Multi-level stakeholder perspectives on barriers and facilitators to engaging older adult cancer survivors in mental health treatment

AI Summary

Systemic care pathway limitations, including scarce referral resources and limited provider knowledge, leave older adult cancer survivors disconnected from mental health services.
Patient-level barriers, such as low motivation and mental health stigma, reduce uptake of recommended psychological treatment among older cancer survivors.
Telehealth can improve access to mental health care but may present technological and usability challenges for some older adults; research should improve care pathways.

BMC Cancer. 2026 Jul 3. doi: 10.1186/s12885-026-16396-2. Online ahead of print.

ABSTRACT

BACKGROUND: The current study sought to identify the barriers to and facilitators of connecting older adult cancer survivors (OACS) to mental health treatment in cancer survivorship and to better understand the opportunities to improve the likelihood that OACS receive appropriate services in survivorship.

METHODS: Four virtual focus groups with 22 stakeholders (i.e., OACS, social workers, and APPs) were conducted. A semi-structured focus group guide queried participants about their experiences of referring and connecting to mental health services during cancer survivorship with a focus on barriers and facilitators. Thematic content analysis guided the generation and interpretation of major and minor study themes from the focus groups.

RESULTS: OACS were 56% female [n = 5; mean age = 74 (range: 66-85)]. Providers were 92% female (n = 12) and 69% (n = 9) had been working in oncology for over ten years. Three major conceptual themes were identified: (1) Care pathway characteristics (i.e., limited referral resources and knowledge); (2) Patient-level characteristics (i.e., motivation, stigma); (3) Perspectives on telehealth (i.e., overall increased access to care but may present challenges for some OACS). These overarching themes included sub-themes of barriers and facilitators to connecting OACS to mental health services.

CONCLUSIONS: OACS remain disconnected from mental health services and providers struggle to overcome systemic barriers to getting survivors the care they need. Given the standard of care to screen for depression in cancer survivorship, OACS will continue to be identified as depressed with no clear recourse for intervention. Therefore, future research on how to mitigate barriers and improve existing care pathways to connect OACS to mental health treatment is warranted.

PMID:42399839 | DOI:10.1186/s12885-026-16396-2

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