Concern no patient counselling

A group of Dunedin psychotherapists is concerned there is no counselling service for cancer patients at Dunedin Hospital following a staff resignation, but a limited service will be available from mid-February.

Concern the counselling service might be scrapped as a cost-cutting measure has been dismissed by hospital management.

Psychotherapist Sandra Turner, who wrote a letter to the Otago Daily Times, signed by six of her colleagues, was concerned cancer patients, who needed help would be required to fund it themselves, even though they were already under financial pressure.

"Once again, only those who can afford it will get the care they need."

The free service, which was staffed by two part-time counsellors, has been unable to take patients since the end of December, following the resignation of a staff member.

The other staff member is on extended leave.

Southern District Health Board (Otago) emergency medicine and surgery general manager Dr Colleen Coop said staffing for the service and the way it was provided were being reviewed.

Because of the board's financial position, this type of review had been a requirement for several months for services where there were staff resignations.

It did not mean the service was going to be removed, but that different ways of providing it would be considered, looking at best practice and evidence-based research.

It was anticipated that a limited psychological support service would be reinstated by mid-February using a private clinical psychologist at 0.3 full-time equivalent (FTE) for three months while the staffing issues were sorted out.

This would offer a free service on about two days a week - "inpatient and outpatient, depending on urgency".

The service available to the end of last year cost less than $100,000 a year for 1.2 FTE. Dr Coop said it was unfortunate there was a gap in the service provision, but it was difficult in any service reliant on one or two people when circumstances changed suddenly.

In the meantime, the hospital had the ability to provide some psychological support service to patients.

Ms Turner, who runs a cancer support group, took issue with a suggestion patients could go to emergency psychiatric services for help.

"Most of these people have anxiety and distress. They do not have a full-blown psychosis."

Nor were they suicidal.

It was not desirable to have people only able to get treatment when they were in an extreme state.

Dr Coop said some patients could be desperate and suffering an acute depressive reaction and referral to emergency psychiatric services could be appropriate.

General practitioners had the ability to offer short-term support for patients, although she accepted that would not be free.

She agreed with Ms Turner it was desirable to have cancer patients requiring counselling treated within the multidisciplinary oncology team.

Dr Coop was unable to readily provide information on how many patients the oncology counselling service saw over a year.

elspeth.mclean@odt.co.nz

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