Policy Context

Australia’s population level of psychological distress increased significantly from 2001 to 2017/18, and demand for psychological services has grown with this increase in prevalence.^1,2 In 2020–22, more than 17% of Australian adults accessed mental health services, an increase of 46% compared to 2007.³ This has increased demand for psychological services, and there is a significant mental health treatment gap, with barriers to accessing high-quality care for people with mental ill-health within an under-resourced mental health system.^{2, 4, 5} To address these shortcomings, the federal, state and territory governments, who share responsibility for the delivery of mental health services in Australia, have developed several strategies for reform:

• Fifth National Mental Health and Suicide Prevention Plan
• National Mental Health and Suicide Prevention Agreement
• Vision 2030: Blueprint for Mental Health and Suicide Prevention
• National Mental Health Workforce Strategy (2022–32)
• National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing (2017–2023)

These strategies recognise the need to enhance the mental health system and shift the focus to prevention and early intervention, as well as address the social determinants of mental health. However, these strategies do not specifically address the intersection between the delivery of physical health and mental health care services, the needs of people affected by cancer and the psycho-oncology workforce.

Developed by Cancer Australia, the Australian Cancer Plan (ACP) outlines short- and long-term goals and actions to improve cancer outcomes for all Australians. It emphasises the importance of addressing the mental health of people living with cancer and highlights people living with mental illness as a priority population. This aligns with the Equally Well Consensus Statement in calling for the need to improve the physical health and wellbeing of people living with mental illness in Australia.

Optimal Care Pathways (OCPs) are a key component of implementing the ACP aimed at improving outcomes by promoting quality cancer care and ensuring all people affected by cancer receive the optimal care.⁶ The OCPs include recommendations around psychological screening and referral to support systems and mental health specialists within a comprehensive cancer care approach.

There are specific clinical practice guidelines for the detection and management of psychosocial care in cancer. These include the Clinical Pathway for the Screening, Assessment and Management of Anxiety and Depression in Adult Cancer Patients, developed by the Psycho-Oncology Co-operative Research Group,⁷ the Clinical Society of Australia’s (COSA) guidelines for the Psychosocial Management of AYAs Diagnosed with Cancer, and the Palliative Care Aged Care Evidence Group guidelines for palliative care.