Supporting the emotional and mental health needs of people with cancer

How can poor mental health, anxiety and depression be prevented during and after cancer treatment by good support provision?

A cancer diagnosis is a life changing and challenging experience for anyone

While great progress has been made in researching cancer causes and treatments, there has been little research conducted into mental health during cancer and how best to support mental health and wellbeing.  

Through interviews with people with lived experience of using cancer services and cancer support providers working in Scotland, we undertook a qualitative research study to better understand emotional and mental health during cancer. This investigation focused on the negative mental health impacts of cancer, how effective support can be delivered, the barriers to support and the unmet mental health support needs.

Throughout the cancer journey there needs to be an appreciation of the different mental health needs at each stage

Cancer brings many challenges for wellbeing with fear, isolation, loss of self-esteem and of independence all having an impact. How service providers engage with service users, before, during and after treatment also has an impact, with good communication and signposting to support services an important part in promoting wellbeing. Effective support needs to be built around tailored, person-centred initiatives based on need to ensure the right support is available at the right time. 

The research we conducted highlighted that the post-treatment phase is an especially volatile time for mental wellbeing

With full psychosocial impacts of cancer and treatment likely to be felt most acutely at this stage. But it is also the time when the well-managed clincial pathway if support is withdrawn, This can lead to people being unable to access support services due to lack of signposting or co-ordination between clinical and non-clincial support providers. Whilst there are many excellent support initiatives in Scotland, with work being done to improve support routes and encourage multi-agency approaches, there is still much to be done to ensure that everyone can access the support they need. 

Such barriers to emotional and mental health support can often stem from the lack of collaboration between service providers, creating this absence of sign posting and integratred support pathways throughout the whole cancer journey. There are also serious inequalities in service access across Scotland, with rural and deprived areas facing an unmet need in terms of service provision. Certain groups, especially men and minority groups again represent an unmet need and service provision needs to be better suited to their needs.

In order to address the unmet need in terms of service provision for mental health during cancer and to strengthen existing programmes, we make the following recommendations:

Recommendations
  1. There needs to be greater awareness by all service providers of the mental health impacts of cancer and the need to support emotional wellbeing and mental health

  2. The right support needs to be given at the right time

  3. Tailored, person-centred support needs to be offered at all stages of the cancer journey

  4. There must be more collaboration and communication between service providers

  5. Improve signposting for mental wellbeing services

  6. Provide clearer and more co-ordinated support pathways after treatment 

  7. Improve the provision of support across Scotland

  8. More research is needed into how best to tackle social deprivation and co-morbed health inequalities

  9. More research and awareness is needed to design cancer and wellbeing support services that engage BME communities

  10. Ensure all people with cancer have access to some level of tumour support