Surgeon Perspectives on Addressing Mental Health Among Total Laryngectomy Patients.

Abstract

Objective: Head and neck cancer patients, particularly those undergoing total laryngectomy, exhibit high rates of depression and suicide, even compared to other cancer patients. Thus, this study seeks to understand head and neck surgeons' perceived roles in and treatment patterns regarding mental health sequelae among total laryngectomy patients.

Methods: An anonymous survey regarding provider perspectives about the mental health experiences of total laryngectomy patients was designed and distributed via email to American Head and Neck Society members and academic otolaryngology head and neck surgery departments. Descriptive statistics were utilized to describe results.

Results: Respondents (n = 63) reported frequently seeing mental health issues among total laryngectomy patients (on average, 48% of patients) and believed otolaryngologists should frequently screen for these conditions (85%). However, a significant subset of the sample (39%) reported feeling uncomfortable addressing mental health issues and cited factors such as lack of expertise (73%) or lack of resources to address mental health (73%). Overall, most respondents agreed that this population could receive better mental healthcare (88%). Referral to speech-language pathologists (80%), community-based support groups (54%), and referral to a mental health provider (n = 35, 54%) were frequently recommended post-operative prophylactic measures.

Conclusion: This national cross-sectional survey of head and neck surgeons demonstrated that while physicians acknowledge and appreciate the need for mental health services among laryngectomy patients, a significant minority feel unprepared to address mental health due to a lack of training and resources. Additional research is needed to identify methods to effectively address this gap in care for laryngectomy patients.