Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Accessing psycho-oncology services: A systematic review of factors influencing the help seeking decisions of cancer patients with co-morbid anxiety and depression. (#411)

Joanne Shaw 1 , Anastasia SERAFIMOVSKA 1 , Haryana Dhillon 1 , Richard De Abreo Lourenco 2 , Phyllis Butow 1
  1. Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, NSW, Australia
  2. Centre for Health Economic Research and Evaluartion, University of Technology, Sydney, NSW, Australia

Aims: Despite availability of effective mental health and psycho-oncology treatments, many people do not seek treatment. Inadequate treatment potentially produces a cascade of serious medical and psychological consequences. Understanding the factors underlying individual decision-making about help-seeking is crucial in order to increase the uptake of psycho-oncology referrals. The aim of this systematic review was to explore the factors that influence the help-seeking decisions of adults with cancer and co-morbid anxiety and/or depression.

Methods: PubMed, MEDLINE, EMBASE, PsycINFO, CINAHL and The Cochrane Library were searched to identify studies reporting help-seeking for cancer-related mental health concerns. Any study reporting primary data published in English between 2000-present was included. Two researchers reviewed articles for eligibility, extracted data and conducted quality appraisals using the Mixed Methods Appraisal Tool (Prospero CRD42018110741).

Results: Of the 5278 records screened 99 articles met the eligibility criteria for data extraction and quality appraisal. Low mental health literacy, concern about being identified as being perceived as not coping, as well as severity of psychological symptoms, influenced help-seeking behaviours.  Research quality was relatively poor due to the high number (67%) of small qualitative studies or cross-sectional surveys exploring unmet need. The majority of studies failed to define help-seeking or differentiate between specialist mental health, general supportive care and informal support Mental health status was not recorded at baseline. Studies typically reported service utilisation in terms of general supportive care and did not explore reasons for service uptake (or not).

Conclusions: To facilitate greater uptake of psycho-oncology treatment among people with cancer there is an urgent need to move beyond studies focused on access barriers and perceived unmet need. Understanding the factors influencing patients’ decisions to engage with psychological treatment is critical.