Screening and referral is not enough: a qualitative exploration of barriers to access and uptake of mental health services in patients with cardiovascular diseases

Abstract Background Cardiovascular diseases (CVD) are commonly comorbid with mental health disorders, portending poorer cardiac prognosis. Despite the high prevalence of depression and anxiety, guidelines recommending routine screening referral, uptake healthcare in CVD populations remains low. Reasons for underutilisation psychological services this population remain largely unknown. Methods Thirteen patients clinically significant symptoms (depression, anxiety and/or stress) participated one-on-one in-depth semi-structured interviews. Data were analysed using inductive thematic analysis. Results Barriers to included timing referral screening, reporting a need longer term follow-up. A lack information provision understanding around services, especially following cardiac-events further barriers. reluctance report or engage was also identified, indicating preference informal peer support networks. range practical barriers such as mobility, transport cost reported. Conclusions Longer follow-up assessment may be beneficial facilitate use services. Upskilling practitioners avenue promote enhance service use. Further focus on enhancing valuable initial approach population. The implications improving discussed.