ArticleLupus science & medicine2024
Improving routine mental health screening for depression and anxiety in a paediatric lupus clinic: a quality improvement initiative for enhanced mental healthcare.
Article in Lupus science & medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Impact of race on comorbidity burden and clinical outcomes among Southeast Asians with lupus nephritis: a single-center retrospective study.International urology and nephrology · 2026Article
- Mental health monitoring in adolescents with SLE: associations with lupus low disease activity state and remission.Lupus science & medicine · 2026Article
- Article
- Mental health needs of children and young people with arthritis.Arthritis research & therapy · 2026Review
- Using a Mental Health Care Navigator to Overcome Barriers to Care in Childhood-Onset Systemic Lupus Erythematosus.ACR open rheumatology · 2025Article
- Improving Mental Health Care for People With Systemic Lupus Erythematosus: Time to Take Action.The Journal of rheumatology · 2025Article
- Effects of environmentally-induced anxiety on autoimmunity in the MRL/lpr mouse.Lupus science & medicine · 2025Article
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19 authors.
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Abstract
backgroundMental health (MH) conditions are prevalent in adolescents with childhood-onset SLE (cSLE). Early identification is crucial in preventing poor patient outcomes; however, MH screening rates remain low. LOCAL PROBLEM: From July 2021-January 2022, only 15% of adolescents in a paediatric tertiary care cSLE clinic were being screened for depression and anxiety. By November 2023, we aimed to increase the percentage of patients with cSLE (≥12-18 years) screened for depression (Patient Health Questionnaire: PHQ-9) and anxiety (Generalised Anxiety Disorder-7: GAD-7) from 15% to 80%.
methodsThis quality improvement project employed the Model for Improvement framework. Stakeholders included the clinic team, patients and families, and MH providers. Statistical process control charts were used to analyse the outcome measure for percentage of screened patients with cSLE. Patient and caregiver satisfaction surveys were conducted at baseline and after screening as a balancing measure.
interventionsMH screening workflow with a referral algorithm was developed with stakeholders. Additional interventions included two MH training workshops for healthcare providers and a preclinic reminder of eligible patients for screening.
resultsOver 21 months, 146 patients with cSLE completed 270 MH screens, increasing the screening rate from 15%, peaking at 100%, to a median of 56%. Sixty-six individuals (45%) reported symptoms of depression and/or anxiety on their initial screen. Of 270 screens, 44 individuals (17%) reported moderate to severe symptoms meeting the screening workflow criteria for referral to a MH service; 10% of patients screened were referred and seen by the MH service within 2-12 weeks. Patients and caregivers reported satisfaction with the MH screening process and quality of MH follow-up.
conclusionDespite not sustainably meeting the target, MH screening rates increased in the cSLE clinic by nearly fourfold, demonstrating feasibility and acceptability. Patients expressed satisfaction with their mental health follow-up, emphasising its importance in their care.
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