Developing new approaches to mental health care for individuals with congenital heart disease: a tri-national qualitative study exploring health professionals' views and experiences.

内容摘要

Increasingly, hospitals are recognizing the need to address the high mental health care needs of individuals with chronic illness, including congenital heart disease (CHD). This qualitative study explored health professionals' views on integrated mental health care in CHD. Individual, semi-structured interviews were conducted with health professionals from diverse disciplines at five CHD centers in the United States, Australia, and Switzerland. Each center had a distinct model of mental healthcare integration and a unique healthcare ecosystem. The Consolidated Framework for Implementation Research was used to guide study design and analysis. Verbatim transcriptions were analyzed thematically using MAX Qualitative Data Analysis (MAXQDA) software. Health professionals representing medicine, psychology, nursing, social work, education, and healthcare administration participated (N = 46, 58% response rate, 72% women, M = 15.5 ± 8.0 years of professional experience, interview duration: M = 47.9 ± 18.8 min). Five key themes were identified: (1) high need and demand for mental health care among individuals with CHD and their families; (2) multiple, inter-related barriers to care, including stigma and socioeconomic factors; (3) barriers to mental healthcare integration for CHD centers, including understaffing, time and fiscal constraints, and lack of clear referral pathways; (4) strategies to promote integration, including interdisciplinary teamwork and regular communication with mental health professionals embedded in cardiac care; and (5) facilitators of access to care, including routine mental health screening, multiple entry points across the medical trajectory, a preventive focus, and skills-based staff training. Results highlight the need for innovative implementation strategies to accelerate access to integrated mental healthcare for individuals with CHD across the lifespan.