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One small change: Two psychology researchers on how to improve our health system

Health professionals caring for cancer patients should be able to refer them for psychological support

Lorna Gurren and Simon Dunne

(Psychology researchers at Dublin City University)

In May 2022, the National Cancer Control Programme (NCCP) launched its model of care for psycho-oncology, which was a clear sign that when it comes to cancer care, recognising and treating signs of psychological distress is a top national priority. Psycho-oncology focuses on the psychological and mental health care of people affected by cancer, their carers and families.

The NCCP report noted that a lack of psycho-oncology services can result in the amplification of physical symptoms, reduced patient immunity through the effect of psychological stress, and even increased hospital visits and longer stays.

Yet, through our research we have found that many healthcare professionals treating cancer patients can’t refer their patients for psychological support. In fact, currently GPs and consultants are the only ones who are legally entitled to refer patients to the mental health services.


We discovered that many health professionals, including cancer nurse specialists – who can refer patients for everything from radiation oncology and medical oncology to dietetics, physiotherapy and dentistry – are questioned if they suggest their patients need psycho-oncology services.

One of the social workers we spoke with called this an example of Ireland’s “old-fashioned” healthcare service – where physical health is considered more important than mental health, and where doctors are considered to be at the top of the professional hierarchy.

The lack of mental health services in some regions and mental health stigma are other barriers to cancer patients accessing these mental health supports – but the one small change we would like to see is that all healthcare professionals dealing with cancer patients are able to refer their patients for psychological support if they consider it to be important.

By removing the hierarchy of referral through a GP or medical consultant, patients could receive the critical interventions that make such a difference to their recovery in a more efficient way.

  • As our health system begins to return to normal activity levels following the Covid-19 pandemic, we would like to hear about one change you would like to see. It can be something simple that annoys you, day in, day out, that is easily fixed, or it can be a small change in practice or attitude that would make life easier for everyone. Email with your suggestion or fill in the form below
Sylvia Thompson

Sylvia Thompson

Sylvia Thompson, a contributor to The Irish Times, writes about health, heritage and the environment