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Introduction Inflammatory bowel disease (IBD) is a chronic health condition that has a direct impact on mental health and is a major factor for poor psychological health (Barberio B, et al., 2021). This can worsen quality of life, treatment adherence, and service use especially during periods of active disease (Fairbrass KM, et al., 2023). Routine screening for depression is not consistent in many IBD pathways. Nurse-led screening effectively measures symptom severity and rapidly identifies safeguarding risks.Methods To describe the prevalence and severity of depressive symptoms, a nurse-led service evaluation using the Patient Health Questionnaire-9 (PHQ-9) was conducted, self-completed by patients attending an IBD service. Validated PHQ-9 severity bands were defined as 0–4 minimal, 5–9 mild, 10–14 moderate, 15–19 moderately severe, and 20–27 severe. Total scores were calculated when at least 7 items were completed. Clinically relevant depressive symptoms were defined as PHQ-9 total score 10 or above. Any response above 0 on item 9 triggered safeguarding flagging for clinical review in line with local protocol. We summarised results using counts, percentages, and medians.Results Valid PHQ-9 totals were available for 208 patients. The median PHQ-9 total score was 5. Minimal symptoms were reported by 97/208 (46.6%) and mild symptoms by 46/208 (22.1%). Moderate symptoms were reported by 32/208 (15.4%), moderately severe by 17/208 (8.2%), and severe by 16/208 (7.7%). Overall, 65/208 (31.2%) screened PHQ-9 10 or above. Safeguarding concerns were identified in 23/208 (11.1%) with item 9 above 0. Item-level analysis showed the highest mean scores for fatigue and sleep disturbance.Conclusion Routine nurse-led PHQ-9 screening in an IBD service identified high unmet mental health need, with almost one-third screening at a clinically relevant threshold. Over one in ten screened positive on item 9, supporting the need for clear safeguarding pathways embedded within IBD services. These findings support applying nurse-led mental health screening and clear safeguarding pathways into standard IBD care, with specific focus on fatigue, sleep and targeted signposting to psychological services. Further work should evaluate patient acceptability, referral uptake and the impact of this approach on outcomes over time.References Barberio B, et al. Prevalence of symptoms of anxiety and depression in patients with inflammatory bowel disease: a systematic review and meta-analysis. The Lancet. Gastroenterology & Hepatology. 2021.Fairbrass KM, et al. Characteristics and effect of anxiety and depression trajectories in inflammatory bowel disease. The American Journal of Gastroenterology. 2023.Abstract P239 Figure 1