Finding Time for Mental Health Specialist Appointments Can Be Challenging for Patients With Cancer

In an interview with Pharmacy Times, Bruce Feinberg, DO, discussed the importance of mental health when treating patients with cancer. Although treating mental health symptoms is essential, finding the time and energy for more appointments can be challenging for these patients.

Q: Does mental health treatment differ in the community setting versus the hospital setting?

Bruce Feinberg, DO: So, for the most part, cancer treatment is outpatient, and so the notion of in-hospital is kind of often translated as an academic center rather than a community practice. But the reality is, it's the same. It's an outpatient delivery system that's highly fragmented, in which there are multiple practitioners involved in caring for that patient. And often there is a saturation point where patients can either afford in time or money to see one more doctor, and the disease management physicians always take top rungs of the ladder in terms of priority. And so, if there is a medical oncologist, a surgical oncologist, a radiation oncologist, and maybe a specialist that's managing some particular aspect of the patient's health, often that patient is saturated. And so, it's very difficult to add one more visit to a doctor with one more copay into the mix, as well as training and to get those patients referred in in a timely fashion, which again, gets back to that notion of almost pre-planning. Don't wait because there are so many impediments. Try to see if you incorporate it early on. And in our research, what we've seen is that nearly half of the physicians we surveyed have brought in psychologists and social workers into the care team exactly for that reason, so they can be engaged in that proactive manner.

Q: What role do pharmacists play in mental health care for patients with cancer?

Bruce Feinberg, DO: So, pharmacists could play a role. The question is do they play a role? Currently, we are seeing that in more and more academic institutions, pharmacists are part of the care team. I think that's much less the case when we get into community practice. They do bring a skill set in terms of their knowledge of drug and disease and certainly if there is a drug intervention that's believed to be beneficial—antidepressant, anti-anxiety—I think they can play a role. But I think at the core, it is individuals who are skilled professional in their profession, to deal with the issues that relate to mental health and, at a minimum, social workers who can help guide the patients through crises and also navigate the care they need and where they can possibly get it. And to a larger degree, if we can actually get psychologists into the mix.