P376 Prevalence and treatment of severe mental health symptoms at 120 cystic fibrosis centres: clinician preparation to intervene and sustain mental health screening

Impact of COVID-19 on mental health: Effects on screening, care delivery, and people with cystic fibrosis

“…Despite the substantial reduction in rates of screening , 71% of pwCF with elevated depression symptoms received psychological interventions in clinic and 67% were referred to community providers. This compares favorably with previous MHC survey data across the first 3 years of mental health guideline implementation, pre-pandemic [ 11 , 18 , 19 ]. In Year 1, with the initiation of MHC grants to 84 CF centers, 33% of patients with elevated symptoms of depression received psychological interventions in clinic and 17% were referred to community providers; in Year 2, interventions in clinic were provided to 75% of those with depressive symptomatology, with 12% referred to the community; in Year 3, when many centers were in their last year of grant support with no certainty of sustaining future funding, 47% of those with elevated symptoms of depression received interventions in clinic, with 31% referred to community providers.…”

“…3 ). These successes are nearly identical to the top five successes reported in Years 1-3 of the MHC survey, although they appeared in slightly different order [ 11 , 18 , 19 ].

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“…Average screening numbers from the CF Foundation Patient Registry, reported by CF centers beginning in 2015, show that by 2019, over 83% of adolescents and over 90% of adults completed annual mental health screening [20] . Furthermore, the MHC survey in Year 2 of grant funding [18] indicated that 8,566 pwCF were screened in the past 12 months. Given that the COVID-19 survey captured only 6 months of data, we would have expected over 4000 pwCF to be screened by mid-year, however, the COVID-19 data indicates that only 785 and 779 were screened for depression and anxiety, respectively, which represents 18% of the expected screening rate.…”

“…Suicidal ideation during the pandemic (assessed with question #9 on the PHQ-9) was endorsed by 3.1% of pwCF. Although direct comparisons are difficult to make given that the COVID-19 survey was based on 6 months of data, in both Years 1 and 2 of the MHC surveys, 52.4% and 49.7% of those screened were in the elevated range, including mild to severe symptomatology, on either or both screeners, and endorsement of suicidal ideation was 2.8% in Year 1, 3.8% in Year 2 and 4% in Year 3 [ 18 , 19 ].…”

“…Rates of screening dropped precipitously in the first six months of the pandemic; 40% of programs stopped screening, and screening rates decreased in 60% of programs that continued screening. These rates represent only 18% of the expected number of screenings over 6 months, based on MHC survey data from 2018 in which 125 CF programs were funded for mental health screening and treatment [18] .…”