Introduction
This learning resource provides information about psychological support for people with serious mental illness who have been diagnosed with cancer.
In this module you will find information about:
The importance of psychological support
Being diagnosed with cancer can provoke a range of strong emotions including fear, anxiety, anger and loneliness. Your cancer treatment might also have an impact on your mood and general mental wellbeing, for example feeling more tired, having difficulties sleeping or making it harder to concentrate.
Each person will need their own individualised support. If you have a diagnosed mental health condition, the impacts of cancer might have an impact on your mental health. It can therefore be helpful to work with your mental health and cancer teams to get support early when needed.
If you feel you or someone else is in danger, ring 999 or go to your nearest A&E now. You will be able to access specialist mental health support as quickly as possible.
If you need urgent help for your mental health but it isn’t an emergency, you should telephone 111, select the mental health option and speak to a trained mental health professional.
You can also access the support you need though NHS 111 online or call your GP to arrange an urgent appointment.
Planning in case your mental health worsens
Even if you feel okay at the moment, it is important to have a crisis plan in place with your mental health and cancer teams. This may help you to feel reassured that you will get the help you need if you do experience challenges in the future.
Working with your mental health team, it is a good idea to check that the following plans are up-to-date and take into account your cancer diagnosis:
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Your ongoing care plan, which should be developed with your help and includes support you might need to attend and complete mental health treatment.
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A risk assessment plan, which identifies potential triggers and issues which might lead to you becoming more unwell in terms of your mental health.
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A crisis plan, which is designed to clearly list the steps to take if your mental health is in crisis, including key contact points at your mental health service and elsewhere.
If you are receiving psychological support from your cancer team, you should also speak to them about how they can input into these plans to support you.
Psycho-oncology support
Psycho-oncology services are dedicated NHS services designed to help people with the psychological impact of cancer and cancer treatment. These services offer psychological and emotional support for those with a cancer diagnosis (and those close to them) from diagnosis, throughout treatment, at the end of treatment and beyond.
Everyone’s experience of cancer is different, but these services can help with areas such as:
• Coping with emotions such as fear, sadness, anger, guilt, shame, and frustration
• Feelings of low mood and anxiety related to cancer or cancer treatment
• Living with uncertainty
• Making decisions about cancer treatment
• Coping with change and loss
• Changes in self-esteem or sense of self
• Communicating with family, friends or children
• The impact of cancer and its treatment on relationships
• Concerns related to fertility and sexual functioning
• Adjusting to changes to your body and appearance
• Managing the side effects of cancer treatment, such as pain and fatigue
• Managing the demands of life with cancer treatment
• Fears of cancer coming back or about death and dying
• How cancer has impacted upon a pre-existing mental health issue
Psycho-oncology services do not replace your existing mental health treatments or services, but they may be able to offer help with particularly difficult situations people might experience with cancer and cancer treatment. They may also help your cancer team coordinate your care.
If you think you might benefit from using psycho-oncology services, you should speak to your clinical nurse specialist. If you live in south east London, there are a number of services you might be able to access:
King’s Cancer Psychological Care Team
This service is available for patients or their relatives who are receiving cancer care at King’s College Hospital or the Princess Royal University Hospital (PRUH).
King’s Haemato-oncology Counselling and Psychology Service
The haemato-oncology department has its own counselling and psychology service for patients affected by blood cancers or bone marrow failure disorders, those undergoing stem cell or bone marrow transplants, and their families and carers.
GSTT Psycho-Oncology Support Team
This service is available for patients who are having, or have had, their main treatment at Guy's and St Thomas' NHS Foundation Trust.
Lewisham and Greenwich Macmillan Psychological Support Team
This service is available for patients or their relatives who are receiving cancer care at Lewisham and Greenwich NHS Trust.
Psychological support and self-help tools
Being diagnosed or being treated for cancer can feel isolating. If you’re worried about your mental health you should always speak to your clinical nurse specialist (who will be trained in providing psychological support for people with cancer) and your mental health team. There are also a number of additional services and self-help tools which may help to build your resilience.
Telephone helplines
Both Macmillan and Cancer Research UK run telephone helplines with experts on hand to answer any questions you may have.
Calls are free from all UK landlines and UK mobile phones.
Macmillan Support line (open every day from 8am – 8pm): 0800 808 0000
Cancer Research UK Nurses: (open from Monday to Friday, 9am – 5pm): 0808 800 4040
You can also search for local support services via the Cancer Care Map. Simply select the specific support you are after and then search for what services are offered in your local area.
Cancer Wellbeing London promotes education and support sessions across London for patients to hear from experts about how they can live healthily both while undergoing treatment for cancer and also when treatment has finished.
The Recovery College is run by the South London and Maudsley Hospital trust (SLaM) and offers free, recovery and wellbeing education at different community venues across South London and also online.
Anyone who has used SLaM, along with their supporters, can attend any course in any venue. Descriptions of the courses available alongside the timetable of when they are taking place are on the website.
In other areas of the UK, you can access Recovery Colleges through most mental health NHS trusts. Contact your mental health provider to find out more.
Watch the video below to find out more about how the Recovery College is taking a new approach to supporting people with mental illness:
Talking through your emotions with people who are in the same situation as you can be extremely helpful, and there are specialist online communities where you can easily connect with others.
Macmillan run an online cancer forum called the Online Community which is available 24 hours a day, seven days a week. There are different forums available to join and professionals are on hand to answer your questions.
The community provides a safe environment where you can talk anonymously with other members who understand what you are going through.
Cancer Research UK also provides an online service called Cancer Chat where you can connect with others who have been diagnosed with cancer. There are a number of forums available, and you can see what is being discussed before joining.
Shine offer support for younger people affected by cancer, including via Facebook Groups, workshops and other courses.
NHS talking therapies are services who offer a range of different psychological treatments which can help with feelings of anxiety, depression or stress, as well as a range of other mental health problems.
Although there are different types of talking therapy, the common theme between each of them is giving you time and space to reflect on problems you might be experiencing, and supporting you to feel better. There is good evidence that talking therapies can help a wide range of people.
If you are currently under the care of a specialist mental health team, speak with them about your psychological support. If you don’t currently have a specialist mental health team, as long as you are registered with a GP, you can refer yourself directly to NHS talking therapies online. You may also want to speak to your clinical nurse specialist or another member of your cancer care team about talking therapies, which they might be able to refer you to.
Summary
