Study: Survey of Food Allergy Centers Finds Unmet Need for Mental Health Services

In a clinical correspondence published May 14 in the Journal of Allergy and Clinical Immunology: In Practice, researchers at FARE and at Centers of Excellence in the FARE Clinical Network (FCN) report that, while most FARE Centers of Excellence have patients that would benefit from food-allergy-related mental health support services, Center of Excellence allergists are aware of few mental health professionals to whom they can refer their food allergy patients.

Located in metropolitan areas across the country, FARE Centers of Excellence offer state-of-the-art food allergy care to geographically and racially diverse patient populations. With support from the Patient-Centered Outcomes Research Institute grant that funded FARE’s Outcomes Research Advisory Board, 29 Centers of Excellence were surveyed in early 2018, and 28 submitted responses. Three-quarters of the Centers of Excellence that participated in the survey are outpatient hospital clinics, with specialty practices and academic centers also represented. More than half serve pediatric patients only.

Topics addressed by the survey include:

• The number of mental health professionals employed within the food allergy center’s division
• The availability of mental health professionals in food allergy center’s institution and community
• The inclusion of mental health professionals in food allergy clinical trials
• The perceptions of food allergy center directors or research coordinators regarding mental health concerns related to food allergy

Nearly all Centers of Excellence identified food allergy-related mental health concerns among the people they serve, with 96 percent reporting anxious pediatric patients and 93 percent reporting anxious food allergy parents. However, fewer than one in four Centers of Excellence (21 percent) had a full-time or part-time mental health professional in their division. Mental health professionals include psychiatrists, psychologists, social workers and other masters-level mental health service providers.

Most Centers of Excellence indicated that there are mental health professionals in their institution to which they can refer patients, while fewer were aware of community-based mental health professions available for referral. Only 14 percent reported that students in their institution receive training on food allergy-related mental health issues.

More than 60 percent of the responding Centers of Excellence did not offer mental health support for clinical trial participants, although more than 80 percent would like to offer this service. Research coordinators at the centers note that mental health services would also be beneficial at the time of diagnosis, before notable developmental transitions and before oral food challenges.

While the survey findings are limited to FARE Centers of Excellence, these centers are recognized for their exceptional level of care, suggesting that the wider availability of mental health services to support all food allergy patients may also be limited. Clearly, training more mental health professionals to provide food-allergy-related care would be an important step toward fulfilling unmet need for mental health support among food allergy patients and parents.

The authors of the correspondence encourage the allergy and mental health communities to collaborate in creating food allergy educational programs for mental health professionals and general medical practitioners. FARE is exploring how we can help expand the pool of mental health professionals with food allergy expertise and strengthen the connections linking general practitioners, mental health professionals and allergists, to ensure that patients and parents are able to access the benefits of mental health support services at each age and stage of the food allergy journey.