S1839 Patients With Inflammatory Bowel Disease May Be Undertreated for Psychiatric Comorbidities: An Overlooked Dimension in IBD Care

Introduction: Inflammatory bowel disease (IBD) is associated with significant physical, psychological, and social burden. Mental health symptoms such as depression and anxiety are common and can impair disease control and quality of life yet are often underrecognized and undertreated. This quality improvement project is aimed to assess gaps in mental health screening and support among IBD patients and sought to improve access to mental health resources. Methods: A resident-run primary care clinic at Northport VA Medical Center, consisting of 2,073 patients, was queried for IBD, identifying 35 patients. After excluding 7 (misdiagnosis, transfer, or death), 28 were included. Electronic medical records were reviewed for psychiatric diagnoses, mental health service use, and psychotropic medications. Patients were contacted to assess IBD symptoms, social support, and complete the PHQ-9. All were offered mental health resources, including psychiatry, psychology, and IBD support group links from CrohnsColitisFoundation.org. Psychiatry referrals were offered when clinically appropriate and with patient consent. Results: Among 28 patients (mean age 72.7), 12 (43%) had a current or prior psychiatric diagnosis—most commonly depression, anxiety, or posttraumatic stress disorder. Of these, 8 (66%) were receiving mental health support and 7 (58%) were on psychotropic medications. Outreach was attempted for all; 6 could not be reached. Among 22 respondents, 14 (64%) reported well-controlled IBD, 20 (90%) had strong home support, and 6 (27%) reported active mental health concerns. Of these 6, only one accepted further support, including referral and peer group information. Three were not receiving any form of mental health care. Most patients declined additional resources, including those with elevated PHQ-9 scores. Based on PHQ-9: 1 had moderate (PHQ-9 >9), 5 had mild (5–9), and 17 had minimal or no depressive symptoms (<5). Conclusion: Despite the high prevalence of psychiatric comorbidities in IBD patients, most declined additional mental health support, even with active symptoms or elevated PHQ-9 scores. This suggests barriers such as stigma, limited awareness, or a perception that current support is sufficient. These findings support the need for consistent, proactive mental health screening in IBD care. In-person discussions during clinic visits may foster trust and engagement, potentially improving support uptake. Future initiatives should explore strategies to reduce barriers and normalize mental health care in chronic GI disease.