Congenital Heart Health

National standards need to be developed for mental health care in congenital heart disease (CHD) to help address the significant emotional toll of diagnosis and treatment. In a perspective published in the latest issue of the Medical Journal of Australia A/Prof. Nadine Kasparian from the Heart Centre for Children at The Children's Hospital at Westmead outlines how the need for an integrated approach incorporating physical and mental health is crucial to 'congenital heart health'.

CHD affects more than 2,400 babies in Australia each year. It is the leading cause of infant death and one of the leading causes of diseaserelated disability in children under five. Although advances in medicine have drastically improved the survival rate, they bring a range of new challenges including complex treatment choices and the need to transition from paediatric to adult cardiac services. Children with CHD and their families are also more vulnerable to ongoing physical and mental health issues.

Diagnosis of a life-threatening illness during a child's formative years can have far-reaching effects that ripple through the family and across a lifetime. Infants with complex CHD experience a range of uncommon and painful events that can have profound consequences for their development and for their health and wellbeing into adulthood. Their parents are also more likely to experience anxiety and depression. Half of all babies who need heart surgery in the first year of life are now diagnosed while in the womb and this can lead to an emotional crisis for expectant parents. Research shows one in three mothers and fathers of infants with complex CHD report symptoms that meet the clinical criteria for depression and 50% report severe stress reactions consistent with a need for clinical care up to one year after their baby's diagnosis.

In 2010, as part of our holistic approach to care, the Sydney Children's Hospitals Network established an integrated clinical psychology service to provide a state-wide mental health service for children and young people with all forms of heart disease. Early intervention can make a profound difference for families and influence a lifetime of outcomes for a child. Access to these interventions can help reduce maternal depression and anxiety while increasing positive parent-infant interactions which all contribute to shorter recovery periods and hospital stays. Our focus has been on mental and physical wellbeing for 'congenital heart health' as there are still gaps in access to mental health services for these at-risk patients and their families.

Originally posted on the SCHN website: http://www.schn.health.nsw.gov.au/news-media/articles/2016/08/congenital-heart-health