Written by Sophie Lansdowne, Project Manager for Personalised Cancer Care at South East London Cancer Alliance (SELCA)
This World Mental Health Day, our personalised care team have been reflecting on the emotional, social, spiritual and psychological impacts that cancer can have on our patients’ mental health, and just how important it is to talk about it, to make sure we provide the right support at the right time.
Many of those affected by cancer can experience many different emotions, some of which might be difficult to cope with. We know that in the year after someone receives a diagnosis, around 10% of patients will experience symptoms of depression and/or anxiety which need the support of specialist psychological services[1], and that for those who experience a recurrence of their cancer, this rises to 50%.
Cancer can also affect how we think and our beliefs, as well as our relationships with those who are important to us. This is important for us to remember, as 58% of those living with cancer report feeling that their emotional needs are not looked after as much as their physical needs[2]. In South East London, almost 50% of our patients completing the Quality of Life survey at 18 months after their diagnosis, report facing challenges with anxiety and/or depression. In focus groups, our patients have talked to us about struggling with a range of emotional difficulties, including fear of the unknown and uncertainty, feeling isolated and feeling lonely, and how important it is to have somewhere safe to share their experiences and get support.
All of this is often intertwined with the physical and practical effects of cancer and its treatment, all of which can remain for a long time and affect quality of daily life. We know that 10 years after treatment, 54% of patients continue to experience at least one significant psychological difficulty[3], showing that we need to be able to provide access to, and raise awareness of, support services far beyond treatment and even its follow-up.
Our patients in South East London, have also talked to us about the need for support for families and loved ones throughout cancer treatment and beyond. Nationally, we know that 67% of carers experience symptoms of anxiety and 42% experience symptoms of depression, but over three quarters do not receive any support[4].
So what are we doing in South East London to improve access to psychosocial support for those affected by cancer and their loved ones?
Firstly, we wanted to learn more about psychosocial support in South East London. We wanted to find out what services we have providing emotional, social, psychological and spiritual support for our patients and their families. We wanted to learn more about how they can help and how our patients can access them.
We then brought all of our learning together to share with others in South East London, including our patients and professionals who work with those affected by cancer, and we held a workshop to talk about what else we could do to improve access to support. From this, the importance of key three themes emerged:
- Raising awareness of psychosocial needs; we need to better understand the emotional, psychological, social and spiritual impacts cancer can have, and we need to feel better equipped and more confident in talking about them
- Raising awareness of psychosocial support services across South East London – we can’t signpost to services if we don’t know about them, and our patients and their loved ones can’t access them if they don’t know about them
- Building relationships between services – having closer relationships with other support services means we can better understand the support they provide and we can help our patients to access the right service at the right time
From this, SELCA has been focusing on three key areas of work to help improve access to psychosocial support for those affected by cancer in South East London:
- Developing a support pack for healthcare professionals: We are working with Guy’s Cancer Academy to develop an educational resource for staff to help them better understand the emotional, psychological, social and spiritual impacts of cancer, and the support services we have available locally, to help staff to consider where someone might receive the support that is right for them. This will be open to all staff, working inside and outside of cancer services and we hope it will help staff to feel more confident signposting to psychosocial services. This will be available next year and we will share more information about it in due course, so watch this space!
- NHS Talking Therapies: We have been working with our specialist Cancer Psychology services and our local NHS Talking Therapies for Anxiety and Depression services to see how we can work better together and develop open communications to make sure our patients and their families find support in the right service for them. To help with this, we are working together to develop a training and support model for NHS Talking Therapies, to help improve confidence in talking about cancer and supporting those affected by cancer
- Improving integration between services: We’re continuing to work with as many of our support services across South East London as we can, to build closer relationships, improve integration between services and raise awareness of all the support we have available in as many places as we can. We hope all of this will help those affected by cancer to reach the service that would be of most help to them.
We will be sharing more about all of this work as it continues. If you’d like to find out more or get involved, please get in touch by emailing sophie.lansdowne@gstt.nhs.uk
If you think you or someone close to you might find some support helpful, you can find local support services in your area on the Cancer Care Map, available here: https://www.cancercaremap.org/
[1] Guidance on Improving Supportive and Palliative Care for Adults with Cancer, National Institute for Health and Care Excellence, 2004. Available here: https://www.nice.org.uk/guidance/csg4
[2] Worried Sick: The Emotional Impact of Cancer, Macmillan Cancer Support, 2006. Available here: https://www.macmillan.org.uk/documents/getinvolved/campaigns/campaigns/impact_of_cancer_english.pdf
[3] Commissioning Guidance for Cancer Psychological Support, Healthy London Partnership, 2020. Available here: https://www.transformationpartners.nhs.uk/wp-content/uploads/2020/02/Refreshed-February-2020-Guidance-doc-Psychological-support-for-people-affected-by-cancer-.pdf
[4] Commissioning Guidance for Cancer Psychological Support, Healthy London Partnership, 2020. Available here: https://www.transformationpartners.nhs.uk/wp-content/uploads/2020/02/Refreshed-February-2020-Guidance-doc-Psychological-support-for-people-affected-by-cancer-.pdf