Care Center Corner

Case Study: Mental Health Guidelines Implementation at the NYULMC Fink CF Care Center

It will probably come as no surprise that individuals with chronic disease and caregivers are at increased risk for symptoms of depression and anxiety. After conducting and examining extensive research that supported this hypothesis, Dr. Alexandra L. Quittner, et al. developed recommended guidelines for the Implementation of Screening for Depression and Anxiety of CF Adolescents and their Parents in CFF accredited care centers. The guidelines were released in late 2014.

This report highlights the efforts of one of the care centers in the Greater New York area, NYULMC (New York University Langone Medical Center) Fink CF Care Center, led by Dr. Robert Giusti, as they work to put the guidelines into place:

Project Description:
The CF Foundation data indicated that CF adolescents were at increased risk for depression. Daily treatment burden may be contributing to depression. Research has demonstrated that depression in CF impacts adherence to recommended medical treatment and quality of life. The Fink CF Care Center’s priority is to identify CF patients affected by depression and connect them to the appropriate mental health care. The Fink CF Care Center Depression Screening Initiative goal is to increase the rate of depression screening of patients aged 12 and over from current level of 0% to 75% by July 2015.

In order to do this, the Fink CF Care Center team will intervene through use of 1) an adapted and refined depression and suicide screening algorithm, 2) depression screening using the Patient Health Questionnaire-9 (PHQ-9), 3) suicide risk screening using the Columbia Suicide Risk Severity Scale (C-SRSS), and 4) case management, psych evaluation and treatment referrals will be provided as appropriate.

Work Accomplished:
Since screening was initiated January 2015, 13 of 17 eligible adolescents (12-18) have been screened (as of 4/20).

Progress Evaluation/ Lessons Learned:
Despite cancelations due to weather, the screening for depression in the adolescent population is achievable within the care center setting and should be complete by July 2015. There is great need to develop a referral network that offers accessible care to patients from different social economic status, geographical area, and with different insurance providers.

Work Planned for Future Periods:
Moving forward, The Fink CF Center plans to expand depression screening to include parents and caregivers, expand anxiety screens for teens, and extend behavioral health treatment referral network in collaboration with CF Regional Medical Directors and the CF Foundation.

If you, or anyone in your family, are seeing a psychologist or social worker who is experienced with depression and/or anxiety as it relates to chronic disease/cystic fibrosis and you would be willing to share the name of the provider, please send their contact information to Trina Fontaine at kfontaine@cff.org so we can compile a list of options. Your identity will be held in strict confidence.