Clinician-led mental health conversations significantly associated with outcomes for scoliosis patients

BACKGROUND: The psychological impact of idiopathic scoliosis has been well established in the literature. While the diagnosis of scoliosis is concerning, bracing often compounds patients’ stress, and patients have expressed wanting to discuss their feelings with their healthcare providers. Counseling can be an effective coping strategy for adolescents facing chronic illness, but it has not been studied in individuals diagnosed with scoliosis. AIM: To assess the frequency and effect of counseling and clinician-led mental health discussions on individuals diagnosed with scoliosis in childhood and adolescence. DESIGN: Cross-sectional study. SETTING: Community-based research, online. POPULATION: Individuals diagnosed with scoliosis in childhood and adolescence. METHODS: The online survey included the SRS-22r, the BSSQ-Brace, questions about demographics, mental health, the Scolios-us Mentor Program, and general scoliosis experience. The survey was distributed to Scolios-us Mentor Program participants and to scoliosis clinicians to provide to their patients. Responses about mental health, experiences with healthcare providers, and counseling were analyzed for group differences and associations. RESULTS: Fifty-five subjects participated in the study, with a median age of 13 (IQR: 3). Our results indicate that mental health is not being discussed as much as it is desired. A desire to discuss mental health was associated with lower function (P=0.005), mental health (P<0.001), SRS-22r total scores (P=0.002), and BSSQ-Brace scores (P=0.015). Subjects who engaged in a mental health discussion with one or more scoliosis healthcare providers exhibited higher management scores (P=0.002). Only 18.2% of subjects sought counseling, and two-thirds of these subjects found counseling to be very or extremely helpful. CONCLUSIONS: Mental health is not discussed by scoliosis providers as often as patients desire it, and a desire to have these conversations is negatively associated with several clinical outcomes. Although clinicians are not regularly talking about mental health, the positive associations of mental health discussions with clinical outcomes are encouraging. CLINICAL REHABILITATION IMPACT: The ability to acknowledge the desire to discuss mental health, begin these discussions, and refer patients to a mental health professional may improve patient outcomes.