A cancer diagnosis can turn a patient’s life upside down, physically and mentally, which is why support for mental and emotional health needs is critical.
“When we integrate evidence-based mental health support alongside oncology, patients feel better, function better and often do better with treatment. Behavioral health is a core part of comprehensive and collaborative cancer care,” said Dr. Kyle Lavin ’04, ’10 (MPH) ’11 (MD), a psychiatrist and associate professor in the UNC School of Medicine’s psychiatry department.
Lavin also treats patients in the UNC Palliative Care and Comprehensive Cancer Support programs. The co-founder and chief medical officer for Cerula Care, which provides virtual collaborative care for oncology patients, Lavin answered questions about collaborative care.
How does this approach work?
Collaborative care embeds a behavioral health team into cancer care, not as a separate service but in coordination with your oncologist. That typically includes:
Consulting psychiatrist: guides diagnostic clarification and medication strategies that fit oncology regimensBehavioral health care manager: coordinates assessments, brief therapeutic interventions and care plans
Programs like Cerula Care deliver this as a virtual service integrated with oncology practices, enabling psychosocial support that fits patients’ lives. This care significantly improves anxiety and depression and also improves cancer outcomes.
What are some benefits?
Cancer and its treatments can bring fatigue, pain, nausea, insomnia and “chemo brain.” These physical symptoms often worsen emotional distress, which in turn can exacerbate pain and fatigue. It’s a difficult cycle for patients.
The first collaborative care models were created about seven years ago. Data from oncology practices show that using virtual collaborative care contributes to meaningful improvements in depression, anxiety and quality of life within the first two months of care. There are also benefits for treatment adherence and health equity.
In an analysis of breast cancer patients, integrated virtual behavioral health care led to meaningful reductions in depression and anxiety over five months, consistent with early two‑month gains.
Over 90 randomized controlled trials show that the collaborative care model is the gold standard in how to provide better mental health care. People get better faster because there’s measurement-based care where we’re using validated screening tools to track anxiety and depression month over month. If they’re not improving, we can quickly change their care plan.
How does collaborative care help cancer patients with decisions?
Cancer care involves decisions such as starting or pausing a therapy, managing side effects or balancing clinic visits with family and work. Behavioral health teams help patients clarify goals, make action plans and build habits that support medication adherence and making it to appointments.
Clarifying values is another important part. I think of a grandfather with cancer who wants to live long enough to see his grandson graduate from high school. That’s a goal or value that a team would do its best to make happen.
Behavioral health support helps. In an analysis of breast cancer patients seen by Cerula Care, 70% said it helped them attend oncology visits and 65% said it helped them better adhere to medications. This support — reminders, finding transportation or childcare and coordination with the oncology team — yields improved outcomes amid a demanding treatment schedule.
How does behavioral health support families and caregivers?
Cancer affects the whole family. Social workers and care managers are trained to help loved ones understand the disease, communicate effectively and prepare for changing roles. They offer psychoeducation, caregiver coaching and connections to support groups. When families are engaged and informed, patients experience fewer barriers to care and more consistent follow through on treatment and recovery plans.
It’s important to note that in collaborative behavioral health programs, improvements in quality of life were significantly associated with minority status, suggesting a potential to reduce disparities in cancer care.