Cancer Care for People with Significant Mental Health Difficulties - Understanding the Barriers and Facilitators to Care

Background: Higher rates of cancer mortality exist for people with significant mental health difficulties (SMHD) compared to the general population. The systematic review aimed to identify and synthesise previous qualitative literature regarding barriers and facilitators to accessing and engaging with cancer care for people with SMHD. An empirical study explored the experiences of cancer care from the perspectives of participants with SMHD. Methods: (1) A systematic search across five databases was conducted in January 2021 followed by a narrative synthesis of six eligible studies (2) interviews with participants with SMHD from two hospital settings in Ireland and participants recruited via online mental health and/or cancer support organisations, based on their experiences of accessing and engaging cancer care were analysed thematically. Results: Key findings from the systematic review and the empirical study highlighted similar barriers and facilitators to accessing and engaging with cancer care for people with SMHD. The main barriers included: stigmatising attitudes from staff and family members and the fragmentation of mental health and cancer care delivery across healthcare disciplines. Key facilitators to care included: connection with mental health services, a stronger collaboration among healthcare professionals working across psychiatry and oncology settings and the development of a patient navigator role to facilitate stronger links between patients and healthcare services. Conclusions and clinical implications: Findings from the narrative synthesis and the empirical study provides further evidence for the importance of facilitating timely and integrated mental health and cancer care for patients with SMHD.