How does severe mental illness impact on cancer outcomes in individuals with severe mental illness and cancer? A scoping review of the literature.

INTRODUCTION: Individuals living with severe mental illness (SMI) have a reduced life expectancy of approximately 15-20 years compared to the general population1,2. Individuals with SMI and comorbid cancer have increased cancer related mortality rates compared to the non SMI population. This scoping review examines the current evidence in relation to the impact on cancer outcomes where individuals have a pre-existing SMI. METHODS: Scopus, PsychINFO, PubMed, PsycArticles and the Cochrane Library were searched for peer reviewed research articles, published in English language between 2001 and 2021. Initial title and abstract screening, followed by full text screening sourced articles reporting on the impact of SMI and cancer on: stage at diagnosis, survival, treatment access or quality of life. Articles were quality appraised, and data were extracted and summarised. RESULTS: The search yielded 1226 articles, 27 met the inclusion criteria. The search yielded no articles that met the inclusion criteria that were from the perspective of the service user or that were focused on the impact of SMI and cancer quality of life. Three themes were developed following analysis: Cancer related mortality, stage at diagnosis, and access to stage appropriate treatment. DISCUSSION: The collective study of populations with comorbid SMI and cancer is complex and challenging without a large-scale cohort study. The studies yielded through this scoping review were heterogenous and often study multiple diagnoses of SMI and cancer. Collectively these indicate that cancer related mortality is increased in the population of individuals with pre-existing SMI and the SMI population are more likely to have an increased likelihood of metastatic disease at diagnosis and less likely to receive stage appropriate treatment. CONCLUSIONS: Individuals with pre-existing SMI and cancer have increased cancer specific mortality. Comorbid SMI and cancer is complex, and individuals with SMI and cancer are less likely to receive optimal treatments, experience increased interruptions and delays to treatment.

Changing me to we: Developing teambuilding in radiation therapy.

BACKGROUND: There has been a causal link identified within the literature between poor team function and errors, patient outcomes, staff satisfaction and performance. Lacking is supporting evidence on teambuilding and its impact on overall team performance and team dynamics. Within radiation therapy, there is difficulty in understanding the inner workings of team dynamics due to the unique complex nature of teams and with very little evidence on the impact of team building specific to radiation therapy. The focus of this research is to form a better understanding of the effects of teambuilding before and after a teambuilding education session.The knowledge gained can help in future trainings to promote and facilitate teambuilding to develop team dynamics and lead a change in culture. METHODS: Team building sessions were booked and scheduled for 148 radiation therapists. Pre and post session evaluations were distributed to all participants and collected at the end of each team building session. Descriptive statistics were used to analyze Likert scale responses. Open-ended question responses were coded and analyzed for emerging themes using thematic analysis. RESULTS: 110 of 148 radiation therapists attended one of the scheduled team building sessions. Pre-session evaluations indicated radiation therapists have a good understanding of factors that affect teamwork (88% agree); are aware of the multi-generational impact (78% agree); have the skill set to build a respectful team (86% agree); and are comfortable dealing with conflict (67% agree). Post-session evaluations indicated that participants had gained increased knowledge on teamwork (66.3% agree; 30.7% strongly agree); are more aware of the generational impact within teams (59% agree); new strategiesdeveloped to help improve team dynamics and the ability to use the lessons learnt immediately (67% and 71% respectively agree). Open ended comments indicated an interest in additional teambuilding sessions and further education on conflict resolution. CONCLUSION: Results showed an increased awareness of the factors that impact team dynamics amongst radiation therapists and an interest in receiving further education in teambuilding. Findings will be utilized to better inform debate in future development of teambuilding educational sessions to improve overall team dynamics in radiation therapy.

Experiences of volunteering: a partnership between service users and a mental health service in the UK.

The aim of the study was to investigate how people with serious mental illness perceived the experience of volunteering for the health care organisation in which they had received a service. The study took a qualitative approach and in phase one, eleven service user volunteers were purposefully sampled and interviewed. In depth interviews were analysed using grounded theory. This paper describes the findings from phase one, and highlights the following themes to represent the volunteering experience: 1) rehearsing for a new direction; 2) treading carefully at first; 3) discovering my new self; and, 4) using my experience and extending relationships. These themes further support a tentative theoretical framework that considers supported volunteering to enhance recovery because it fosters positive risk taking and gives individuals a valued identity that integrates their mental health experience. In phase two, this framework will be tested with service users in more diverse volunteer positions. The findings of my study suggest that mental health services are in a unique position to build partnerships with service users to support their recovery and journeys toward employment by providing opportunities for volunteering.