Experience of incorporating a mental health service into patient care after operations for cancers of the head and neck

The psychological needs of patients with cancer have been increasingly recognised. Those with cancers of the head and neck have previously been found to be at relatively high risk of developing mental health difficulties after diagnosis and treatment. To provide for their psychological needs a mental health liaison nurse was attached to the local maxillofacial surgery unit for a trial period of 18 months. Fifty-eight different patients out of a total possible 63 were seen on a total of 102 occasions. The main difficulties encountered were issues of adjustment. Ten patients required brief intervention and treatment as inpatients, and only two required treatment as outpatients. Most interventions were psychological and facilitated the normal adjustment process. Given the appreciable degree of psychopathology, we advocate a stepped care approach to deal with patients’ mental health needs. Initial assessment, information, and support would be provided by ward-based staff with appropriate training and supervision. Patients who were identified as having more complex needs would be seen by a mental health liaison specialist.