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Psychological support waning for heart patients despite nearly half experiencing mental health issues

4th September 2014

Psychological support for heart patients is waning despite nearly half experiencing mental health problems after their heart event.

The British Heart Foundation (BHF) is calling for urgent improvements to the mental health support offered to heart patients after an audit of cardiac rehabilitation schemes - exercise and education programmes to help people recover from a heart attack or heart surgery - revealed fewer than one in ten now provides access to a psychologist (1).

Research shows that up to 20% of people who've suffered a serious heart event, such as a heart attack, will have a major depressive episode within a few weeks and a further 25% experience minor depression or depressive symptoms (2).

Yet the proportion of cardiac rehabilitation services offering specialist mental health support has nearly halved since 2009/10, falling from just 16% to a paltry 9% (3).

Dr Mike Knapton, Associate Medical Director at the BHF, said: “Suffering a heart attack, or discovering you have a heart condition, is understandably distressing as it can have such a huge impact on the way you’re able to live your life.

“It’s no longer enough to send someone home from hospital with a bag of medication to treat their physical symptoms. They need – and deserve – much more holistic support this includes treatment and care for their mental health too.”

The BHF wants everyone who's had a heart attack or heart surgery to benefit from a cardiac rehabilitation programme that includes psychological support.

Currently just 43% of eligible patients take part in any rehab programme, and only 9% of programmes offer mental health services (4). This means only a tiny minority are offered truly holistic healthcare to help them recover.

This is despite efforts by the government to more formally recognise the need and value of mental health services within the NHS Constitution and NHS Mandate.

Dr Knapton said: “There’s a gap between the Government’s topline strategy documents and what’s happening on the ground. We need local commissioners and service providers to understand the value in mental health support for heart patients.”

Graham Bell, 71, from Midlothian, Scotland, said his bypass surgery cured his blocked artery but not the anxiety he felt about his health.

He said: “I felt tense and anxious from the moment I knew something was wrong with my heart. People said it would pass when the operation was over but it didn’t. I felt like I’d lost control. I felt mortal for the first time.

“I was referred, via a cardiac rehabilitation course, to a psychologist and had six sessions of cognitive behavioural therapy which set me on the road to recovery by providing the tools for me to tackle my problem. I also realised the more I talked about my problem the better.

"Without that psychological support, my GP would probably have offered me antidepressants and I’d have taken them by the bucket load I felt so desperate. There's a place for medication in mental health. But I know it wasn't what I needed. If other heart patients miss out because of cuts in services, it could take longer for them to recover. I remember how awful I felt and wouldn't want anyone to suffer a minute longer than they needed to."

For more support in coming to terms with the psychological impact of having a heart condition, or for tips on how to keep your heart healthy if you have mental health problems, visit bhf.org.uk/heartsandminds.

1. British Heart Foundation (2013) The National Audit of Cardiac Rehabilitation.      Annual Statistical Report 2013

2. Thombs BD, Bass EB, Ford DE, Stewart KJ, Tsilidis KK, Patel U, et al. Prevalence of depression in survivors of acute myocardial infarction. Journal of General Internal Medicine 2006; 21(1):30-8

3. British Heart Foundation (2013) The National Audit of Cardiac Rehabilitation.      Annual Statistical Report 2013   

4. British Heart Foundation (2013) The National Audit of Cardiac Rehabilitation.     Annual Statistical Report 2013

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