Objective
People with severe mental illness who are diagnosed with cancer may experience worse treatment adherence, quality of life and poorer survival, but we lack ways to address this. This presentation will discuss how standard psychosocial care may not be sufficient and how key barriers may be addressed through support models and interventions targeting people who face the double burden of severe mental illness and cancer.
Methods
Barriers for receiving optimal cancer care among people with severe mental illness including multiple needs, a siloed healthcare system with limited knowledge of mental illness, as well as persisting stigma are present across the patient, provider and system level and complex interventions are needed to address them. Based on specialized models of care, this presentation will discuss how different intervention components may be relevant to address single barriers and how they may be combined to address the complexity of needs.
Results
Early results suggest several promising care models including intervention components such as e.g. patient-centered care, identification and monitoring of psychiatric symptoms, collaborative care and or cross-sectoral collaboration on treatment and care e.g. through multidisciplinary conference, as well as education of oncology HCPs and caregivers and professional caregivers. One example is the Bridge model which has been tested in the USA and is now being adapted to a Danish setting with the STARS project.
Conclusion and Clinical implications
While further effect studies are needed, we have promising care models and intervention components available. Cultural and healthcare system adaptations of the models and implementation strategies to ensure realistic local uptake should be considered early. We need to improve recovery and cancer outcomes for cancer patients with severe mental illness, despite fluctuations in psychiatric and cancer symptoms.