Digital mental health screening within neurological clinical healthcare settings: a systematic review.

BACKGROUND: This review synthesises literature on the implementation of digital mental health (MH) screening in neurology healthcare services and summarises information about its feasibility, acceptability and associated clinical outcomes. METHODS: Following prospective registration (CRD420251010397) we searched Embase, Medline, PsycINFO, and Central for peer-reviewed articles describing a digitally delivered MH screening procedure using a validated screener implemented in a real-world neurological care service for people of any age with a neurological disorder. Two authors reviewed articles and extracted data. Study quality was assessed for articles reporting outcome data. Of 10,633 abstracts and 228 full-text articles, 31 met eligibility criteria. RESULTS: Articles spanned 10 neurological disorders (most commonly epilepsy) and primarily screened depression and anxiety. Screening was delivered via tablets, kiosks/clinic computers, or patients' devices and often integrated with electronic medical/health record systems. Completion rates varied but acceptability was generally high among clinicians and patients. Positive MH screening results were commonly associated with clinical follow-up such as symptom discussion, medication initiation or adjustment, and referrals. Some services used predefined score thresholds to trigger MH care pathways. Limited pre-post evidence suggested digital screening may increase detection of depression and anxiety, but risk of bias was common, and no articles assessed impacts on MH outcomes over time. CONCLUSION: A subset of articles suggest that digital MH screening appears feasible and acceptable in real-world neurology settings and may improve detection, facilitate doctor-patient communication, and prompt treatment-related actions. These findings may inform the integration of MH screening in neurological care, particularly during pre-implementation planning.