LAUSR

Incorporating psychological care into routine inflammatory bowel disease (IBD) management makes good sense. Psychological problems are highly prevalent in people with IBD and are a challenge for IBD management. Australian national IBD standards state that psychological screening and treatment are needed to improve quality of life and support medical management, yet only a minority of patients report having access to such services. In 2015, our hospital-based IBD service implemented colocated psychological care and evaluated this novel integrated model over 2 years. High rates of distress were found, as well as high rates of participation in screening and treatment, and the model was cost-effective. Since this evaluation, the integrated model of care has continued in the IBD Service, now purposely offering routine psychological assessment to all ‘new to service’ patients (i.e. those newly diagnosed, transitioned from children’s services or another care setting). The main aims are early identification of mental health needs and holistic management of IBD. All new patients are scheduled an appointment with the in-service psychologist, during which a brief assessment of psychosocial functioning and coping is conducted. Screening questionnaires are administered to identify any current problems and/or support needs. Education is provided on the link between mental health and physical health. Psychological therapy is offered where results indicate need. A brief audit of this service revealed that approximately one new patient per week was booked an IBD psychology appointment (n= 150) betweenMarch 2018 and February 2021. Three-quarters (76%) of these appointments were attended (Fig. 1). Two-thirds (66%) of attendees completed psychological screening questionnaires. Two-thirds (68%) of patients who completed screening questionnaires scored within the range for likely psychological distress (34%of the total invited cohort). Of patients (n = 114) who attended the initial appointment, 28% needed and accepted an offer of intervention, 7% needed and declined intervention, 11% were already participating in therapy external to the hospital and 54% were not ‘in need’. In the subgroup (n = 51) that completed questionnaires and scored in the range for likely distress, approximately half (55%) accepted psychological treatment (19% of the total invited cohort). Regarding overall referrals to the IBD psychology service, ‘new to service’ patients account for just over one-third (37%) of the people seen. The remaining referrals are for existing patients: with 55% through doctors or IBD nurses and 8% being self-referrals. This brief audit of routine psychological assessment of new patients at our hospital-based IBD Service shows