Experts from an award winning multidisciplinary team, the Severe Eczema and Psoriasis Team at St. John’s Institute of Dermatology, St Guys’ and St Thomas’ NHS Foundation Trust, today warned that the true need for psychological support amongst dermatology patients is not being met.

The team recently won the first ever “BMJ Dermatology Team of the Year”, up against excellent competition, for their commitment to holistic care – care which accounts for, and treats, the range of issues that come with having a skin disease, particularly the psychological impact.

Recognising that their standard approach to patients wasn’t efficient enough at recognising patients in need of psychological support, the St. John’s team rewrote the rulebook using a tripartite approach first developed by the IMPARTS* team led by Professor Matthew Hotopf. They developed a system whereby iPads are used to survey patients with pre-selected and validated questionnaires relevant to their condition, whilst waiting for their appointment. This information is then automatically uploaded to their electronic patient record.

The questionnaire results are then used to alert doctors to any potential emotional wellbeing issues and automatically suggest treatments or referral pathways that may be appropriate for them. In some cases there may be no need for psychological support. Those who do require help may be provided with self-help materials – such as the IMPARTS materials or the British Association of Dermatologists’ Skin Support** website – or be offered a referral to a team psychologist or liaison psychiatry.

The team found that 71 per cent of their patients, who were subsequently diagnosed with major depressive illness using the new system, and 88.6 per cent with anxiety, were previously unrecognised as having mental health problems.

Professor Catherine Smith, consultant dermatologist within the Severe Eczema and Psoriasis Team, said:

“This rigorous and systematic approach to providing holistic care within our team has reaped huge benefits for our patients, who previously might have had unrecognized morbidity. Prior to evaluating our service and introducing this new approach, we considered that we were already providing holistic care.

“Identifying the high needs of our patient population motivated us to fully integrate psychological support with treatment of the physical symptoms of skin disease throughout the visit to our service. We improved training for all staff, from our receptionists to our consultant dermatologists, and implemented internal care pathways that ensure the mental wellbeing of the patient is monitored and treated according to their needs. By taking this methodical approach we were also able to quantify and justify the need for a full time clinical health psychologist on staff.”

Dr Nick Levell, President of the British Association of Dermatologists, said:

“We are enormously proud of all the teams that were in the running for dermatology team of the year, and I am particularly pleased to see the incredible work that this winning team has put into achieving a parity of esteem between physical and mental health, something the BAD recognises as being hugely important for patient wellbeing. I hope that this will encourage other departments to reflect on their own work, and investigate ways in which they can improve.”

The multidisciplinary team of specialists included consultant dermatologists, receptionists, clinical research and specialist nurses, a consultant rheumatologist, a specialist pharmacist, and a clinical health psychologist in collaboration with the King’s Health Partners IMPARTS team.

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Notes to editors:

For more information please contact the media team: comms@bad.org.uk, 0207 391 6084. Website: www.bad.org.uk.

The BAD Annual Conference will be held at the Birmingham ICC from July 5th to 7th and is attended by approximately 1,300 UK and worldwide dermatologists.

*IMPARTS stands for Integrating Mental & Physical healthcare: Research, Training & Services (IMPARTS) and is an initiative funded by King’s Health Partners to integrate mental and physical healthcare in research, training and clinical services at Guy’s, St Thomas’s and King’s College Hospitals, as well as South London and Maudsley NHS Foundation Trust (http://www.kcl.ac.uk/ioppn/depts/pm/research/imparts/index.aspx).

**Skin Support is a psychological support website for people in distress due to skin conditions (www.skinsupport.org.uk). It is owned and managed by the British Association of Dermatologists.

Skin conditions are the most frequent reason for people to consult their GP. It is not just the physical symptoms that affect sufferers’ lives – diseases that are visible, disfiguring or long-term can carry a multitude of psychological and social effects, including isolation and depression. In the UK, psoriasis alone is linked to 300 suicide attempts annually. A British Association of Dermatologists’ survey in 2011 revealed that 85 per cent of patients indicated to their dermatologist that the psycho-social aspects of their skin disease were a major component of their illness.

About us:
The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. For further information about the charity, visit www.bad.org.uk