Clinical psychology in mesh complications service

Information on what to expect when seeing a clinical psychologist in the mesh complications service.

Who is this leaflet for?

This leaflet is for all women who have been referred to the Mesh Complications Service at Addenbrooke’s Hospital in Cambridge. It may also be helpful to share this information with family and / or carers. We use the terms ‘woman / women’ throughout this leaflet but recognise that mesh surgery for urogynaecological problems may affect individuals who do not identify as women as well.

Addenbrooke’s hospital is one of several regional specialist centres, providing services to women experiencing complications following mesh surgery. The team provide care to women from across the region who are referred to us by their GP or local hospital. The Mesh Complications Service provides care and expertise from a range of healthcare professionals including surgeons, specialist nurses, physiotherapists and clinical psychologists.

Who are clinical psychologists?

Clinical psychologists are trained and professionally qualified to help people with a range of concerns that may be affecting their emotional or psychological well-being. They understand that there are inseparable links between physical health and emotional health and how important a holistic approach is to our general well-being and quality of life.

Psychologists are not medically trained and will not prescribe medications.

Who would see a clinical psychologist?

Women experiencing complications from their mesh surgery have told us of the impact it has on themselves and their loved ones. This can include difficult symptoms such as pain, incontinence, sexual problems and reduced mobility.

These symptoms can affect your emotional well-being and quality of life to varying degrees. There may be other factors resulting from mesh surgery that also impact your emotional well-being, such as how you felt during medical procedures and / or your experience of being cared for by the healthcare system and professionals Some women will have pre-existing difficulties that may make having further treatment difficult for them, such as a needle phobia. We also recognise that some women may have some difficult decisions to make about their treatment options, or feel distressed about the treatments offered and may find speaking with a clinical psychologist helpful.

For these reasons, after the first outpatient appointment with the consultant we offer every woman referred into the service the option of a discussion with the clinical psychologist. This is not compulsory; you can decline to see them.

Whether you choose to see the clinical psychologist or not, will have no impact on the treatment or care that you receive.

What could a clinical psychologist help with?

Every woman will have different reasons for seeing a psychologist, and below are just a few examples:

• A safe and impartial space to consider treatment options. They cannot offer advice or medical information, but they can help you to consider the different options and think about what is most important for you in reaching an informed decision
• Support with managing difficult physical symptoms, such as pain, incontinence or sexual problems
• Feelings of anxiety, low mood, anger and depression
• Coping after traumatic experiences during treatment or afterwards
• Managing difficulties that may interfere with you having treatment, such as needle phobias, claustrophobia or previous trauma

Psychologists will work closely alongside other professionals who can help support you to develop strategies and provide resources for managing the challenges that you are living with.

What happens when you meet a clinical psychologist?

Most women will meet the clinical psychologist as an outpatient. As it is not always possible to see you at the same time as you are seeing the consultant, you may be offered an appointment on a different day. This can be in person in an outpatient clinic room, by telephone or video call, depending on your circumstances and preferences.

The length of the meeting will often vary depending on your needs and wishes, but would not normally be more than one hour.

Some women will want to meet with a psychologist on their own, but it can also be helpful to meet with family members or friends.

At the end of your first appointment, you will come away with a plan which may include arranging further appointments, advice and self-help information or sign-posting to other services.

How can a clinical psychologist help?

A clinical psychologist will provide a safe and non-judgemental space for you to talk through your experiences; how it has made you feel, what you think about it and what you are already doing to cope.

What a psychologist can do to help you will depend on your individual circumstances but it may involve learning techniques or strategies such as relaxation, mindfulness exercises or guided imagery. It may involve exploring the way you think about things, how you relate to other people or how you respond to difficulties and whether making small changes to these could be helpful.

What will happen to the information shared with a clinical psychologist?

Clinical psychologists follow the same rules of confidentiality as all hospital staff. They are part of the clinical team and will routinely communicate with doctors and other health professionals involved in a woman’s care, including your consultant(s) and GP.

Psychologists will always record details of their meetings on a patient’s electronic notes.

There are occasions when information has to be shared more widely with relevant professionals, such as when a person is believed to be at risk of harming themselves or another person. If you have any concerns about the sharing of sensitive information, please do discuss this with the professional involved in your care.