Forty-two percent of patients with atopic dermatitis (eczema) and caregivers of children/teens with the condition never spoke about mental health with primary eczema care providers, according to National Eczema Association (NEA) research published this month in Skin and Health Disease.

This was the second publication from the NEA’s real-world research on eczema and its impacts on mental health; the first examined eczema patients' perceptions of how mental health relates to eczema symptoms, and was published in Dermatitis in March.

Research has already shown that eczema is strongly associated with symptoms of psychological distress, including anxiety, depression and social isolation. However, there had not been an understanding of what type of mental health support eczema patients receive or don't receive from their primary eczema provider.

"This is the first study to explore this important topic for the eczema patient community," said Jessica Johnson, lead author of the study and director of community engagement and research at NEA. 

As part of the study, adult eczema patients and primary caregivers of eczema patients ages 8 to 17 completed a survey that included questions about eczema symptoms, mental health symptoms, perceptions of the connection between eczema and mental health, and experiences accessing mental health services. Mental health services in the survey were defined as, but not limited to: counseling with a mental health provider; cognitive behavioral therapy; social support groups; alternative mental health therapy (such as music or art therapy); and/or mental health medications. 

Other important findings from the study include: 

• 50% of patients were never asked about mental health by their primary eczema care provider during any visits
• 64% of adult patients and caregivers of young patients with eczema were not referred to mental health resources
• The patients more likely to be referred to mental health services included children, men, those with limited education, and people seeing non-specialists
• If patients were referred to mental health resources, the most common referrals were to counseling services (23% of referrals), alternative mental health therapy (15%), cognitive behavioral therapy (13%), and peer/social support groups (12%) 
• Among those who received a referral for mental healthcare, 57% utilized the recommended services 
• The patients more likely to have never spoken with their primary eczema care providers about mental health included women, people of low income, and people seeing specialists (such as dermatologists or allergists) for their primary eczema care
• Young adults 18–34 years old frequently reported not being asked about their mental health but wanted to be

"We know about the emotional and psychological toll that eczema can take on patients of all ages," said Wendy Smith Begolka, study senior author and chief strategy officer at NEA. "Ideally, patients and healthcare providers would feel comfortable discussing mental health during their visits. Our study highlights the opportunity to help this discussion occur more consistently." 

The NEA said in a press release that more research is needed to identify the most effective mental health interventions for eczema patients, as well as current barriers to referring patients to mental healthcare. Additional findings and insights from this study are expected to be published in the coming months.