receipt of legal services reduced their worries (83 percent), improved their financial situation (51 percent), positively affected their family and loved ones (33 percent), helped them follow their treatment regimen (23 percent), and enabled them to keep medical appointments (22 percent) (Retkin et al., 2007).

Help in Managing Financial Demands and Insurance

As described in Chapter 1, cancer imposes substantial financial burdens. A number of services are aimed at relieving these burdens, including financial planning or counseling, insurance counseling (e.g., health, disability), other benefits eligibility assessment/counseling (e.g., Supplemental Security Income, Social Security Disability Income), help in managing day-to-day financial activities such as bill paying, and sometimes monetary awards. Once again, research on the effects of these services is limited, but nonprofit organizations such as the American Cancer Society and CancerCare report that help with financial and insurance problems is a frequently needed and provided service. The New York Legal Assistance Group also reports helping cancer patients arrange debt repayment with their creditors; secure benefits from federal financial assistance programs such as food stamps, Social Security Disability Income, Supplemental Security Income, and long-or short-term disability programs; and secure other insurance benefits. Clients with cancer who received these financial services cited significantly improved financial circumstances, reporting, for example, that receipt of these services “made me able to live with a roof over my head and food to eat” (Retkin et al., 2007:7).

READY AVAILABILITY OF KEY SERVICES

As described in Chapter 1, patients vary in the extent to which they need the psychosocial health services described in this chapter. Given the evidence described in Chapter 2, failing to address these needs can adversely affect the health and health care of patients. Thus all oncology providers should identify patients with psychosocial needs and take steps to ensure that they receive the services necessary to address them.

Psychosocial health services are provided by multiple sectors of the U.S. economy through different types of providers (see Table 6-3, Some Availability of Psychosocial Services in Health and Human Services Sectors and from Informal Supports, in Chapter 6). Depending on each patient’s situation (e.g., geographic location, financial resources, health insurance status), some services are more accessible than others. For example, a shortage of mental health professionals with specific types of training (e.g., in child mental health) is a long-recognized problem in certain parts of the



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