Evaluating the Effectiveness and Cost Effectiveness of BSL (British Sign Language) IAPT (Increasing Access to Psychological Therapies).

IAPT (Improving Access to Psychological Therapies) is a national (England) NHS programme for rolling out NICE approved psychological interventions to manage mental health problems (principally depression and anxiety) in primary care. BSL-IAPT (called ‘BSL Healthy Minds’) is an adapted version to meet the cultural and linguistic needs of Deaf people who use British Sign Language.

Overarching research questions: (i) Is BSL-IAPT more effective than standard IAPT for Deaf people with anxiety and depression? (ii) Is any additional benefit from BSL-IAPT worth any additional cost?

The study will evaluate the differences for Deaf people with anxiety and/or depression if they use BSL-IAPT in comparison with accessing Standard IAPT. It will compare how much Deaf people’s mental health improves if they use BSL-IAPT compared with using standard IAPT. It will work out if one is more expensive than the other. If so, it is worth it? There may be no differences.

Following the MRC Complex Interventions Framework, the first two phases of the study, ‘modelling’ and ‘feasibility’, will lay the groundwork for the full trial, should one be justified. We will: (i) investigate the acceptability of randomisation amongst Deaf people; (ii) compare previous IAPT outcomes of Deaf people; (iii) produce replicable descriptions of Standard IAPT accessed by Deaf people and BSL-IAPT; (iv) translate and validate the Euroqol EQ-5D into BSL; (v) establish clinical cut-offs for PHQ-9 BSL, GAD-7 BSL, and WSAS BSL; (vi) undertake exploratory economic evaluation: and (vii) conduct a pilot trial. Completion of these elements determines whether a full RCT could be undertaken or not.

Should this lead to a full trial, this study will provide an evidence base for decision making about whether the adapted provision best addresses the needs of Deaf people, is cost effective and whether it should be extended nationally.