Investigating factors that influence genetic counselors' decisions to refer patients to mental health providers.
Genetic counselors
genetic counseling
mental health
psychosocial assessment
Journal
Journal of genetic counseling
ISSN: 1573-3599
Titre abrégé: J Genet Couns
Pays: United States
ID NLM: 9206865
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
revised:
06
04
2022
received:
13
08
2021
accepted:
11
04
2022
pubmed:
24
4
2022
medline:
5
10
2022
entrez:
23
4
2022
Statut:
ppublish
Résumé
Genetic counselors (GC) serve patients who are often in distress at the time of their consultation. GC competency includes providing short-term, client-centered counseling, while using community resources, such as mental health providers (MHPs), for psychosocial support. The purpose of this study was to assess the mental health referral practices of GCs; specifically, the rate of referrals, factors influencing a GC's decision to refer, and barriers to referrals. GCs working in direct patient care for at least one year were recruited to take a novel 27 question survey created based on the results of a previous qualitative study. A link to the web-based survey was distributed through the National Society of Genetic Counselors Student Research Program and American Board of Genetic Counselors by email. A total of 144 individuals opened the survey for an estimated response rate of 3%. A majority of respondents (54.3%) reported they assess a patient's need for a mental health referral at least half of the time. The mean number of referrals made in the past 12 months was 5.13. After post-hoc analyses, there were no differences in referral rates between specialties. Common referral indications included patient history of mental illness, distress about having a genetic condition, and limited social support. Common barriers to referral were financial or insurance related, patient receptiveness, and the patient not perceiving a benefit. GCs felt that providing psychosocial support is within their scope of practice, but that MHPs are better equipped to manage long-term needs and those related to a mental health condition. This study provides insight into how GCs decide when they can manage patient distress, circumstances that prompt a referral to MHPs, and barriers. Recognizing common referral indications and barriers may lead to better strategies for connecting patients with such services.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1113-1124Informations de copyright
© 2022 National Society of Genetic Counselors.
Références
Accreditation Council for Genetic Counseling. (2019). Practice-Based Competencies for Genetic Counselors (Domain II). Retrieved August 3, 2021 from https://www.gceducation.org/practice-based-competencies
Asplin, N., Wessel, H., Marions, L., & Georgsson Öhman, S. (2014). Pregnancy termination due to fetal anomaly: Women’s reactions, satisfaction and experiences of care. Midwifery, 30(6), 620-627. https://doi.org/10.1016/j.midw.2013.10.013
Avalos, L. A., Flanagan, T., & Li, D.-K. (2019). Preventing perinatal depression to improve maternal and child health- a healthcare imperative. JAMA Pediatrics, 173(4), 313-314. https://doi.org/10.1001/jamapediatrics.2018.5491
Bassett, A. S., McDonald-McGinn, D. M., Devriendt, K., Digilio, M. C., Goldenberg, P., Habel, A., Marino, B., Oskarsdottir, S., Philip, N., Sullivan, K., Swillen, A., & Vorstman, J. (2011). Practical guidelines for managing patients with 22q11.2 deletion syndrome. The Journal of Pediatrics, 159(2), 332-9.e1. https://doi.org/10.1016/j.jpeds.2011.02.039
Biesecker, B. B. (2019). The psychological well-being of pregnant women undergoing prenatal testing and screening: A narrative review. Special Report. Looking for Psychosocial Impacts of Genomic Information. Hastings Center Reports, 49(3), s53-s60. https://doi.org/10.1002/hast.1017
Boivin, J., Griffiths, E., & Venetis, C. A. (2011). Emotional distress in infertile women and failure of assisted reproductive technologies: Meta-analysis of prospective psychosocial studies. BMJ (Clinical Research Ed.), 342, d223. https://doi.org/10.1136/bmj.d223
Bosco, A. F. (2000). Caring for the caregiver: The benefit of a peer supervision group. Journal of Genetic Counseling, 9(5), 425-430. https://doi.org/10.1023/A:1009458316485
Chappuy, H., Doz, F., Blanche, S., Gentet, J.-C., Pons, G., & Tréluyer, J.-M. (2006). Parental consent in paediatric clinical research. Archives of Disease in Childhood, 91(2), 112-116. https://doi.org/10.1136/adc.2005.076141
Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., Morgan, C., Rusch, N., Brown, J. S. L., & Thornicroft, G. (2015). What is the impact of mental health related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45(1), 11-27. https://doi.org/10.1017/S0033291714000129
Cunningham, M., Morreale, M., & Trepanier, A. (2018). Referrals to mental health services: Exploring the referral process in genetic counseling. Journal of Genetic Counseling, 27(1), 289-300. https://doi.org/10.1007/s10897-017-0147-y
