employment rate of those with mental health disorders or learning disabilities & overall population

Finance domain two indicators

  • Cost of GP prescribing for hypnotics and anxiolytics
  • Cost of GP prescribing for antidepressant drugs

August 2017

Twenty indicators updated:

3 Annual prescribing indicators in the services domain 2016/17

  • Antidepressant prescribing: average daily quantities (ADQs) per STAR-PU
  • Hypnotics prescribing: average daily quantities (ADQs) per STAR-PU
  • Primary care prescribing of '1st choice' antidepressants: % of prescription items

 

6 Quarterly IAPT indicators Quarter 3 – 2016/17

Services domain 5 indicators.

  • IAPT referrals
  • IAPT ethnic group coding completeness
  • IAPT use by BME groups
  • Entering IAPT treatment
  • Completion of IAPT treatment

Quality and Outcomes domain one indicator.

  • IAPT reliable improvement

11 monthly IAPT indicators  with data from September 2016 – March 2017 

Quality and Outcomes domain 11 indicators

  • Access to IAPT services
  • IAPT recovery
  • IAPT DNAs: % of IAPT appointments
  • Paired data completeness
  • Waiting < 6 weeks to enter treatment (supporting waiting time measure)
  • Waiting < 18 weeks to enter treatment (supporting waiting time measure)
  • Waiting < 6 weeks for treatment (waiting time standard measure)
  • Waiting < 18 weeks for treatment (waiting time standard measure)
  • Average wait to enter IAPT treatment: Mean wait(in month) for first treatment (Days)
  • Average IAPT treatment dosage
  • Maximum IAPT treatment dosage

July 2017

11 new indicators added from the IAPT annual report 2015/16 to the availability of therapy type domain.

Two indicators updated in finance domain.

  • Cost of GP prescribing for hypnotics and anxiolytics
  • Cost of GP prescribing for antidepressant drugs

 

14 indicators migrated to Quality & Outcomes domain.

  • Average waiting time between 1st & 2nd treatment
  • Percentage waiting < 28 days between 1st & 2nd treatment
  • 6 measures for the Patient Health Questionnaire-9.
  • 6 measures for the Generalized Anxiety Disorder 7 Questionnaire

 

June 2017

19 new indicators added from the IAPT annual report 2015/16.

Two new indicators in the CMHD pathway domain

  • Average waiting time between 1st & 2nd treatment
  • Percentage waiting < 28 days between 1st & 2nd treatment

Seventeen new indicators in the outcomes by problem descriptor domain.

  • 5 indicators which show the % of referrals finishing a course of treatment in the year with appropriate paired Anxiety Disorder Specific Measures by problem descriptor.
  • 6 measures for the Patient Health Questionnaire-9.
  • 6 measures for the Generalized Anxiety Disorder 7 Questionnaire

April 2017

2 indicators updated from the IAPT annual report 2015/16.

Two indicators in the outcomes by problem descriptor domain 

  • Recovery rate for depression (Annual): % of referrals finishing a course of treatment who are "moving to recovery"
  • Recovery rate for obsessive compulsive disorder (Annual): % of referrals finishing a course of treatment who are "moving to recovery

6 indicators updated from Q2 2016/17 July to Sept 2016 IAPT quarterly report.

 Five indicators in the services domain

  • IAPT use by BME groups: % of referrals (in quarter) which are for people of black and minority ethnic groups
  • IAPT referrals: Rate (quarterly) per 100,000 population aged 18+
  • Completion of IAPT treatment: Rate (quarterly) completing treatment per 100,000 population aged 18+
  • Entering IAPT treatment: Rate (quarterly) beginning IAPT treatment per 100,000 population aged 18+
  • IAPT ethnic group coding completeness: % of referrals (in quarter) with a valid ethnic group code

One indicator in the quality and outcomes domain.

