Predictors of Mental Health Concerns in a Men's Health Clinic
Leelakrishna Channa, BS1, Ilene Staff, PhD2, Tara McLaughlin, PhD2, Kevin Pinto, BS3, Laura Olivo Valentin, BS3, Jared Bieniek, MD3.
1UConn School of Medicine, Farmington, CT, USA, 2Hartford Hospital, Hartford, CT, USA, 3Tallwood Urology & Kidney Institute, Hartford HealthCare, Hartford, CT, USA.
BACKGROUND: Mental health is increasingly recognized as a critical component of overall health status. Urologic diseases commonly impact patients' mental wellbeing, especially considering the sensitive nature of many male urologic conditions. Despite the need for mental health screening as a component of urologic care, most providers are ill prepared to recognize individuals at highest risk of mental illness. The current study is designed to tabulate rates of self-reported mental health struggles and identify factors differentiating men reporting such struggles among men presenting to a men's health clinic.
METHODS: Each urologic patient presenting to a multidisciplinary men's health clinic was asked to complete a self-reported men's health checklist based on preventative health guidelines in addition to weight and mental health screenings. A retrospective sample of checklists completed between March 1, 2019 and February 29, 2020 was reviewed. Medical records were queried to supplement patient and visit information. The cohort was subdivided based on “yes” vs “no” responses to the question asking if respondees were “struggling with mental health and in need of help.” Clinical data and other checklist responses were compared between men reporting mental health struggles and those not reporting such struggles using Wilcoxon ranked sum tests and Pearson's chi-squared or Fisher's exact tests, as appropriate. SPSSv26 was used for all statistical analyses with p<0.05 significance level.
RESULTS: A sample of 803 men with available checklist data was selected from a total of 1,706 during the study period. After excluding 11 patients with missing responses to the mental health question, data from 792 unique patient checklists were included for analysis. Of those responding, 8.0% (n=63) of patients identified as struggling with mental health and looking for help. There was a significant difference in the distribution of age with a lower median in the mental health struggles (MHS) group (59.7 vs 64.2, p=0.03). BMI was conversely higher in MHS (29.4 vs 27.5, p=0.003) with associated self-reported rates of weight struggles of 52.5% for MHS vs 12.7% for non-MHS (p<0.001). The three most common primary diagnoses were unevenly distributed (p=0.001) with a higher rate of ED in the MHS group (47.6% vs 23.5%), lower rate of prostate cancer (23.8% vs 48.2%), and similar rates of benign prostatic hyperplasia (28.6% vs 28.3%). Men in both groups reported high rates of compliance with recommended primary care follow up (94.7% vs 97.8%, p=0.15).
CONCLUSIONS: While a minority of men presenting to a men's health clinic reported mental health difficulties in need of attention, these men tended to be younger, have a higher BMI, and present with ED as a primary complaint. These factors should continue to be explored and kept in mind during patient encounters to better address the mental health needs of urologic patients.
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