Identifying the State of Mental Health Care in Canadian Adults With Systemic Lupus Erythematosus
Bibliographic record
Abstract
OBJECTIVE: To identify barriers to accessing mental health care among adult patients with systemic lupus erythematosus (SLE) in Canada, by exploring physician- and patient-reported barriers and evaluating possible interventions. METHODS: We surveyed Canadian rheumatologists and adult patients with SLE. Physicians reported current practices, barriers, and interventions for mental health care. Patients reported their mental health experiences, barriers to access, and preferences for interventions. Surveys were distributed through professional networks, clinics, and social media, with analyses conducted using descriptive statistics and Cohen κ for agreement. RESULTS: In total, 25 rheumatologists and 235 patients participated. Physicians cited limited availability of mental health providers (88%) and insufficient time (84%) as top barriers. Few used standardized screening tools like PHQ-9 (16%) or GAD-7 (12%). Patients reported anxiety (41.7%) and depression (39.9%) as common concerns, with many facing challenges accessing care owing to long wait times and lack of affordability. Patients favored integrated mental health services within rheumatology clinics (58.6%), whereas physicians preferred external referrals. Agreement between groups on interventions ranged from moderate (κ 0.64) for primary care screening to low (κ 0.25) for integration of services into the rheumatology clinic. CONCLUSION: Mental health care in SLE management remains underdeveloped, hindered by systemic barriers and discordance between patient and provider preferences. Standardized screening, interprofessional collaboration, and alignment of perspectives would likely improve mental health outcomes and overall patient quality of life. These findings highlight opportunities for targeted interventions and guideline development in mental health care for SLE.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".