Parental mental health screening in paediatric cardiology clinics: a feasibility and acceptability study
Andrea DeTemple Smith, Leandra Bitterfeld, Alexa Black, Kristi Lewis Glotzbach, Nelangi M. Pinto, Laura K. Wood, Zhining Ou, Sean Cunningham, Whitnee HoganAbstract
Objective:
To evaluate the need, feasibility, and acceptability of parental mental health screening in cardiology clinics and explore the relationship between social risk factors and parental mental health.
Study design:
Single-centre pilot study in two outpatient cardiology clinics. Participants were parents or caregivers of a fetus or child with CHD. Parental mental health was assessed using the Depression, Anxiety, and Stress Scale – 21 Items and the Edinburgh Postnatal Depression Scale. A validated social risk factor screener was also completed. Parents with positive screening results were referred for follow-up with the clinic social worker.
Results:
A total of 131 participants enrolled, with an 83% consent rate. A total of 30% of participants screened positive for depression, anxiety, and/or stress. Among participants with a positive mental health screen, 36% did not have a previous mental health diagnosis; most were not currently receiving mental health services, and more than half were interested in receiving mental health services. Rates were similar between the prenatal and postnatal/early childhood years. Participants with a positive mental health screen had higher rates of several social risk factors. Acceptability was high, and the clinic social worker spent an average of 34 min per participant providing follow-up care.
Conclusion:
Stress, anxiety, and depression are common in parents/caregivers of a fetus or child with CHD. Longitudinal mental health screening in paediatric cardiology clinics identifies parents at risk for psychosocial challenges and structures related supports. Intervention sustainability using this approach is dependent on post-screening follow-up from social work support or staff with similar expertise.