How Can Patients With Cancer, Caregivers Find the Best Mental Health Care Available?

Seeking mental health care during one’s cancer journey can help improve symptoms related to anxiety, depression, fear and stress, but how does a patient or caregiver get started to find the best modality for them?

“Sometimes we think it’s more commonplace for some­body to experience anxiety, depression or stress in the middle of treatment or at the beginning, but once somebody completes treatment, that’s when those stressors become even more prevalent,” Diane Schaab told CURE®. “Your work, your life has changed, you feel different physically, psychologically, you want to go back to normal. … It’s really important to make sure we focus on mental health from the day of diagnosis all the way through survivorship.”

CURE® spoke with Schaab and Elaine Smith, behavioral health therapists at Cancer Treatment Centers of America in Atlanta, to learn more about why mental health is impor­tant from diagnosis through survivorship, the different types of therapy and helpful resources.

Why is mental health important?

• When you receive a diagnosis of cancer, it’s a six-letter word full of trauma. There’s a multitude of emotional responses, and it can be very difficult to determine the most immediate need.
• You’re going to have levels of distress, or “adjustment issues,” at any point along the spectrum. For many, at immediate diagnosis, throughout treatment and during survivor­ship, there will be levels of anxiety and fear.

What does therapy entail?

• Various issues can affect the mental health care patients need and can be related to practical matters (i.e., family, finances, work, communication), spiritual matters, physical matters or relationship matters. Different approaches can be utilized to fit one’s needs.
• Modalities of therapy include individual, marital, group and family; spiritual care; psychiatric evaluation for medica­tions; cognitive behavioral therapy for pain, sleep, anxiety and depression; psychoeducation and webinars.
• Physicians can refer patients to behavioral health therapists. This referral can also happen with the first nurse visit or the first general assessment. Behavioral health services may be offered through the hospital providing cancer care or externally depending on resources.

How do I know what is right for me?

• Consider what the primary stressor is (communication, anxiety, etc.). It’s normal for stressors to change from day to day, and it can be difficult to determine the best path forward. Be open and share your ever-changing needs so you and your therapist can formulate the best treatment plan.
• Remember, quality of life is important. What is this problem and what’s causing it? What resources can help produce a better quality of life? Whether the problem is related to sleep, fatigue, anxiety or depression, tackle it and enhance it with talk therapy, a psychiatrist and webinars.

What may prevent me from seeking the care I need?

• It’s common for patients to focus on the physical challenges of cancer when talking to their doctors, but often they may minimize or forget to talk about psychological challenges.
• Fears: Will I like my therapist? How can I reveal this? Am I going to be judged? Patients have the ability and the power to meet with a therapist and create a treatment plan.
• Saying, “I’m afraid I’m going to die,” and loved ones not wanting to hear that. Loved ones want to encourage and not discourage. When the patient voices a deep fear, caregivers think it is a negative statement. Family members and caregivers should encourage loved ones to get emotional support.
• Adding another layer of appointments and possible medications. Mental health counseling during cancer treatment marries the mind to the body and helps the patient feel empowered during their healing journey.

What should I be aware of when looking for support?

• A support group may present some challenges depending on how it is facilitated. Find out what a group entails and make sure it’s a good fit. The same goes for finding a therapist.
• Not everybody has an accessible pathway, depending upon their insurance. This includes Medicaid and Medicare. State laws can affect how a Medicaid patient gets access to mental health care, among other hurdles. Centers for Medicare and Medicaid Services (CMS) can direct patients to appropriate community providers.

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