Too many people failing to get mental health services they need: experts
OTTAWA, March 19, 2013 /CNW/ - New guidelines released today for physicians, nurses and allied health professionals recommend depression screening for all individuals living with stroke and their caregivers. The incidence of depression in both groups exceeds 30 per cent - and too many people fail to receive proper care, according to experts.
"The occurrence of post-stroke depression and changes to cognition affect a large proportion of patients who have experienced stroke," says Dalhousie University professor Dr. Gail Eskes, who chaired an expert national panel on Mood and Cognition in Patients Following Stroke. "Of equal concern is the large number of spouses and informal caregivers who experience depressive symptoms in the post-stroke recovery phase."
New recommendations, posted at www.strokebestpractices.ca, will be widely disseminated in the Canadian health-care community. Recent reports on the quality of stroke services in Canada show inconsistent screening and monitoring of stroke patients for depression and cognitive changes, even in large urban centres. Treatment delays may lead to poor outcomes, prolonged recovery and desperation on the part of patients and families.
This update to the Canadian Best Practice Recommendations for Stroke Care marks a new emphasis on psychological care of family and caregivers in addition to stroke patients. Depression can happen at different points in the recovery process - from months to years after the stroke. Annual assessment is recommended for patients and caregivers, who should have access to specially trained providers with expertise in mental health, neuropsychology, psychiatry and occupational therapy.
"Stroke impacts on the whole family, not just the person who has suffered a stroke," says neuropsychologist Dr. Elizabeth Gilchrist of Glenrose Hospital in Edmonton, who helped develop the new recommendations. "Just like the patient, families and caregivers are at heightened risk of depression after a loved-one has had such a health crisis. With these new guidelines, there is not only recognition of the value of regularly monitoring the mood of patients but of the importance of doing so for the patient's family and caregivers."
Neurologist Dr. Eric Smith of the Calgary Stroke Program, a member of the expert panel says: "Depressive symptoms are very common and may inhibit full recovery from stroke, including return to work. Depression is not seen only in severe strokes. Many patients with milder strokes, even strokes that appear to have resolved completely, may be still affected by depression or cognitive problems that decrease quality of life."
Recommendations also highlight the need to screen stroke patients for cognitive decline and dementia. Research shows that two-thirds of patients experience cognitive impairment (changes to the way they think) and as many as a third of patients develop dementia. Mortality rates among stroke patients with cognitive impairment are double those of other patients.
The Canadian Best Practice Recommendations for Stroke Care is a joint initiative of the Canadian Stroke Network and the Heart and Stroke Foundation.
There are about 50,000 strokes in Canada every year and 300,000 people living with the after-effects of stroke. Stroke is a leading cause of adult disability and a leading cause of death. Learn more by visiting www.strokebestpractices.ca.
The Canadian Stroke Network (www.canadianstrokenetwork.ca) is a national research network headquartered at the University of Ottawa. It includes scientists, clinicians and health-policy experts committed to reducing the impact of stroke.
The Heart and Stroke Foundation, a volunteer-based health charity, leads in eliminating heart disease and stroke, reducing their impact through the advancement of research and its application, the promotion of healthy living and advocacy. Healthy lives free of heart disease and stroke. Together we will make it happen. Heartandstroke.ca
The Foundation is asking all Canadians to Make Health Last by taking action today to give themselves, their friends and families longer, healthier, fuller lives. Take the Heart&Stroke risk assessment today at makehealthlast.ca
SOURCE: CANADIAN STROKE NETWORK
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