Daugirdaitė, V., van den Akker, O., & Purewal, S. (2015). Posttraumatic stress and posttraumatic stress disorder after termination of pregnancy and reproductive loss: A systematic review. Journal of Pregnancy, 2015, 646345. https://doi.org/10.1155/2015/646345
Hartmann, J. E., Veach, P. M., MacFarlane, I. M., & LeRoy, B. S. (2015). Genetic counselor perceptions of genetic counseling session goals: A validation study of the Reciprocal-Engagement Model. Journal of Genetic Counseling, 24, 225-237. https://doi.org/10.1007/s10897-013-9647-6
Huntington’s Disease Society of America (2016). Genetic testing protocol for Huntington’s disease. Retrieved August 3, 2021 from: https://hdsa.org/news/huntingtons-disease-society-of-america-releases-updated-genetic-testing-protocol-for-huntingtons-disease/
Kazdin, A. E. (2019). Annual research review: Expanding mental health services trhough novel models of intervention delivery. Journal of Child Psychology and Psychiatry, 60(4), 455-472. https://doi.org/10.1111/jcpp.12937
Kowalcek, I. (2007). Stress and anxiety associated with prenatal diagnosis. Best Practice & Research Clinical Obstetrics & Gynaecology, 21(2), 221-228. https://doi.org/10.1016/j.bpobgyn.2006.11.009
Krabbenborg, L., Vissers, L. E. L. M., Schieving, J., Kleefstra, T., Kamsteeg, E. J., Veltman, J. A., & Van der Burg, S. (2016). Understanding the psychosocial effects of WES test results on parents of children with rare diseases. Journal of Genetic Counseling, 25(6), 1207-1214. https://doi.org/10.1007/s10897-016-9958-5
Kuramoto-Crawford, S. J., Han, B., Jacobus-Kantor, L., & Mojtabai, R. (2015). Differences inpatients' perceived helpfulness of depression treatment provided by general medical providers and specialty mental health providers. General Hospital Psychiatry, 37(4), 340-346. https://doi.org/10.1016/j.genhosppsych.2015.04.006
Lafarge, C., Mitchell, K., & Fox, P. (2013). Perinatal grief following a termination of pregnancy for foetal abnormality: The impact of coping strategies. Prenatal Diagnosis, 33(12), 1173-1182. https://doi.org/10.1002/pd.4218
Laurino, M. Y., Bennett, R. L., Saraiya, D. S., Baumeister, L., Doyle, D. L., Leppig, K., Pettersen, B., Resta, R., Shields, L., Uhrich, S., Varga, E. A., & Raskind, W. H. (2005). Genetic evaluation and counseling of couples with recurrent miscarriage: Recommendations of the National Society of Genetic Counselors. Journal of Genetic Counseling, 14(3), 165-181. https://doi.org/10.1007/s10897-005-3241-5
Leonard, B. J., Brust, J. D., & Nelson, R. P. (1993). Parental distress: Caring for medically fragile children at home. Journal of Pediatric Nursing, 8(1), 22-30.
Lindström, C., Åman, J., & Norberg, A. L. (2010). Increased prevalence of burnout symptoms in parents of chronically ill children. Acta Paediatrica, 99(3), 427-432. https://doi.org/10.1111/j.1651-2227.2009.01586.x
Matthews, A. K., Brandenburg, D. L., Cummings, S., & Olopade, O. I. (2002). Incorporating a psychological counselor in a cancer risk assessment program: Necessity, acceptability, and potential roles. Journal of Genetic Counseling, 11(1), 51-64. https://doi.org/10.1023/A:1013820515603
National Society of Genetic Counselors (2020a). Genetic counselor scope of practice. Retrieved August 3, 2021 from https://www.nsgc.org/Policy-Research-and-Publications/State-Licensure-for-Genetic-Counselors/Model-Legislative-Provisions#scope
National Society of Genetic Counselors (2020b). Professional Status Survey, Service Delivery and Access. Retrieved August 3, 2021 from https://www.nsgc.org/Policy-Research-and-Publications/Professional-Status-Survey (member-only access)
Pasacreta, J. V. (2003). Psychosocial issues associated with genetic testing for breast and ovarian cancer risk: An integrative review. Cancer Investigation, 21(4), 588-623. https://doi.org/10.1081/cnv-120022380
Pelentsov, L. J., Fielder, A. L., Laws, T. A., & Esterman, A. J. (2016). The supportive care needs of parents with a child with a rare disease: Results of an online survey. BMC Family Practice, 17(1), 88. https://doi.org/10.1186/s12875-016-0488-x
Peters, J. A. (1994). Suicide prevention in the genetic counseling context. Journal of Genetic Counseling, 3(3), 199-213. https://doi.org/10.1007/BF01412227
Rothmier, J. D., Lasley, M. V., & Shapiro, G. G. (2003). Factors influencing parental consent in pediatric clinical research. Pediatrics, 111(5), 1037-1041. https://doi.org/10.1542/peds.111.5.1037
Skreden, M., Skari, H., Malt, U. F., Haugen, G., Pripp, A. H., Faugli, A., & Emblem, R. (2010). Long-term parental psychological distress among parents of children with a malformation-A prospective longitudinal study. American Journal of Medical Genetics Part A, 152A(9), 2193-2202. https://doi.org/10.1002/ajmg.a.33605
Söllner, W., DeVrries, A., Steixner, E., Lukas, P., Sprinzl, G., Rumpold, G., & Maislinger, S. (2001). How successful are oncologists in identifying patient distress, perceived social support, and need for psychosocial counseling? British Journal of Cancer, 84(2), 179-185.
