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Alex J Mitchell Consultant in Psycho-oncology and Hon SnR University of Leicester

How many people with distress or depression receive psychosocial care in cancer settings? ………………An updated meta-analysis. Alex J Mitchell Consultant in Psycho-oncology and Hon SnR University of Leicester.

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Alex J Mitchell Consultant in Psycho-oncology and Hon SnR University of Leicester

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  1. How many people with distress or depression receive psychosocial care in cancer settings? ………………An updated meta-analysis Alex J Mitchell Consultant in Psycho-oncology and Hon SnR University of Leicester ajm80@le.ac.uk www.twitter.com/_alexjmitchell

  2. Daily Mail

  3. Screening Symptoms Help-seeking Diagnosis Treatment Aftercare

  4. Context

  5. Millions Living with Cancers (2010 SEER) http://seer.cancer.gov/faststats/

  6. Prevalence of depression in Oncology settings • 70 studies involving 10,071 individuals;14 countries. • 16.3% (95% CI = 13.9% to 19.5%) • Mj 15% Mn 19% Adj 20% Anx 10% Dysthymia 3%

  7. “Most Pressing Issue” Leicester N=540

  8. Rates of medical care? Baseline treatment and diagnosis rates

  9. Chances of No Treatment for Colorectal Ca (2011) Baillargeon J, et al Effect of mental disorders on diagnosis, treatment, and survival of older adults with colon cancer. J Am Geriatr Soc. 2011 Jul;59(7):1268-73.

  10. Chances of No Diagnosis for Colorectal Ca (2011) Baillargeon J, et al Effect of mental disorders on diagnosis, treatment, and survival of older adults with colon cancer. J Am Geriatr Soc. 2011 Jul;59(7):1268-73.

  11. Dx Mental Health? Are mental health diagnosed?

  12. Comment: Slide illustrates diagnostic accuracy according to score on DT

  13. Rx Mental Health? Are mental health treated?

  14. % Receiving Any treatment for Mental Health 12mo Service Use (NIH, 2002) Two explanations=> Maria Hewitt, Julia H. RowlandMental Health Service Use Among Adult Cancer Survivors: Analyses of the National Health Interview Survey Journal of Clinical Oncology, Vol 20, Issue 23 (December), 2002: 4581-4590

  15. Receipt of Care Receipt of Any Help Receipt of Individual Support Receipt of Information Receipt of Group

  16. Clinician Intervention (n=540)

  17. Updated meta-analysis

  18. Distress Want Help Offered help Received care

  19. PATIENTS……….. Want Help? (n=1844)

  20. CLINICIANS. Who Offers Psychosocial Help? (n=2557)

  21. How Many Patients Receive Psychosocial Help?

  22. What Help is wanted

  23. “Desire for Help” City of Hope n=4000

  24. Inequalities in care? Are mental health concerns disproportionately ignored?

  25. 1660 Cancer Patients in Florida (Jacobsen, 2010) Psychooncology. 2011 Nov;20(11):1221-7. doi: 10.1002/pon.1849. Epub 2010 Sep 27.

  26. Where Next?? Addressing the gap

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