New Data Reveals Low Rates of Mental Health Support for Atopic Dermatitis Patients

Mental health can be a real struggle for people with atopic dermatitis (AD). Research has shown that AD is associated with anxiety, depression and social isolation.^1-5 With mental health being such a big factor in a patient’s experience, the National Eczema Association (NEA) research team wanted to investigate what type of mental health support AD patients receive, or don’t receive, from their primary eczema provider. The results were recently published in the Skin Health and Disease journal in June 2024. Read on to learn more about the findings.

Research methods 

NEA researchers conducted an online survey of US-based adults (18 years or older) and adult caregivers of children and teens (8–17 years) with AD. Survey participants were recruited through the NEA website, email, social media and EczemaWise app. More than 950 people completed the survey.

Among those who completed the survey, the majority were adults (83%), women (68%), white (67%), from urban areas (89%) and people who saw a specialist (such as an allergist or dermatologist) for their primary eczema care.

Mental health services in the survey were defined as but not limited to: counseling with a mental health provider; cognitive behavioral therapy; social support groups; alternative mental health therapy (such as music or art therapy); and/or mental health medications.

Key takeaways

Important findings from the study include: 

• 42% of patients with AD and caregivers of children/teens with AD never spoke about mental health with their primary eczema care providers
  
• 50% of patients were never asked about mental health by their primary eczema care provider during any visits
  
• 64% of adult patients and caregivers of young patients with AD were not referred to mental health resources
  
• The patients more likely to be referred to mental health services included children, men, those with limited education and people seeing nonspecialists

• If patients were referred to mental health resources, the most common referrals were to counseling services (23% of referrals), alternative mental health therapy (15%), cognitive behavioral therapy (13%) and peer/social support groups (12%) 

• Among those who received a referral for mental healthcare, 57% utilized the recommended services
  
• The patients more likely to have never spoken with their primary eczema care providers about mental health included women, people of low income and people seeing specialists (such as dermatologists or allergists) for their primary eczema care
  
• Young adults 18–34 years old frequently reported not being asked about their mental health but wanted to be

Why this research matters

“This is the first study to explore the mental health support received by patients with AD from their primary eczema care providers,” said Jessica Johnson, lead author of the study and director of community engagement and research at NEA. 

This survey showed that a significant portion of patients are not being asked about or did not speak to their eczema care provider about mental health. Furthermore, most patients with AD are not receiving referrals for mental health support. 

“We know about the emotional and psychological toll that AD can take on patients of all ages,” added Wendy Smith Begolka, senior author of the study and chief strategy officer at NEA. “Ideally, patients and healthcare providers would feel comfortable discussing mental health during their visits. Our study highlights the opportunity to help this discussion occur more consistently.” 

More research is needed to identify the most effective mental health interventions for patients with AD, as well as current barriers to referring patients to mental healthcare. For example, do specialists need more training on screening for mental health or better screening tools? Future studies may also help us better understand the role of patient advocacy organizations, like NEA, in helping to mitigate the overall mental health burden of AD. 

References:

1. Drucker AM, Wang AR, Li WQ, Sevetson E, Block JK, Qureshi AA. The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association. J Invest Dermatol. Jan 2017;137(1):26-30. doi:10.1016/j.jid.2016.07.012

2. Kage P, Simon JC, Treudler R. Atopic dermatitis and psychosocial comorbidities. J Dtsch Dermatol Ges. Feb 2020;18(2):93-102. doi:10.1111/ddg.14029

3. Cheng BT, Silverberg JI. Depression and psychological distress in US adults with
atopic dermatitis. Ann Allergy Asthma Immunol. Aug 2019;123(2):179-185. doi:10.1016/j.anai.2019.06.002

4. Yu SH, Silverberg JI. Association between atopic dermatitis and depression in US adults. J Invest Dermatol. 2015;135:3183-3186.

5. Silverberg JI, Gelfand JM, Margolis DJ, et al. Patient burden and quality of life in atopic dermatitis in US adults: A population-based cross-sectional study. Annals of Allergy, Asthma & Immunology. 2018/9// 2018;121(3):340-347. doi:10.1016/J.ANAI.2018.07.006