  • IAPT reliable improvement: % of people (in quarter) who have completed IAPT treatment who achieved "reliable improvement"

March 2017

33 indicators updated from the IAPT annual report 2015/16

  • 26 indicators updated in the outcome by problem descriptor domain
  • 7 indicators in the availability of therapy type domain

February 2017

11 Monthly IAPT indicators in the quality and outcomes domain and 1 indicator in the Risk factors domain updated

 

  • Eleven monthly IAPT indicators have been updated for July - Sept 2016: they include indicators on access, recovery and reliable improvement rates, non-attendance rates and waiting times. These are in the quality and outcomes domain.
  • Supported asylum seekers per 10,000 in the risk and related factors domain.

 

December 2016

SIX IAPT INDICATORS UPDATED

The CCG quarterly data for Q1 2016/17 April to June 2016 has been uploaded this month.

 

Five indicators in the services domain

  • IAPT use by BME groups: % of referrals (in quarter) which are for people of black and minority ethnic groups
  • IAPT referrals: Rate (quarterly) per 100,000 population aged 18+
  • Completion of IAPT treatment: Rate (quarterly) completing treatment per 100,000 population aged 18+
  • Entering IAPT treatment: Rate (quarterly) beginning IAPT treatment per 100,000 population aged 18+
  • IAPT ethnic group coding completeness: % of referrals (in quarter) with a valid ethnic group code

 

 

One indicator in the quality and outcomes domain.

  • IAPT reliable improvement: % of people (in quarter) who have completed IAPT treatment who achieved "reliable improvement"

 

 

THREE QUALITY AND OUTCOMES FRAMEWORK DATA UPDATED FOR 2015/16

  • Depression prevalence
  • Depression incidence
  • Newly diagnosed patients with depression who had a review 10-56 days after diagnosis

 

GP SURVEY DATA UPDATED IN THE PREVALENCE DOMAIN

  • Depression and anxiety % of patients completing the GP patient survey

November 2016

* 11 IAPT INDICATORS UPDATED

* TWO PRESCRIBING INDICATORS UPDATED

* FURTHER INDICATORS UPDATED IN RISK & RELATED FACTORS, PREVALENCE AND QUALITY & OUTCOMES DOMAINS

 

Eleven monthly IAPT indicators have been updated for April – June 2016: they include indicators on access, recovery and reliable improvement rates, non-attendance rates, data completeness, waiting times and numbers of attended treatments. These are in the Quality and Outcomes domain 

The quarterly IAPT indicators have not been updated because they were not available from NHS Digital when updates were run.

Two prescribing indicators have been updated to Q1 2016/17: cost of GP prescribing for hypnotics and anxiolytics and cost of GP prescribing for antidepressant drugs. These are  in the Finance domain.

 Six indicators in the Risk and related factors domain have been updated:

  • Long-term unemployment
  • Statutory homelessness rate
  • Supported asylum seekers
  • Population turnover (internal migration)
  • Migrant GP registrations
  • Quality of indoor living environment

One indicator in the Prevalence domain has been updated:

  • Long term mental health problems among GP survey respondents

 A further four indicators in the Quality and outcomes domain have been updated

  • Support for people with LTCs
  • Gap in employment rate between those with mental health disorders & overall population
  • Satisfaction with social care support
  • Employment of people with mental health disorders

 

October 2016

IAPT INDICATOR REVISED

- the IAPT moving to recovery indicator in the Quality & Outcomes domain has been revised for the period December 2015 - March 2016. The data published in September had a small error as a result of numbers not at caseness being omitted from the denominator.

- the Domestic Abuse indicator in the Risk and related factors domain has been updated with 2014/15 data.

September 2016

* 17 IAPT INDICATORS UPDATED

- 11 indicators in the Quality and Outcomes domain and 6 indicators in the Services domain for CCGs relating to IAPT, have been updated for January - March 2016.

- 5 of these updated indicators also appear in the CMHD pathway domain.

August 2016

- Two indicators at CCG level based on prescribing data provided by the HSCIC and the NHS Business Services Authority have been updated for Q3 and Q4 2015/16, both in the Finance domain.

- Three indicators at CCG level based on prescribing data provided by the NHS Business Services Authority have been updated for 2015/16, all in the Services domain.

