Abstract
IMPORTANCE: Atopic dermatitis (AD) is associated with psychosocial symptoms, resulting in significant mental health burden and reduced quality of life. OBJECTIVE: To understand mental health support received by patients from their primary eczema provider. DESIGN: We administered a cross-sectional survey (N = 954) to US caregivers and adult patients with AD. SETTING: The National Eczema Association (United States) conducted an online survey in October 2022 among self-selected patients and caregivers. OUTCOME: Patients and caregivers of AD patients reported on mental health conversations and types of mental health support received by their/their child's provider. RESULTS: Many patients did not discuss (41.9%) or were not asked (50.5%) about their mental health by their eczema provider, and 64% reported not receiving a mental health referral. Patients were more likely to receive mental health support if they were male (2.00 [1.08-3.69]), low or middle education level (4.89 [2.10-11.36], 2.71 [1.36-5.40]), or had purchased insurance policies (4.43 [1.79-10.98]). Providers were most likely to refer patients to counseling services (22.5%), followed by alternative mental health therapy (14.9%), cognitive behavioural therapy (13.3%) and peer/social support groups (12.2%). CONCLUSION: Despite the strong association between AD and mental health conditions, there is a significant proportion of patients that report not receiving mental health support from their/their child's primary eczema provider. Screening with validated measures may improve the identification of patients requiring additional support. Future research should evaluate the efficacy of mental health resources and barriers to accessing and referring patients for mental health care.