Increasing access to psychological treatments for adults by improving uptake and equity: rationale and lessons from the UK.

objectivesAccess to psychological treatments has been defined by Gulliford as comprising supply, effectiveness, equity and uptake. In the UK, a recent national programme "Improving Access to Psychological Treatments" has significantly increased supply and assessed effectiveness, but paid less attention to uptake and equity. The model developed by Gask et al. delineating processes relevant to improving access for 'hard-to-engage' groups in the UK, including black and minority groups seems relevant. This paper presents studies of a large-scale 'community workshop' intervention model developed by Brown to improve access for adults in the UK, designed to improve uptake and equity. We describe two 'community workshop' interventions for common mental health problems to which people have been able to self-refer and where uptake and equity have been high. Key components of this model are a 'group-sensitive engagement' ethos which includes self-referral, non-diagnostic titles of the intervention, a non-mental health setting, face-to-face presentation as well as a brief intervention and an acceptable format.

conclusionThe model of community workshops with its 'group-sensitive engagement' ethos to which adults can self-refer may be very relevant in providing access for people with mental health needs in national and international settings.