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Royal Commission into Victoria’s Mental Health System

Case study:

Psychosocial Oncology Program (Peter MacCallum Cancer Centre)

The Psychosocial Oncology Program at the Peter MacCallum Cancer Centre (Peter Mac) delivers integrated mental health care, treatment and support to patients with cancer.

The program is delivered by an embedded multidisciplinary team made up of clinical psychologists, social workers, music therapists, psychiatric consultation‑liaison nurses, and psychiatrists and psychiatric registrars. The multidisciplinary team is able to screen, assess, detect and respond to any pre‑existing or emerging mental health issues, in the context of the cancer affecting the patient. Mental health care, treatment and support is delivered to patients as part of routine cancer care.

Professor Steve Ellen, Director of the Psychosocial Oncology Program at Peter Mac, said the multidisciplinary team approach allows patients’ care to be assessed and adapted as needed.

The multidisciplinary team approach brings all aspects of wellbeing, mental health and cancer together, and allows us to feed back to each other to make sure we are on the same page. The multidisciplinary teams are great because patient care is often fragmented and clinicians are so busy—one member of the team presents a quick summary and everyone gets the chance to see the files, add to the information, provide input and coordinate care.

Professor Ellen said patients are referred to the program from throughout the hospital, and they can access support for the duration of their cancer treatment, both while they are in hospital and as outpatients. Patients in need are identified in two ways—during a screening process when registering with Peter Mac, and if a clinician in the hospital notices distress. Patients are contacted once they have been referred, to establish whether they are already receiving help from a mental health professional.

We take referrals from anyone within the hospital, including doctors, nurses and allied health workers, such as a physio or a nutritionist. Patients can also self‑refer. We triage to determine the urgency, type of problem and most appropriate clinician for the patient’s problem and according to their preference—we also look at their external supports to make sure we are not doubling up for patients who are already engaged with community services.

Professor Ellen explained that the four broad areas of the program focus on social work, music therapy, psychiatry and psychology, and that patients can access all or some services.

The psychosocial program is also closely connected to the spiritual care team and the wellbeing program. Our aim is to match the care to the patient’s preferences and problems in a seamless manner, with the ability to scale up and down according to their needs over time.

Professor Ellen said the psychiatric service can provide assessment and treatment, but can also work in conjunction with community clinicians to ensure patients get the best possible mental health care, as well as cancer care.

People may have a pre‑existing psychiatric disorder when they are diagnosed with cancer. Psychosocial clinicians at Peter Mac have the expertise to look after the psychiatric disorder in a way that allows them to get the cancer treatment they need.

The clinical psychology team offers a range of psychological therapies and interventions, such as cognitive behavioural therapy, mindfulness, acceptance and commitment therapy, and existential therapy. The team has also developed a number of online resources for patients whose cancer care limits their ability to attend appointments. Psychologists adapt their approach to meet a patient’s needs, and offer individual, couple or family consultations.

The social work service helps patients, families and carers during the period of change associated with a cancer diagnosis, and provides support with legal and financial support services, home support services, childcare, housing and support groups. They also assist with supports to help patients once they have been discharged from hospital, and provide referrals to local services.

Music therapy has also been a key feature of the program at Peter Mac. Professor Ellen said the music therapy offered at Peter Mac provides patients with an alternative entry to psychological wellbeing and has proved helpful to many people.

Music therapy has been one of the most successful components. It’s incredibly good for cancer patients, especially younger patients who often feel less comfortable with psychiatrists and psychologists. It’s a good entry point and may give people the opportunity to reflect and provide new ways to share positive experiences with family and friends.

Sources: RCVMHS, Interview with Professor Steve Ellen, October 2020; Peter MacCallum Cancer Centre, ‘Psychosocial Oncology’ [accessed 27 October 2020].