Digital mental health screening within neurological clinical healthcare settings: a systematic review

This review synthesises literature on the implementation of digital mental health (MH) screening in neurology healthcare services and summarises information about its feasibility, acceptability and associated clinical outcomes.

Following prospective registration (CRD420251010397) we searched Embase, Medline, PsycINFO, and Central for peer-reviewed articles describing a digitally delivered MH screening procedure using a validated screener implemented in a real-world neurological care service for people of any age with a neurological disorder. Two authors reviewed articles and extracted data. Study quality was assessed for articles reporting outcome data. Of 10,633 abstracts and 228 full-text articles, 31 met eligibility criteria.

Articles spanned 10 neurological disorders (most commonly epilepsy) and primarily screened depression and anxiety. Screening was delivered via tablets, kiosks/clinic computers, or patients' devices and often integrated with electronic medical/health record systems. Completion rates varied but acceptability was generally high among clinicians and patients. Positive MH screening results were commonly associated with clinical follow-up such as symptom discussion, medication initiation or adjustment, and referrals. Some services used predefined score thresholds to trigger MH care pathways. Limited pre-post evidence suggested digital screening may increase detection of depression and anxiety, but risk of bias was common, and no articles assessed impacts on MH outcomes over time.

A subset of articles suggest that digital MH screening appears feasible and acceptable in real-world neurology settings and may improve detection, facilitate doctor-patient communication, and prompt treatment-related actions. These findings may inform the integration of MH screening in neurological care, particularly during pre-implementation planning.