Enabling coping in people living with cancer and severe mental illness

People with severe mental illness and cancer experience worse cancer outcomes compared to those without mental illness, however there is a gap in the literature investigating the perception of needs from the perspective of those with lived experience. The aim of this research was to provide theoretical analysis of the perception of needs of people with a pre-existing severe mental illness who receive a diagnosis of and treatment for cancer. This research was underpinned by a relativist ontological stance and a constructivist epistemological position and adopted a constructivist grounded theory methodology. The research was undertaken in England and data were generated through in depth one-to-one interviews with people with lived experience of severe mental illness and cancer. Grounded theory coding methods of initial, focused, and theoretical coding were adopted alongside constant comparative methods and memoing. People living with severe mental illness and cancer perceived their needs to be focused on a set of interconnected factors that affected their ability to cope. These factors were formed from their personal circumstances and experiences, their encounters within the health system, their experiences of stigma in the health and care setting, and their ability to stay in balance with their mental health. People in this study explained their needs when being diagnosed with cancer and subsequently living with both severe mental illness and cancer. Four main categories of: staying resilient, foundational needs from healthcare, avoiding stigma and keeping in balance were connected by a central category of coping. This resulted in the substantive theory: enabling coping in people living with severe mental illness and cancer. This theory offers new insight into how people experiencing severe mental illness and cancer perceive their needs in order to cope with comorbidity.