Outcomes of a mental health screening program for adults with congenital heart disease

Adult congenital heart disease (ACHD) patients face a significant burden of mental health challenges related to their primary cardiac disease.

This study characterizes the outcomes of mental health follow up, the prevalence and associated risk factors for mental health concerns in our single center ACHD population.

The Wisconsin Adult Congenital Heart Disease (WAtCH) program began an outpatient mental health screening program in May 2021 using the Patient Health Questionnaire-4 (PHQ-4). Through a retrospective chart review of ACHD patients seen from May 3, 2021, to May 5, 2022, we report on outcomes of a mental health referral process for ACHD patients with positive mental health screens. We also examined associations between mental health screens and patient demographic and clinical variables.

Among 778 ACHD patient encounters (from 681 patients), there were 213 (27.4 %) positive mental health screens. Of 157 patient encounters with a positive screen and a recorded mental health disposition, 55 (35 %) reported no preexisting mental health provider. Patients at 21 of these encounters accepted a mental health referral, resulting in 3 completed appointments with an in-house mental health specialist. Younger age, female gender, minority race, great complexity congenital heart disease (CHD), were independently associated with a positive screen.

We found limited established mental health care and a low rate of mental health follow up in our ACHD population with a positive mental health screen. Several demographic and disease related factors are related to a greater risk of mental health concerns in ACHD patients.