COR LOE Recommendations I B-NR Patients with ACHD should be evaluated for depression and anxiety.S3.7-1 S3.7-3 IIa B-NR Referral for mental health evaluation and treatment is reasonable in patients with IIb B-NR Neurodevelopmental or neuropsychological testing may be considered in some patients with ACHD to guide therapies that enhance academic, behavioral, psychosocial, and Synopsis Mental health and neurodevelopmental issues are com- mon in patients with ACHD and may significantly affect QoL. Neurodevelopmental abnormalities are more fre- quently seen in children who have complex disease, com- plex surgical repairs, and other characteristics.S3.7-10 S3.7-12 There is extensive literature in the pediatric population on the frequency and importance of neurodevelopmen- tal abnormalities, However, many adults may not have been evaluated as children in accordance with current diagnostic and treatment strategies.S3.7-13,S3.7-14 Neurode- velopmental disorders, such as impairment of cognition, social skills and communication, and attention disorders, are often underrecognized even though appropriate di- agnosis, treatment, and rehabilitation may be beneficial in optimizing function and QoL. An AHA scientific state- ment describes the common neurodevelopmental disor- ders affecting children with CHD and may inform neu- rodevelopmental issues related to adults with CHD.S3.7-13 Recommendation-Specific Supportive Text 1. Anxiety and depression are underrecognized in the ACHD population. Point-of-care assessment with simple questions about anxiety and depres- sion should be included in the symptom review. 2. Anxiety and depression are prevalent among patients with ACHD. Self-reported symptoms are incomplete to identify the existence of mood disorders. Structured professional psychological evaluation can identify up to 50% more patients with mood disorders.S3.7-1 3. 