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“ Mental Health as it Relates to Individuals with Chronic Kidney Disease and End Stage Renal Disease .” The Roundtable brought together patient activists and healthcare providers , including nephrologists , psychologists , a psychiatrist , a social worker , an art therapist , a nurse , a healthcare administrator . The goal of the Roundtable was to define the challenges related to mental health and kidney disease patients and to leave with multiple ideas for pilot projects to be implemented at The Rogosin Institute and with partners across the country to begin to address the defined problems .
The day began with a brief introduction to The Rogosin Institute , followed by a presentation on the current state of research related to kidney disease and mental health by Dr . Rajnish Mehrotra from University of Washington Division of Nephrology and leader of a multi-site research study on depression and ESRD patients . Following the presentation , Roundtable participants engaged in a robust discussion about the mental health challenges impacting kidney disease patients . Issues identified included :
· Insufficient support and empowerment of patients , particularly during the first 120 days of dialysis
· Few opportunities for peer-to-peer learning and patient engagement
· Limited education about mental health needs
· Stigma around mental health issues
· Staffing challenges , particularly staff burnout and the burden of administrative tasks on social workers , limiting their ability to provide counseling
· Limited research and understanding of mental health issues among chronic disease patients and their families
In addition to the issues identified by the Roundtable participants from the provider and patient activist point of view , the Rogosin CHAP team had conducted in-depth interviews with 29 patients from six dialysis units in Brooklyn , Manhattan , and Queens in New York City prior to the event . Interviews included questions related to experience with kidney disease , stressors , patient self-efficacy ( confidence in their abilities to manage their disease ), support systems , and coping mechanisms .
Interviewees ranged in age from 37 to 86 , just over half were female , and they came from diverse racial and cultural backgrounds . Interviewees had been on dialysis for varying lengths of time , ranging from three months to 27 years .
When asked how dialysis had changed their lives , many respondents shared their concerns , including that of the limitations on their ability to work and travel , the burden of the time commitment required by dialysis insomnia and a lack of enjoyment in activities important to them . However , others acknowledged that dialysis kept them alive and gave them a second chance at life . When asked about coping mechanisms , interviewees shared watching TV , listening to music , walking , turning to friends and family for support , relying on prayer or meditation , and engaging in hobbies or crafts . Some interviewees shared that support groups or counseling sessions had helped them cope with their diagnosis and the demands of dialysis . Using the PHQ-9 depression screening tool , the investigators found that approximately one third of patients interviewed had mild depression and close to 20 % more scored as having moderate to severe depression .
Patients were also asked about what could be done to help them better manage their physical and mental healthcare needs . Responses included additional support groups , patient appreciation days at the dialysis units , more information about treatment choices , and more upstream education about the risk factors for and prevention of chronic kidney disease .
With the concerns and suggestions highlighted by the patient interviews and provider perspectives in mind , Roundtable participants looked at the issues identified during the group discussion and developed actionable ideas for projects to address the mental health challenges impacting dialysis and chronic kidney disease patients . By the end of the day , participants left with the following list of project ideas for implementation at Rogosin and around the country :
1 . A needs assessment to better understand patient mental health needs and openness to counseling or other treatment .
2 . Increased staff support and training around patient
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