Train support staff to be aware of mental health concerns in IBD to avoid future trauma
SAN FRANCISCO — Patients with inflammatory bowel disease remain at higher risk for mental health disorders, but training support staff to recognize the symptoms could be key to preventing further traumatization, noted a presenter here.
“The mental health burden in IBD is really significant across most mental health conditions,” Katrina S. Hacker, PhD, assistant professor of psychiatry at Dartmouth Hitchcock Medical Center, said at Crohn’s & Colitis Congress. “Anxiety, depression, insomnia, PTSD — patients with IBD experience these conditions at a much higher rate than people in the general population.
“One in 13 patients with IBD experience psychological distress that gets in the way of them living their daily life and doing the things that matter to them — nearly 50% higher than adults without IBD,” she added.
Hacker noted that addressing mental health is just as important as addressing physical symptoms, as the two directly impact one another. And despite the fact that 95% of patients want providers to address their mental health concerns, “only 33% are actually getting that care.”
While many barriers to this kind of care occur at the systemic level — namely screening disparities, stigma and cost — providers’ concerns around lack of training and confidence in speaking to patients about their concerns can easily be mitigated.
“There is just a lot of doubt and uncertainty about what to do,” Hacker said. “[Providers] had a sense that it was out there and that it was important, but didn’t know specifically what to do and felt kind of stuck.”
In these “stuck” situations, Hacker offered attendees easy conversation-starters to gauge where their patients stand, such as:
- “How have you been doing emotionally?”
- “What sort of worries have you been having?”
- “Who are the people in your life who can support you through this?”
- “What helps you get through the tough times?”
In addition to these routine mental health questions, Hacker noted that providers should also consider the possibility that some aspects of IBD care may bring up past trauma that may or may not be related to treatment.
“If we can be aware of what might be going on for people, then we can respond to it and prevent future traumatization by changing what we do,” she said. “This is really important in IBD because the resources somebody has in the aftermath of a trauma predict the ability to be resilient.”
To promote trauma-informed care, providers can ask patients:
- “Are there IBD-related experiences that are very difficult to move on from?”
- “Are there experiences from your past that you feel are impacting your disease and care?”
- “Do you feel like thoughts and memories about your IBD are spilling out into the rest of your life?”
The next step involves validating patients’ concerns and experiences and normalizing their struggles so they know they are not alone. From there, Hacker advised providers to educate patients with resources about trauma, build hope and refer them for additional support and care.
“We know that these conversations take time and may be daunting, but practicing helps,” she said. “Training support staff in some of these trauma-informed methods helps so that everybody is onboard and everybody knows how to respond in situations where maybe something unexpected and stressful happens.”
She added, “You don’t need to become a mental health professional; if you want one, we are always happy to figure out what the next step is. If you ever have a question, just ask.”
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Hacker KS. How do you discuss mental health with your IBD patient? Presented at: Crohn’s & Colitis Congress; Feb. 6-8, 2025; San Francsico.
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