P313 Understanding Inflammatory Bowel Disease patients’ experiences, expectations, and insights in identifying and managing anxiety and depression.

Zelinsky, S.(1)*;Daley, K.(2);Patel, A.(3);Jeffs, L.(4);Zeng, L.(5);Targownik, L.(3);

(1)University of Calgary, Community Health Sciences, Calgary, Canada;(2)IMAGINE SPOR Network, Patient Engagement, Hamilton, Canada;(3)University of Toronto, Gastroenterology, Toronto, Canada;(4)University of Toronto, Faculty of Nursing, Toronto, Canada;(5)University of Toronto, Mount Sinai Hospital, Toronto, Canada;

Background

Patients living with Inflammatory Bowel Disease (IBD) commonly experience mental health (MH) challenges, specifically anxiety and/or depression. Although, there is a growing awareness of the relationship between IBD and MH; detection, treatment, and management amongst care providers is limited. The purpose of this patient-oriented, qualitative study was to explore IBD patient experiences, perspectives, and insights of living with MH challenges and to understand their interactions with GI clinicians, from diverse care settings, to determine how to best support IBD and MH in IBD care.   

Methods

Convenient and snowball sampling was used to recruit adult participants diagnosed with IBD and who had experience of living with MH challenges and were seeing a Gastroenterologist in Canada. This qualitative descriptive study used online focus groups to collect data. Focus groups were audio recorded and transcribed verbatim. Data was analyzed using thematic analysis.

Results

Twenty-four participants from across Canada, both from rural and urban locations, participated in the study. IBD patient participants indicated that MH should be discussed by GI’s as part of routine clinical practice. All participants indicated that there is a lack of resources and access to MH services for IBD patients. Four main themes emerged from the data: 1) experiences with IBD: difficulties related to reintegrating into social settings, feelings of loneliness; 2) expectations around mental health support: the need to develop their own resiliency strategies due to the lack of structural resources regarding mental health and IBD in the clinical space; 3) GI engagement: HCPs were dismissive of mental health symptoms, often gaslighting patients when mentioning mental health concerns during clinical encounters; and 4) expectations: a need to standardize mental health care across IBD care settings with a focus on integrating specialized healthcare providers as part of multidisciplinary care teams to help address the need for mental health supports for IBD patients in Canada.

Conclusion

Effective detection, awareness, management, and the integration of patients’ perspectives and insights can help inform the development of mental health supports and services to help improve IBD care to a more wholistic approach to care. Results from this study will be interpreted in line with insights gathered from upcoming interviews of gastroenterologists and HCPs.