|LETTER TO EDITOR
|Year : 2020 | Volume
| Issue : 1 | Page : 158-159
Unmet mental health needs in cancer patients in India: What needs to be done?
Sujita Kumar Kar1, Monika Thakur2
1 Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
2 Department of Psychology, AIPS Amity University, Noida, Uttar Pradesh, India
|Date of Submission||28-Dec-2019|
|Date of Decision||29-Dec-2019|
|Date of Acceptance||03-Jan-2020|
|Date of Web Publication||24-Feb-2020|
Sujita Kumar Kar
Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kar SK, Thakur M. Unmet mental health needs in cancer patients in India: What needs to be done?. Cancer Res Stat Treat 2020;3:158-9
Jagan et al., in their recent article, emphasized the relevance and importance of addressing the mental health needs of patients suffering from terminal illnesses such as cancer. The impact of diagnosis and cost of care further increase the chance of developing psychological distress. We agree that although the patients with cancer go through significant psychological distress, their mental health needs are not properly addressed. Very often, the psychological difficulties in patients diagnosed with cancer are acknowledged as a normal and natural reaction. Hence, rarely, they are provided or suggested for psychiatric evaluation. The unstructured supportive counseling falls short of addressing the mental health needs and does not differ much from the consolations the patient receives from the caregivers and well-wishers.
In a recent study, we found the prevalence of diagnosable form of depression in nearly half of the patients diagnosed with breast cancer. Mild depression is the most common form of depression in this population. However, this was a cross-sectional study, and if these patients had been followed up during their illness, the severity of depressive symptoms may have changed over time. However, there is a scarcity of research that measures the burden of mental morbidities among cancer patients as rightly pointed out by Jagan et al. Patients diagnosed with cancer also face difficulty in coping, which might be attributing to the development of psychological distress and even suicidal behavior.
Suicide is a serious sequel to mental illnesses. Suicide is understudied among patients with terminal illnesses such as cancer. Studies are much scarcer in the context of developing countries such as India. Complex psychodynamic factors interplay in the causation of suicide in patients with cancer.
The recently concluded National Mental Health Survey of India concluded that 0.9% of the general population living in the community possesses a high risk of suicide and the high risk of suicide is more in the age group of 40–59 years. When it comes to the endangered population of cancer patients, the prevalence of high suicidal risk is expected to be much higher. Unfortunately, there is a paucity of research in India, addressing this domain.
Patients suffering from cancer have higher rates of mental morbidity and increased risk of suicide. They need to be evaluated for mental health issues as part of standardized assessment and care which should be mandated periodically for timely identification and appropriate management, as comorbid mental illness may compromise the quality of life and adversely affect the outcome in cancer patients. Interdisciplinary collaboration and filling the interdisciplinary gap by psycho-oncologists may help bridge the gap.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Jagan SM, Abraham J, Mathew A. Mental health care as part of cancer care: A call for action. Cancer Res Stat Treat 2019;2:244. [Full text]
Thakur M, Gupta B, Kumar R, Mishra AK, Gupta S, Kar SK. Depression among women diagnosed with breast cancer: A study from North India. Indian J Med Paediatr Oncol 2019;40:347. [Full text]
Thakur M, Gupta B, Kumar R, Mishra AK, Gupta S, Kar SK, et al
. Coping among women diagnosed with breast cancer with co-morbid depression: A study from North India. Delhi Psychiatry J 2018;21:358-65.
Noronha V. Making a case for cancer research in India. Cancer Res Stat Treat 2018;1:71-4. [Full text]
Swain R, Pooniya S, Kar SK, Dhaka S. Suicide in a patient of rectal carcinoma: Exploration of psychodynamics from the suicide note. Med J Dr DY Patil Univ 2017;10:281.
Gururaj G, Varghese M, Benegal V, Rao G, Pathak K, Singh L, et al
. National Mental Health Survey of India, 2015–16: Prevalence, patterns and outcomes. Bengaluru: NIMHANS Publication; 2016. p. 90-121.