Identifying targets for improving mental healthcare of adolescents with systemic lupus erythematosus: Perspectives from pediatric rheumatology clinicians in the United States and Canada

Andrea M. Knight, Michelle E. Vickery, Eyal Muscal, Alaina M. Davis, Julia G. Harris, Arzu Soybilgic, Karen B. Onel, Laura E. Schanberg, Tamar Rubinstein, Beth S. Gottlieb, David S. Mandell, Emily Von Scheven

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Objective. To identify targets for improving mental healthcare of adolescents with systemic lupus erythematosus (SLE) by assessing current practices and perceived barriers for mental health intervention by pediatric rheumatology clinicians. Methods. Members of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) completed a Web-based survey assessing current mental health practices, beliefs, and barriers. We examined associations between provider characteristics and the frequency of barriers to mental health screening and treatment using multivariable linear regression. Results. Of the 375 eligible CARRA members, 130 responded (35%) and 119 completed the survey. Fifty-two percent described identification of depression/anxiety in adolescents with SLE at their practice as inadequate, and 45% described treatment as inadequate. Seventy-seven percent stated that routine screening for depression/anxiety in pediatric rheumatology should be conducted, but only 2% routinely used a standardized instrument. Limited staff resources and time were the most frequent barriers to screening. Respondents with formal postgraduate mental health training, experience treating young adults, and practicing at sites with very accessible mental health staff, in urban locations, and in Canada reported fewer barriers to screening. Long waitlists and limited availability of mental health providers were the most frequent barriers to treatment. Male clinicians and those practicing in the Midwest and Canada reported fewer barriers to treatment. Conclusion. Pediatric rheumatology clinicians perceive a need for improved mental healthcare of adolescents with SLE. Potential strategies to overcome barriers include enhanced mental health training for pediatric rheumatologists, standardized rheumatology-based mental health practices, and better integration of medical and mental health services.

Original languageEnglish (US)
Pages (from-to)1136-1145
Number of pages10
JournalJournal of Rheumatology
Volume43
Issue number6
DOIs
StatePublished - Jun 2016

Keywords

  • Anxiety
  • Depression
  • Mental Health
  • Pediatric Rheumatology
  • Systemic Lupus Erythematosus

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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    Knight, A. M., Vickery, M. E., Muscal, E., Davis, A. M., Harris, J. G., Soybilgic, A., Onel, K. B., Schanberg, L. E., Rubinstein, T., Gottlieb, B. S., Mandell, D. S., & Von Scheven, E. (2016). Identifying targets for improving mental healthcare of adolescents with systemic lupus erythematosus: Perspectives from pediatric rheumatology clinicians in the United States and Canada. Journal of Rheumatology, 43(6), 1136-1145. https://doi.org/10.3899/jrheum.151228