Cancer and mental health: an example of good support
Julie Cain
Nicola Miller
Samantha Termer
Nicola, Julie and Sam from the teenage and young adult cancer team in Glasgow tell us how they support young people with their mental health throughout cancer and after treatment.
Dr Nicola Miller (Principal Clinical Psychologist), Julie Cain (Teenage Cancer Trust Nurse) and Samantha Termer (Youth Support Coordinator) work together at The Beatson West of Scotland Cancer Centre in Glasgow, supporting young people through cancer.
The way their team is set up means they’re able to focus on supporting young people’s mental health alongside their physical health, from the moment they’re diagnosed with cancer.
It’s a great example of what good support looks like – but currently, not all young people across the UK can access the same level of support. Through our #NotOK campaign, we’re calling on UK Governments to change this.
Tell us about your roles – how do you work together to support young people?
Julie: We have a very holistic approach to working with young people, and that’s reflected in the fact that we have a teenage and young adult cancer psychologist as well as the other members of the team. We’ve got Sam (our Youth Support Coordinator), myself and Kirsty who are the nurse specialists, and we’ve also got a Young Lives vs Cancer social worker, so we’ve got lots of different roles that intertwine.
As the nurse specialists, we complete a holistic needs assessment with each young person so we can identify what they feel their challenges are, and use that as a basis for onward referral. We complete this when we meet them initially, then again at critical time points.
But we try to have the psychologist and the other members of the team meet with each young person at a very early stage. So, long before there’s ever any kind of concern about their mental health, Nicola will have introduced herself, and the young people will be aware that there’s a psychologist in the team.
So right from the offset, we’re making it clear that we’re here to treat the cancer, but at the same time, we’re focusing on their mental health as well. I think by introducing that idea very early on, there’s less stigma attached to it. You’re not waiting until there’s a ‘crisis point’. I think that just makes it easier for young people to work with the psychologist.
We’re here to treat the cancer, but we’re focusing on their mental health as well.
Nicola: I try to meet with all of our young people when they first come into the service and hope to introduce a similar approach at the end of treatment. I think it’s really important to be proactive, to normalise distress and also to pre-empt some of the challenges they might experience further down the line.
We do have different roles in the team, but we also have a shared understanding that while cure is important, preserving that young person’s identity and sense of self, and enabling them to live a life that’s been worth the challenges of cancer, is really important.
Working as a team is really important and valuable, while we each have a slightly different understanding or experience of the young person and their family, by coming together we can create a much fuller picture of their needs that then enables us to work together to meet that aim.
What kind of things do our nurses and Youth Support Coordinators do to support young people’s mental wellbeing?
Sam: The main part of my role is to encourage peer support and peer interactions. I offer support groups on focused topics around cancer, but also activities that have nothing to do with cancer, so it’s bringing in a bit of normality and focusing on who that young person is beyond their cancer diagnosis and treatment.
For example, we’ve got a support group coming up that’s focused around a group of young people who will be undergoing a transplant. For the next few months, that group will be for those young people to meet and interact, to form a support group of their own, and we’ll just facilitate that so they can have a shared experience and meet new people going through something similar.
But equally we run some fun activities that have a therapeutic element to them. Last month I got a facilitator in to run a Japanese sashiko stitching workshop, and we had five girls come along to that who all said they felt that particular activity was very mindful and relaxing. They learned a new skill, but also learned new coping strategies to help them through difficult times, and met new people going through similar experiences.
I also offer one-to-one support, whether that’s visiting young people on the wards or communicating via text, phone calls or emails. The role’s great in that it can be adapted to suit each young person.
For example, we often find that young people struggle when coming to the end of their treatment, and while Nicola works working with them to unpack the trauma of what they’ve been through, I’m able to do a bit of supplementary work with them and focus on coping strategies.
It doesn’t all have to be about breathing techniques or ‘classic’ mental health coping strategies. It can very much be about finding a hobby or interest to focus on, and that’s what we offer – different activities that young people can find some joy in, and that offer them a bit of reprieve from cancer.
Nicola: I think your role also adds a lot of structure, Sam. A lot of young people will say in my sessions, ‘I’ve got a session with Sam today’ or ‘there’s a group today’, and I think so much structure is lost when you go through cancer.
Sometimes it’s the nurse specialist that’s the first to be aware of a difficulty with someone’s mental health.
Julie: From a nursing point of view, our role is very much as a single point of contact for the young person. We build up a supportive relationship with the young person and their family, so it’s often reassuring for them that they’ve got this one person who knows them, knows their treatment plan and knows pretty much everything about them. And quite often, I think that makes it much easier for them to come and say, ‘I’m really not feeling good about myself’ or ‘I’m really worried about this’.
So sometimes it’s the nurse specialist that’s the first to be aware of a difficulty with someone’s mental health. And it’s also something we pick up ourselves when we get to know these young people so well – they may come into clinic one day and they’re just not themselves, and we’re able to pick up on that because we have that close relationship with them at every stage.
Nicola: I try to ensure that I am accessible to young people and limit the number of barriers to accessing my support. When I meet a young person at the start of treatment, I will share my contact details, including my email address, so that they can get in touch without needing to ask for referral.
The wider team are also good at noticing when a young person isn’t doing quite as well as they had been, for example Sam or Julie might enquire ‘are things more difficult, do you think it would be helpful to see Nicola?’ and I will arrange to see them and explore together whether psychological support could be helpful.
If you’re a young person going through cancer and you feel you’re struggling with your mental health, please do speak to your clinical team, Teenage Cancer Trust Nurse or Youth Support Coordinator. They’ll do whatever they can to help you, which may include referring you to specialist support.
If you or someone else is in crisis and needs urgent help or further support, please our urgent help page.