These multiple threats make attention to psychosocial problems in cancer patients and their families critically important. Although reducing psychosocial stressors and improving psychosocial services may not increase cancer “cure rates,” the committee concludes that

Addressing psychosocial needs should be an integral part of quality cancer care. All components of the health care system that are involved in cancer care should explicitly incorporate attention to psychosocial needs into their policies, practices, and standards addressing clinical medical practice. These policies, practices, and standards should be aimed at ensuring the provision of psychosocial health services to all patients who need them.

Essential to this conclusion—and to this study overall—is the definition of “psychosocial health services” developed by the committee:

Psychosocial health services are psychological and social services and interventions that enable patients, their families, and health care providers to optimize biomedical health care and to manage the psychological/behavioral and social aspects of illness and its consequences so as to promote better health.

Several aspects of this definition merit discussion. First, a wide variety of psychological and social services are delivered by providers of health and human services. The committee uses the term “psychosocial health services” to distinguish psychological/behavioral and social services that are delivered to improve health and health care from psychosocial services provided to achieve other goals. For example, psychosocial services are provided in the child welfare and criminal/juvenile justice systems to meet such goals as strengthening a family or preventing incarceration or reincarceration. These are psychosocial services, but generally are provided outside of the health care system, and in such settings are not thought of as health care services. While a particular psychosocial service, such as mental health care, can be delivered in more than one sector to help achieve multiple goals (e.g., improved health and prevention of incarceration), when psychosocial services are proposed as worthy of attention from the health care system, the intended effects on health and health care services should be clear. By adopting the terminology of psychosocial health services, the committee aims to define psychosocial services in a way that recognizes the legitimate and sometimes different purposes of such services across different health and human service sectors, while simultaneously establishing an expectation for efficacy and effectiveness in improving health or health care. Second, the committee’s definition of psychosocial health services distinguishes between services directly needed by the patient (e.g., treatment for depression or financial assistance) and the interventions or strategies used to secure those services (e.g., screening, formal referral, or case management). This distinction is elaborated in Chapters



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