Integrating Behavioral Health into Oncology: A Collaborative Approach

In an interview with Targeted Oncology, Nina Balanchivadze, MD, Sarah Cannon Research Institute at Virginia Oncology Associates, and Kyle Lavin, MD, MPH, UNC School of Medicine, University of North Carolina at Chapel Hill, discuss the background of a study evaluating the integration of virtual collaborative behavioral health care for patients with breast cancer.

The Intersection of Mental Health and Cancer Care

Both doctors emphasize that depression and anxiety are not just side effects of a cancer diagnosis; they are significant barriers to recovery. They routinely witness how mental health struggles diminish a patient’s ability to "show up" for their care. These issues frequently lead to a lack of adherence to strict treatment regimens and a general inability to cope with the life-altering transitions inherent in a cancer journey.

While the medical community is generally good at recognizing these symptoms, the primary failure lies in the follow-through. Under current systems, when an oncology team identifies a mental health crisis, they must make a referral to an outside health system. These external systems are often difficult to access in a timely manner, creating a gap in care during the patient’s most vulnerable moments.

The Virtual Collaborative Care Model

To bridge this gap, Balanchivadze and Lavin are evaluating a virtual collaborative care model. Unlike traditional "siloed" programs that operate in isolation, this model is embedded directly within the oncology department. The objective is to deliver measurable improvements in patient symptoms and daily engagement without adding to the existing workload of the oncology staff.

Lavin’s dedication to this cause is deeply personal. For 20 years, he has been driven by the lived experience of his own mother, who struggled with comorbid mental and physical health concerns. This background fueled his passion for integrating behavioral health into palliative and specialty care.

Expanding Access to Community Oncology

The study focuses heavily on community oncology, where resources are often more limited than in large academic medical centers. In these community settings, access to psycho-oncologists or specialized therapists is rare. By leveraging a virtual, integrated model, the team believes they can expand high-quality care to all patients, regardless of their location. Ultimately, they aim to prove that this integrated approach improves not only patient outcomes but also the daily quality of work for the oncologists themselves.