(57) QI: Improving Access to Mental Health Services in the Cystic Fibrosis Population

Background: Mental health has a tremendous impact on patients with cystic fibrosis (CF) ability to manage their disease, which may impact their long-term health-related quality of life. Cronly, et. Al (2019)¹ concluded that “Mental health variables, depression, and anxiety were strongly associated with health-related quality of life in subjects with cystic fibrosis and demonstrated greater effect sizes and explained a higher proportion of the variance overall than the physical indicators, FEV1% and body mass index, which highlighted the importance of screening for, and treating, depression and anxiety symptoms”. Access to mental health services (MHS) has historically been sporadic at our center, with partially availability from a CF Foundation Mental Health Coordinator grant (2015-2018). Between 2018- August 2021, our patients had no access to mental health services directly in clinic. We chose the quality improvement objective of improving long-term access to MHS at our center with the specific aim of increasing the percentage of patients with access to mental health services from < 10% to >85% by September 1, 2022.

Methods: A determination of the baseline patient access to MHS at WVU was performed using a review of electronic medical records. Mental health services were determined for the previous 12 months to be less than 10%. In August 2021, a clinical psychologist joined the CF team, enabling the center to successfully integrate her services into clinical care. The MHS visits have been prospectively followed by the tally to track method since 9/1/21. This process is ongoing.

Results: The baseline rate of MHS was 2(1)% patients. After introduction of MHS in routine CF clinics with the availability of the clinical psychologist, patient access increased from < 10% to 59.8% as of March 31, 2022. Out of 169 unique patients, clinical psychology has made contact with 101 patients (59.8%)

Conclusions: Mental health services are vital for improving health-related quality of life for patients with cystic fibrosis. Based on this knowledge, we set the goal to improve access to mental health services in our population from < 10% to >85% in a 12-month time. Within 7 months, we have increased access to 58%; among those patients, 8(5%) are engaged in regular therapy sessions. As we continue to expand access, we expect these numbers to grow. As a secondary improvement arm, we may look in future at the health outcomes of those patients engaging in therapy.

Acknowledgements:

References: ¹Cronly, et. Al (2019) Health Related Quality of Life in Adolescents and Adults With Cystic Fibrosis: Physical and Mental Health Predictors, Respiratory Care, 64(4).,406-415.