- Indicators that correspond to PHOF indicators and have been updated in the PHOF profile have been updated.

- Please note that the definition of the Mortality from suicide and injury undetermined, age standardised rate indicator, in the Quality and Outcomes domain, has been changed so that it is in line with the National Statistics definition, as such the values have changed slightly. Historic data has been changed, so all time periods use the same National Statistics definition.

 

July 2016

* 17 IAPT INDICATORS UPDATED

- 11 indicators in the Quality and Outcomes domain and 6 indicators in the Services domain for CCGs relating to IAPT, have been updated for October to December 2015.

 

May 2016

* CHANGES to PHOF, DEPRIVATION & PRESCRIBING INDICATORS:

- In the Risk and Related Factors and Pathway domains the Socioeconomic deprivation indicator has been updated for 2015.

- Indicators that correspond to PHOF indicators and have been updated in the PHOF profile have been updated.

- Two prescribing indicators in the Finance domain have been updated.

- The finished course of treatment indicator in the Quality & Outcomes and Pathway domains has been withdrawn pending a review of the indicator

April 2016

*20 IAPT INDICATORS & ONE RISK & RELATED FACTOR INDICATOR UPDATED:

- 14 indicators in the Services domain and 6 indicators in the Quality and Outcomes domain for CCGs relating to IAPT, have been updated for July to September 2015.

- In the Risk and Related Factors domain the Socioeconomic deprivation indicator has been updated for 2015.

 

March 2016

*TWO NEW DOMAINS ADDED: OUTCOMES BY PROBLEM DESCRIPTOR AND AVAILABILITY OF THERAPY TYPE:

- Indicators based on IAPT Annual Report 2014/15 data are included in the two new domains.

  1. Outcomes by problem descriptor domain

  • Completeness of problem descriptor
  • Recovery rates for referrals with a range of problem descriptors
  • Percentage of those finishing a course of treatment with each of the problem descriptors

   2. Availability of therapy type domain

  • Numbers of referrals finishing a course of treatment that receive a range of therapy types
  • Number of different high intensity and low intensity therapies available.

The IAPT Annual Report data has been used for these indicators to improve the levels of suppressed data due to small numbers of referrals. As data quality improves these indicators may be able to be reported on a more frequent basis in the future

*7 OTHER INDICATORS UPDATED:

- The indicators in the Quality and outcomes domain for CCGs related to IAPT waiting times and treatment dosage have been updated for April to June 2015.

February 2016

*11 IAPT INDICATORS UPDATED:

- 6 indicators in the Services domain and 5 indicators in the Quality and Outcomes domain have been updated with data for Q1 2015/16.

- 3 of the Quality & Outcomes domain indicators that had changed from quarterly to monthly reporting now include 6 months data and the quarterly data has been archived

*9 OTHER INDICATORS UPDATED:

- 3 Risk Factor indicators on socioeconomic deprivation, statutory homeless and children in poverty have been updated at County & UA and District & UA levels

- 4 Prevalence indicators related to self-reported wellbeing have been updated at County & UA level

- 2 CCG prescribing indicators in Finance domain have been updated 

January 2016

*7 NEW IAPT INDICATORS INCLUDED:

- New data from the monthly IAPT data reports is now included in the Quality and Outcomes domain by CCG for Q4 2014/15. The seven new indicators relate to waiting times (5 indicators) and treatment dosage (2 indicators).

