What Assessment Tools Are Used for Patients With Cancer and Psychiatric Diagnoses?
Helen Meldrum is a researcher, lecturer, and associate professor of psychology at Bentley University, Waltham, MA.

When patients with cancer also suffer from psychiatric diagnoses, it can present unique challenges to healthcare professionals. Because oncology nurses build relationships with patients while addressing issues, understanding the obstacles to practice is key to providing the best possible care. By having a keen understanding of symptoms, assessment procedures, and necessary response skills, oncology nurses can work together with the mental health team to provide holistic care throughout the cancer journey. 

Oncology professionals must check their own emotional responses when treating this patient population. By recognizing different mental illnesses and their associated behaviors, symptoms, and treatments, healthcare professionals can understand the specific profile of each patient and his or her condition. Coordinating with a patient’s mental health team helps provide a safe environment for both patients and oncology professionals. Through collaboration, nurses can learn the unique language of mental illness and close the gap between patient and provider.

When caring for patients who struggle with mental challenges, oncology nurses should consider implementing concepts from Psychological First Aid (PFA). The key components of PFA include a focus on compassionate listening, meeting a patient’s basic needs, encouraging support from family members and significant others, and protecting the patient from potential harm. As a recommended practice from the American Psychological Association, this evidence-based intervention helps providers guide patients through traumatic events such as cancer diagnoses to help them better cope with difficult situations. Moreover, PFA training gives oncology nurses the knowledge and resources to manage their own stressful events—along with their patients’—and can potentially work as a form of self-care.

In cases of unruly or unusual behavior in a clinical setting, oncology nurses and oncology nurse navigators should employ the Mental Status Exam (MSE), a psychological equivalent to a physical exam, to gather standardized information that’s easily disseminated among the healthcare team. Often, healthcare professionals immediately call for security when a patient is acting abnormally, but MSE allows nurses to assess and understand the nature of a patient’s issue, potentially providing support or an effective referral to a psychiatric consultation onsite in the clinical setting. This could prevent missed oncology appointments or delays in a patient’s cancer treatments. 

Through subjective patient feedback and objective observations, MSE helps distinguish between mood and thought disorders, cognitive impairments, and other psychiatric issues, allowing nurses and navigators to collect the most important information to make referrals for the best possible patient care.

Oncology nurses are not expected to be experienced psychologists or mental health professionals. However, they are uniquely equipped with the expertise to address patient issues and advocate for vulnerable patient populations—including their patients who also are being treated for psychiatric diagnoses. Through mental health assessment training, oncology nurses can understand the emotional and behavioral issues patients face and respond to them in a caring, efficient manner to provide the best care possible.