PARE0015 EMOTIONAL HEALTH AND WELL-BEING MATTERS
Authors: Matthew Bezzant, Hayley Mcbain, Ailsa Bosworth
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> The most common co-morbidities amongst people with RA are mental health conditions, such as depression and anxiety, as evidenced by previous surveys and reports by the NRAS. NRAS also understands, through interaction with its membership across the UK, that mental health and well-being are important issues for people living with RA and JIA. NRAS therefore partnered with City University to undertake a survey exploring the impact of RA and adult JIA on mental health. <h3>Objectives:</h3> To explore the psychological impact of Rheumatoid Arthritis (RA) and Juvenile Idiopathic Arthritis (JIA), along with any psychological support people may have received or would like to have access to, to help manage the anxiety, emotions and stresses that come with being diagnosed with and living with RA or JIA and its treatment. <h3>Methods:</h3> Following a focus group held in Central London in early 2018 with a dozen NRAS members, NRAS and City University designed a survey to look at a range of aspects relating to emotional health and well-being, including validated questionnaires to compare data to existing research. The survey was open between May and July 2018, with participants recruited via NRAS newsletters, social media platforms, the NRAS HealthUnlocked forum and via healthcare professionals at rheumatology units. A total of 1,999 people participated in the survey and a final sample of 1,650 was used for analysis. <h3>Results:</h3> The survey found that people with RA and adult JIA were less satisfied with their life, believed the things in their life were less worthwhile, and were less happy. The proportion of people who scored poorly on life satisfaction and life worth was over 7 times greater in those with RA and adult JIA than the national average. Despite this, the survey found that 2 in 5 people had never been asked by a health professional about their emotional and psychological well-being, and 1 in 3 people who had requested or been offered support had never received it. Positive experiences that respondents shared of psychological support, such as GPs and rheumatologists being very supportive, the importance of family, and services offered by NRAS, demonstrate the benefits of good and appropriate support being available. Negative experiences, such as lack of health professional understanding about mental health, lack of understanding of RA by counsellors, and lack of personalised care demonstrate the future work that must be done to help adequately support people with RA and adult JIA. <h3>Conclusion:</h3> The survey has demonstrated the need to provide more effective self-management techniques of emotional as well as physical well-being, ultimately leading to overall improved health outcomes. In line with NICE guidelines, other additional support is needed, such as the availability of cognitive behavioural therapy and the implementation of mental health and well-being assessments at annual review. Further research is needed into specific areas, such as health inequalities and why people with severe mental health issues experience poorer disease activity, understanding why adults with JIA have poorer life quality than people with RA, and understanding the impact of psychological interventions for people with adult JIA. <h3>References</h3> [1] Emotional Health and Well-being Matters, McBain, H., Bezzant, M., Bosworth, A., 2018. <h3>Disclosure of Interests:</h3> None declared