Bridging the mental health gap in oncology: A pharmacist-led stepped care model for China

Abstract

Cancer patients in China face a significant mental health care gap due to systemic underprioritization and limited psychiatric resources. This comment proposes a pharmacist-led stepped care model (SCM) to bridge this disparity. The model stratifies patients by distress severity, offering tiered interventions from psychoeducation (mild symptoms) to specialist referrals (severe cases), coordinated by oncology pharmacists. By capitalizing on pharmacists’ medication management roles and collaboration with oncologists and psychiatrists, the SCM ensures culturally-grounded support through stigma-reduced terminology and family-inclusive decision protocols while optimizing resource allocation. This framework aligns with China’s hierarchical medical system and may serve as a blueprint for low- and middle-income countries confronting similar challenges in psycho-oncology integration.