Objective
Older adults with cancer commonly experience psychological distress. However, the rate they receive mental health services is low, but reasons for this are inconsistently documented. This study aims to characterise adults with cancer referred to mental health services, explore how age influences referrals, and explore health professionals' attitudes towards mental health in older adults and referral preferences.
Methods
We retrospectively collected data from 557 adults with cancer who were referred to the Clinical Psychology Department at Peter MacCallum Cancer Centre in Melbourne, including demographics, clinical details, and mental health referrals. Additionally, we surveyed 18 healthcare professionals using the General Help-Seeking Questionnaire, Gatekeeper Behavior Scale, Mental Health Literacy Scale, and Attitude Questions.
Results
Adults with cancer aged under 65 are more likely to be referred to mental health services than those 65 and older (p<0.001), but among those referred there is no significant difference (p = 0.25) in referral acceptance rates. Among referral reasons, adults with cancer under 65 are more likely to be referred for adjustment reasons compared to those 65 and older (p<0.05). Healthcare professionals endorse opportunity and motivation factors more when referring adults with cancer aged over 65, but capability factors are a bigger barrier, with nearly half of these factors endorsed by less than 60%.
Conclusions
Older adults with cancer may face inequities in mental health service referrals, but those referred were equally open to engaging with services. Capability factors present the greatest barrier for healthcare professionals in referring these adults, highlighting the need for training.