*3 INDICATORS UPDATED:

- 2 Risk Factor indicators on looked after children and children leaving care updated at County & UA level

- 1 Quality & Outcomes indicator related to QOF exceptions for depression indicators updated at CCG level

 

December 2015

*12 INDICATORS UPDATED:

- 1 Risk Factor indicator on older people living in income deprived households updated at CCG level

- 4 Prevalence indicators updated at CCG level; two related to QOF depression and two related to GP Patient Survey data

- 1 Services indicator on IAPT problem descriptor completeness updated at CCG level

- 2 Quality & Outcomes indicators related to QOF depression updated at CCG level

- 4 Quality & Outcomes indicators related to IAPT services updated at CCG level, with three of the indicators moving from quarterly to monthly reporting due to changes in IAPT data reporting by HSCIC

November 2015

*1 INDICATOR UPDATED:

- 1 Quality & Outcomes indicator related to mortality from suicide and injury undetermined at County & UA level

 The Quality and Outcomes County & UA Indicators on employment of people with mental health have been slightly revised to be in line with published values based on unrounded numerators and denominators. This has resulted in confidence intervals not being available for the employment rate indicator.

October 2015

*12 INDICATORS UPDATED:

- 2 additional Risk Factor indicators now included at District & UA level as well as at County & UA level

- 3 Services prescribing indicators updated at CCG level

- 1 Quality & Outcomes indicator related to GP patient survey updated at CCG level

- 1 Prevalence indicator related to Adult Social Care Survey updated at County & UA level

- 1 Services indicator related to emergency admissions for neuroses updated at County & UA level and data at District & UA level now included

- 2 Quality & Outcomes indicators related to employment of people with mental health disorders updated at County & UA level

- 2 Finance prescribing indicators updated at CCG level

PROGRAMME BUDGETING DATA

New programme budgeting data for 2013/14 for CCGs is now included in the Finance domain. Due to changes in the way the data is reported, new indicators are now included:

  • Mental Health spend per head of population
  • Mental Health prescribing spend per head of population
  • Proportion of CCG spend that is on specialist Mental Health services

 

September 2015

*16 INDICATORS UPDATED:

- 4 additional Risk Factor indicators now included at District & UA level as well as at County & UA level

- 2 Quality & Outcomes indicators related to the Adult Social Care Survey updated at County & UA level

- 10 IAPT indicators updated for CCGs to March 2015. These updates use the new IAPT dataset formats provided by the HSCIC

- 4 IAPT indicators that are also in the CMHD Pathway updated

PROGRAMME BUDGETING DATA PROPOSALS

Programme budgeting data for CCGs is now available from NHS England for 2013/14. Due to changes in the way the data is reported, indicators in the Finance domain cannot be updated. Three new indicators are proposed:

  • Mental Health spend per head of population
  • Mental Health prescribing spend per head of population
  • Proportion of CCG spend that is on specialist Mental Health services

These new indicators will be included in the October update. At the same time the previous indicators based on programme budgeting data will be archived, unless there is a demand for these to remain in the tool. If you have any feedback on this please send to mhdnin@phe.gov.uk

 

June 2015

*20 INDICATORS UPDATED:

- All IAPT indicators updated for CCGs (16 indicators)

- IAPT indicators that are also in CMHD Pathway updated

- Cost of GP prescribing indicators for CCGs in Finance domain updated (2 indicators)

- Support for people with LTCs indicator based on GP Patient Survey data for CCGs updated in Quality & Outcomes domain (1 indicator)

- Depression and anxiety among GP survey respondents indicator updated to include survey data that fall within the financial year

 

 

 

March 2015

*26 INDICATORS UPDATED:

- All IAPT indicators updated for CCGs (16 indicators)

- IAPT indicators that are also in CMHD Pathway updated

- Updates to some Risk and Related Factors indicators for upper and lower tier local authorities (6 indicators)

- Updates to some Prevalence indicators for County & Unitary Authorities (4 indicators)

 

December 2014

*32 INDICATORS UPDATED:

 - All IAPT indicators updated plus new indicator on ethnicity coding completeness

 - New QOF indicators and updates

 - Updates to prescribing indicators

+ Updates to some Risk and Outcomes indicators

October 2014

*23 INDICATORS UPDATED *

CMHD pathway revised and finalised

+ NEW indicators:

- Contact with MH secondary care for people with CMHD

- IAPT patients finishing a course of treatment

August 2014

Updated indicator: People estimated to have any common mental health disorder:  Estimated % of population aged 16-74 (CCG level)

June 2014

First version released: