Addressing mental health following ACS
Having a heart attack is a major life event, and addressing mental health is an important part of patient education. Left unmanaged, mental health disorders may increase the risk of behaviors that impact negatively on recovery and may make heart disease worse.
Addressing mental health starts in acute care. If the patient is exhibiting acute mental distress (e.g. significant anxiety or depressive symptoms and/or suicidal ideation) inform medical staff and initiate inpatient consultation with an appropriate care provider.
Teaching points in our ACS Network Education module:
Risk factors for poor adjustment
Typical reactions following an event
Warning signs of depression
Warning signs of anxiety
Common adaptive challenges
Realistic goal setting
Relaxation/downregulation tips
Combating negative or catastrophic thinking
Dependency-autonomy struggle and anger towards others
Other reasons for seeking help
Where help is available for cardiac-related distress
Resources are available to assist healthcare professionals in beginning the conversation.
Go over essential teaching points with the patient regarding mental health. At the end of the session, you can refer the patient to the book Living Well with Heart Disease, published by Heart & Stroke. Chapter 5 goes into detail about topics covered. Make sure the patient has this book in some format.
Reinforce what to do if a patient is in crisis following their hospital discharge. Ensure that the patient has a copy of the pamphlet Patient Information for Cardiac Psychology Services in the Winnipeg Regional Health Region.
When talking to the patient, emphasize that joining a cardiac rehabilitation program is an important part of recovery. Communicate the benefits of meeting others with the same diagnosis, joining a social network or online support group, and talking about their diagnosis.
To review:
Talk to your patients about the relationship between mental health and heart disease.
Incorporate mental health screening and treatment into care surrounding a major heart disease event and chronic disease.
Involve individuals and their family members in communication and decision-making regarding treatment following a heart disease event
For patients with severe mental health disorders and pre-existing heart disease or its risk factors:
Psychotropic medication with lower risk for heart disease may be employed. In such cases, the prescriber must weigh clinical benefits and potential for adverse events.
