psychological support lacking for dermatology patients

Psychological support Lacking For Dermatology Patients

Author: talkhealth

Date: JUL 2016

psychological support lacking for dermatology patientsExperts from the Severe Eczema and Psoriasis Team at St. John's Institute of Dermatology, St Guys’ and St Thomas’ NHS Foundation Trust, have warned that dermatology patients are not receiving the sufficient psychological support they truly need.

The team, that were recently recognised as the first ever BMJ Dermatology Team of the Year, have argued that patients with dermatological problems are not receiving the holistic care that they need to help treat the psychological issues that arise as a result of having a skin disease.

Studies suggest that every person at some point in their life will experience a skin problem. Those who experience moderate to severe cases of dermatological conditions such as eczema, psoriasis and acne, can often find themselves feeling frustrated and depressed. With 68% of people with a skin condition saying that the number one issue they face is a fall in self-confidence, and with over 30% of dermatology patients being diagnosed as depressed, it comes as no surprise that there is a desperate need for support.

After establishing that their current approach to patients wasn’t efficient enough to recognise their patients’ psychological support needs, St John’s decided to develop a new system to ensure they captured every patient that needed extra support.

This new approach involved patients being asked to fill out surveys on iPads, containing questions relating to their condition as well as their psychological state, while waiting for their appointment. As these were done electronically, patients’ answers were automatically uploaded to their electronic patient record which allowed the team to track any irregularities in a patient’s mental wellbeing. Doctors were then alerted if the questionnaire results showed a patient was struggling and in turn allowed them the opportunity to offer advice, treatment suggestions or referrals to other helpful sources which fitted their need.

Data showed that, “71% of their patients, who were subsequently diagnosed with major depressive illness using the new system, and 89% with anxiety, were previously unrecognised as having mental health problems.”

With such high numbers of patients’ psychological problems now being recognised, it is surprising that so many still remain under the radar. However, with mental illness still being considered quite a taboo issue even now, it can be left undetected if the right questions aren’t being asked. Professor Catherine Smith, Consultant Dermatologist within the Severe Eczema and Psoriasis Team, did shed some light on this issue, “…prior to evaluating our service and introducing this new approach, we considered that we were already providing holistic care. Identifying the high needs of our patient population motivated us to fully integrate psychological support with treatment of the physical symptoms of skin disease throughout the visit to our service.” It was only after identifying this need for psychological support that the team reassessed their approach, which they previously considered holistic enough, and made it more effective.

With a team that is now made up of emotionally trained dermatologists, doctors, and even receptionists, St John’s is now able to provide the most efficient holistic care. Dr Nick Levell, President of the British Association of Dermatologists, stated, “I hope that [the work of St John’s] will encourage other departments to reflect on their own work, and investigate ways in which they can improve.” The time has now come for all dermatology practices to recognise the importance of psychological support to ensure patients no longer suffer in silence.

British Association of Dermatologists, ‘The need for psychological support amongst dermatology patients’, July 2016.
British Skin Foundation, 2012.
‘Depression in dermatology: an integrative perspective’, July 2016.
British Association of Dermatologists, ‘The need for psychological support amongst dermatology patients’, July 2016.


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