In America, over 5,000 adolescents are diagnosed with cancer each year (American Cancer Society, 2023). While their physical health is prioritized, their mental health needs often go neglected. For the past two decades, I have pursued ways to improve mental health care options for this young population. Obtaining a Psychiatric Mental health Nurse Practitioner degree will further my efforts to help these young people.

In my first career as an experiential facilitator I attended the spring 2003 conference for Wilderness Experiential Education. Here my path crossed with Mario, a mountaineer from Canada. The stories Mario shared with me profoundly altered the trajectory of my life. One of these stories was about a teenager named Jon, whom I have never met and never will. Jon’s body and spirit had been devastated by cancer treatments. But after a trip in the mountains with Mario and his team he returned home to his parents renewed and full of life. So powerful was his transformation that though he relapsed and died the following year, the quality of his life remained vibrant though to the end.  Jon’s parents asked Mario to spread their son’s ashes at the summit of the next trip.  Jon’s experience inspired me to bring awareness to and improve our psychosocial approach to adolescents undergoing cancer treatment.

There is a 19-34% increased rate of mortality for these teens with depressive symptoms (Park & Rosenstein 2015), the risk for depression itself being 30% greater for this population (Kwak et al.,2013). One study showed a four-fold increased likelihood of a suicide attempt (Par Druss & Pincus,2 000), with 41% reporting unmet needs for counseling and support (Hølge-Hazelton et al, 2016), and 75% wishing for a support group (Barnett et al, 2016).  At a time when they should be fully immersed in experiences that promote independence, self-efficacy, identity formation, and cognitive abilities, they are often confined to their homes or hospitals, cut off from peers and activities, and at the mercy of their bodies and their doctors. The consequences of this disruption lead to devastating psychosocial outcomes and hinder progression into adulthood.

After hearing Jon’s story, it was clear to me that, as someone outside the medical profession, I would have little influence. With my eye on the goal, I pivoted to increase my credibility and became an RN. Along the way, I relentlessly pursued education and research on this underserved demographic. I developed a trauma-informed wilderness approach and built an age-appropriate curriculum to address the psychosocial disruption that often happens during treatment.

In 2019 See You at the Summit (SYATS) launched its pilot expedition. Eight teenagers experiencing a cancer diagnosis took a nine-day medically supported backpacking trip into the Oregon wilderness and summited a mountain.

My career in bedside nursing has taken me as far as it can. Although the medical background and connections were instrumental in the birth of SYATS, it is time for me to pursue education and skills more specific to mental health. My goal of educating the medical community on the psycho-social needs of this demographic and providing direct care to these young people will be better possible after completing a PMHNP degree.

References

American Cancer Society.(2023). Cancer facts and figures 2023. American Cancer Society. Retrieved fromhttps://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2023/cancer-facts-and-figures-2023.pdf

Barnett, M., McDonnell, G., DeRosa, A., Schuler, T., Philip, E., Peterson, L., . . . Ford, J. S. (2016). Psychosocial outcomes and interventions among cancer survivors diagnosed during adolescence and young adulthood (AYA): a systematic review. J Cancer Surviv, 10(5), 814-831. doi: 10.1007/s11764-016- 0527-6

Druss, B., & Pincus, H. (2000). Suicidal ideation and suicide attempts in general medical illnesses. Arch Intern Med, 160(10), 1522-1526.

Hølge-Hazelton, B., Timm, H. U., Graugaard, C., Boisen, K. A., & Sperling, C. D. (2016). "Perhaps I will die young." Fears and worries regarding disease and death among Danish adolescents and young adults with cancer. A mixed method study. Support Care Cancer, 24(11), 4727-4737. doi: 10.1007/s00520-016- 3322-z

Kwak, M., Zebrack, B. J., Meeske, K. A., Embry, L., Aguilar, C., Block, R., . . . Cole, S. (2013). Trajectories of psychological distress in adolescent and young adult patients with cancer: a 1-year longitudinal study. J Clin Oncol, 31(17), 2160-2166. doi: 10.1200/JCO.2012.45.9222

Park, E. M., & Rosenstein, D. L. (2015). Depression in adolescents and young adults with cancer. Dialogues Clin Neurosci, 17(2), 171-180.