Witnessing unnecessary suffering: A call for action and policy change to increase access to psycho‐oncology care

Abstract

This Special Issue was proposed and supported by the Board of the American Psychosocial Oncology Society (APOS). Our esteemed Guest Editors were nominated by APOS to bring these papers together and reflect the special circumstances their members face, and indeed that are faced by psycho-oncology professionals globally, namely ensuring that psychosocial care is fully accepted and integrated, equally and without bias, as part of comprehensive cancer care.-.Maggie Watson, Editor-in-Chief This year, we have witnessed so much suffering as we have confronted the intersecting public health crises of the COVID-19 pandemic and systemic racism. Marginalized populations: Black, Latino, indigenous populations, older adults, individuals affected by poverty, disabilities, and mental illness, have experienced disproportionate burden from the pandemic. These populations have increased rates of infection, worse health outcomes, and encounter additional barriers to maintaining financial wellbeing and accessing care. We have experienced the impact of a health care system that is ill-prepared and ill-designed to meet the minimal health needs of underserved populations. As psycho-oncologists, we have seen our patients struggle with the decision to delay their cancer care and experience increased isolation and fear. As care delivery has rapidly transformed from in-person to virtual models, we are failing to reach the patients who likely need our interventions the most. Adults with low socioeconomic status, particularly older adults from marginalized populations, lack access to technology, are socially isolated, and must balance many competing needs.

Oncology mental health providers' adaptation of an evidence‐based intervention: A mixed‐methods study

“…Rather than changes to BBI's core components, the described adaptations were grounded in the difficult circumstances of psychosocial care in oncology settings (i.e., shortage of mental health providers, insufficient administrative services, and limited insurance coverage for services). [20][21][22][23] Overwhelmingly, the rationale for shortening BBI by session number/length was to treat more patients and generate more revenue. This was also consistent with organizational rules for caseload numbers and session length (e.g., 30 min).…”

“…For example, use of autogenic relaxation versus progressive relaxation does not change a core component, whereas using expressive writing or music therapy in combination with BBI would yield an intervention of unknown efficacy. Rather than changes to BBI's core components, the described adaptations were grounded in the difficult circumstances of psychosocial care in oncology settings (i.e., shortage of mental health providers, insufficient administrative services, and limited insurance coverage for services) 20–23 …”

Emotion Regulation Flexibility and Electronic Patient-Reported Outcomes: A Framework for Understanding Symptoms and Affect Dynamics in Pediatric Psycho-Oncology

“…Simultaneously, due to various reasons, such as a rise in internet and smartphone accessibility worldwide, but also due to global circumstances such as the COVID-19 pandemic, digital health solutions (DHS) have become a valuable and much-needed resource for improving the quality of research and treatment of a wide variety of behaviors and diseases, especially within oncology and psycho-oncology [ 25 , 26 , 27 ]. They constitute a resource that inevitably must be reckoned with.…”