RT Journal Article SR Electronic T1 Identifying Targets for Improving Mental Healthcare of Adolescents with Systemic Lupus Erythematosus: Perspectives from Pediatric Rheumatology Clinicians in the United States and Canada JF The Journal of Rheumatology JO J Rheumatol FD The Journal of Rheumatology SP 1136 OP 1145 DO 10.3899/jrheum.151228 VO 43 IS 6 A1 Andrea M. Knight A1 Michelle E. Vickery A1 Eyal Muscal A1 Alaina M. Davis A1 Julia G. Harris A1 Arzu Soybilgic A1 Karen B. Onel A1 Laura E. Schanberg A1 Tamar Rubinstein A1 Beth S. Gottlieb A1 David S. Mandell A1 Emily von Scheven YR 2016 UL http://www.jrheum.org/content/43/6/1136.abstract AB Objective. To identify targets for improving mental healthcare of adolescents with systemic lupus erythematosus (SLE) by assessing current practices and perceived barriers for mental health intervention by pediatric rheumatology clinicians.Methods. Members of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) completed a Web-based survey assessing current mental health practices, beliefs, and barriers. We examined associations between provider characteristics and the frequency of barriers to mental health screening and treatment using multivariable linear regression.Results. Of the 375 eligible CARRA members, 130 responded (35%) and 119 completed the survey. Fifty-two percent described identification of depression/anxiety in adolescents with SLE at their practice as inadequate, and 45% described treatment as inadequate. Seventy-seven percent stated that routine screening for depression/anxiety in pediatric rheumatology should be conducted, but only 2% routinely used a standardized instrument. Limited staff resources and time were the most frequent barriers to screening. Respondents with formal postgraduate mental health training, experience treating young adults, and practicing at sites with very accessible mental health staff, in urban locations, and in Canada reported fewer barriers to screening. Long waitlists and limited availability of mental health providers were the most frequent barriers to treatment. Male clinicians and those practicing in the Midwest and Canada reported fewer barriers to treatment.Conclusion. Pediatric rheumatology clinicians perceive a need for improved mental healthcare of adolescents with SLE. Potential strategies to overcome barriers include enhanced mental health training for pediatric rheumatologists, standardized rheumatology-based mental health practices, and better integration of medical and mental health services.