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2012). Counseling and psychotherapy theories in context and practice: Skills, strategies, and techniques, 2nd ed. John Wiley & Sons Inc.
Stafford, L., Judd, F., Gibson, P., Komiti, A., Mann, G. B., & Quinn, M. (2015). Anxiety and depression symptoms in the 2 years following diagnosis of breast or gynaecologic cancer: Prevalence, course and determinants of outcome. Supportive Care in Cancer, 23(8), 2215-2224. https://doi.org/10.1007/s00520-014-2571-y
Substance Abuse and Mental Health Services Administration (2019). Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. Retrieved August 3, 2021 from: https://store.samhsa.gov/product/key-substance-use-and-mental-health-indicators-in-the-united-states-results-from-the-2018-national-survey-on-Drug-Use-and-Health/PEP19-5068
Tabachnick, B. G., & Fidell, L. S. (2013). Using Multivariate Statistics, 6th ed. Pearson.
Veach, P. M., Bartels, D. M., & LeRoy, B. S. (2007). Coming full circle: A reciprocal-engagement model of genetic counseling practice. Journal of Genetic Counseling, 16(6), 713-728. https://doi.org/10.1007/s10897-007-9113-4
Verhaak, C. M., Smeenk, J. M. J., Evers, A. W. M., Kremer, J., Kraaimaat, F. W., & Braat, D. (2007). Women’s emotional adjustment to IVF: A systematic review of 25 years of research. Human Reproduction Update, 13(1), 27-36. https://doi.org/10.1093/humupd/dml040
Verhoeven, W. M. A., Tuinier, S., Kuijpers, H. J. H., Egger, J. I. M., & Brunner, H. G. (2009). Psychiatric profile in Rubinstein-Taybi syndrome. Psychopathology; Basel, 43(1), 63-68. https://doi.org/10.1159/000260045
Vogels, A., Hert, M. D., Descheemaeker, M. J., Govers, V., Devriendt, K., Legius, E., Prinzie, P., & Fryns, J. P. (2004). Psychotic disorders in Prader-Willi syndrome. American Journal of Medical Genetics Part A, 127A(3), 238-243. https://doi.org/10.1002/ajmg.a.30004
Vos, J., van Asperen, C. J., Oosterwijk, J. C., Menko, F. H., Collee, M. J., Garcia, E. G., & Tibben, A. (2013). The counselees’ self-reported request for psychological help in genetic counseling for hereditary breast/ovarian cancer: Not only psychopathology matters. Psycho-Oncology, 22(4), 902-910. https://doi.org/10.1002/pon.3081
Weinberger, M. I., Bruce, M. L., Roth, A. J., Breitbart, W., & Nelson, C. J. (2011). Depression and barriers to mental health care in older cancer patients. International Journal of Geriatric Psychiatry, 26(1), 21-26. https://doi.org/10.1002/gps.2497
Werner-Lin, A., McCoyd, J. L. M., & Bernhardt, B. (2019). Actions and uncertainty: How prenatally diagnosed variants of uncertain significance become actionable. Special Report: Looking for the Psychosocial Impacts of Genomic Information. Hastings Center Report, 49(3), s61-s71. https://doi.org/10.1002/hast.1018
Zierhut, H. A., MacFarlane, I. M., Ahmed, Z., & Davies, J. (2018). Genetic counselors’ experiences and interest in telegenetics and remote counseling. Journal of Genetic Counseling; New York, 27(2), 329-338. https://doi.org/10.1007/s10897-017-0200-x
Zupancic, J. A. F., Gillie, P., Streiner, D. L., Watts, J. L., & Schmidt, B. (1997). Determinants of parental authorization for involvement of newborn infants in clinical trials. Pediatrics, 99(1), e6. https://doi.org/10.1542/peds.99.1.e6