Abstracts

Rationale: People with epilepsy are at greater risk for depression and suicide than people without epilepsy. Currently, there is no routine screening for depression in people with epilepsy outside of an encounter with a healthcare provider (HCP). The Epilepsy Foundation’s 24/7 Helpline received 10,310 inquiries in the past year offering a possible venue for depression screening and referral for mental health care and education in adults with epilepsy. Methods: The 24/7 Helpline provides non-medical help in English and Spanish to people with questions about epilepsy and related issues. The Helpline is accredited by the Alliance of Information and Referral Services and staffed by certified information and referral specialists who provide epilepsy information, referrals and suicide assessments. Types of call since July 2017 include: information only (57.9%), information and referral (38.9%), and advocacy (3.7%). Crisis and suicide calls are rare (n=57), but many callers mention difficulty coping with epilepsy and other psychosocial concerns during calls for epilepsy information and resources.Depression Screening: The PHQ 2 (Table 1) was chosen for ease of use and validity for telephone screening (Medical Care 2003;41:1284). Testing of the tool by two information and referral specialists to determine ease of use, caller feedback, and call flow began in February 2018. Screening by all information and referral specialists began in May 2018.Adults with epilepsy who called the Helpline with a psychosocial concern were asked two questions about the frequency of depressed mood and anhedonia. Responses were rated on a likert scale with summed scores determining the call specialist’s response:0 - 2:  no intervention required, caller is offered information about epilepsy and mood.3 - 6:  indicates possible depression, caller encouraged to contact healthcare provider to discuss their mood. Callers without a healthcare provider offered a referral to a mental health provider for assessment and services.4 - 6: indicates possible depression, suicide assessment done. Results: Figure 1 illustrates the PHQ 2 scores (n=14) for the initial feasibility testing. The majority (n=9) scored between 0 - 2 which did not indicate depression. Callers who scored 3 - 5 (n=5) were referred to their epilepsy or primary HCP for further assessment; two received mental health referrals. There was no negative feedback from callers about the screening. The majority of callers were positive about the screening process and information provided.       Conclusions: Telephone screening for depression was piloted using a validated tool by a non-medical 24/7 epilepsy helpline. Initial results found over 30% of callers with possible depression which required a referral for further assessment and treatment. Depression screening was well received in this sample. The screening process will now be expanded to any adult caller with epilepsy requesting information and referral. Results will assist in development of the Epilepsy Foundation’s emotional health initiative to enhance access to appropriate mental health services. Funding: The Epilepsy Foundation Helpline is made possible with funding from the Centers for Disease Control and Prevention (CDC) under cooperative grant agreement number 1 NU58DP006256-02-00. Its contents are solely the responsibility of the Epilepsy Foundation and do not necessarily represent the views of the CDC.