Access to inpatient mood management services after stroke in Australian acute and rehabilitation hospitals.

Participation in the audit was voluntary, and hospitals included in the analysis had to meet minimum admission thresholds, which may skew the sample toward larger centers. The cross-sectional nature of the data prevented linking individual patient outcomes across multiple admissions or tracking long-term recovery. Information on pre-existing mental health diagnoses and specific staffing levels (full-time equivalents) was not available, which could influence the likelihood of receiving care. Data on 'other therapies' provided for mood impairment was not recorded, so the shift away from antidepressants may reflect a move toward unrecorded interventions rather than just psychological therapy. The study relies on documentation in medical records, so poor documentation could be mistaken for a lack of care.

The authors declared no potential conflicts of interest. Funding was provided by Monash University (Research Training Program Scholarship), the National Health and Medical Research Council (Senior Research Fellowship), and the National Heart Foundation of Australia (Research Future Leader Fellowship).

Do not interpret the increase in screening rates as a resolution of the problem. In acute hospitals, despite more patients being screened, the rate of those actually seeing a psychologist remained flat at 9%, indicating a bottleneck in access to treatment that screening alone has not fixed.