The Severe Eczema and Psoriasis Team at St. John’s Institute of Dermatology, St Guys’ and St Thomas’ NHS Foundation Trust in London, U.K. report that the psychological support needs of dermatology patients are not being adequately met. That’s according to a press release from the British Association of Dermatologists (July 7, 2016).
Depression, anxiety being missed
To assess this study parameter, the team utilized a system where dermatology patients waiting for their appointments completed digital surveys on tablet computers, using pre-selected and validated questionnaires relevant to their skin condition. Results from the questionnaires were then used to alert physicians to any issues with emotional wellbeing of patients, and to immediately suggest treatments or referral pathways. Patients that need psychological support were then either offered self-help materials or offered a referral to a psychologist on the team or a psychiatry liaison.
Strikingly, 71% of the patients who were subsequently diagnosed with major depressive illness, and 88.6% with anxiety, had previously been unrecognized as having mental health problems.
Team striving for holistic care
Before implementing the new screening system that was developed from this study, the team believed they were already providing holistic care, said Professor Catherine Smith, a consultant dermatologist with the team. “This rigorous and systematic approach to providing holistic care within our team has reaped huge benefits for our patients, who previously might have had unrecognized morbidity. Prior to evaluating our service and introducing this new approach, we considered that we were already providing holistic care.”
“Identifying the high needs of our patient population motivated us to fully integrate psychological support with treatment of the physical symptoms of skin disease throughout the visit to our service,” said Professor Smith. “By taking this methodical approach we were also able to quantify and justify the need for a full time clinical health psychologist on staff.”
The digital questionnaire system was developed by the Integrating Mental & Physical healthcare: Research, Training & Services (IMPARTS) team; an initiative funded by King’s Health Partners to integrate mental and physical healthcare in research, training and clinical services at Guy’s, St Thomas’s and King’s College Hospitals in London, as well as South London and Maudsley NHS Foundation Trust.