Abstract
Purpose :
Loss of vision has been linked to loneliness, social isolation, and feelings of worry, anxiety, fear and depression and younger age, a non-white ethnicity, and poorer self-reported health and visual function are risk factors for significant depressive symptoms. Prior to this study, we encountered a suicidal patient who was about to undergo sight-saving treatment but the procedure had to be abandoned due to mental ill health. This study sought to determine whether mental health assessments are conducted in research patients circa consenting and the prevalence of mental health issues among patients in an ophthalmic CRF as the UK national guidance states that all patients with a functional impairment should be assessed for depression using validated measure.
Methods :
Hospital Anxiety and Depression (HADS) questionnaire was administered to all patients aged 18 years and older attending the ophthalmic CRF between January - February 2020 (pre-COVID in the UK). As per scoring matrix, non-cases scored 0-7, borderline cases scored 8-10, and cases scored ≥11. Patients who scored ≥8 were asked whether they wanted to be referred to the counselling service. The nursing team conducted 6 monthly follow-up phone calls to monitor the patient’s on-going need for psychological support.
Results :
N=122 patients, aged 21-99 years were seen. As per HADS scoring, 52.5% (n=64) of patients were non-cases, 9.8% (n=12) were borderline cases and 37.7% (n=46) were cases. No assessment for mental health status was found in the patient’s medical notes at the time of consent. None of the patients wanted to be referred for psychological support at time of assessment. Patients reported that they “really appreciated” the 6-monthly phone calls. They expressed the reason for their anxiety was that they “did not understand the research process” and “what was supposed to happen to them” but “they needed to be involved in the research as its sight-saving treatment”.
Conclusions :
Patients may have a history of mental health issues before attending the Clinical Research Facility. This is not assessed on admission/ circa consenting. Poor understanding of research procedures and processes may exacerbate previously existing mental health issues. Inclusion of on-going mental health assessment throughout the research process will contribute to the psychological safety of the patient.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.