World Kidney Day: Charity calls for increased access to counselling
News from BACP

A survey by Kidney Research UK found a high prevalence of psychological distress among kidney patients.

Now the charity is calling for urgent action to improve access to specialist renal counsellors for anyone newly diagnosed with kidney disease.

Two-thirds (67%) of respondents to Kidney Research UK’s survey reported experiences of depression while 36% agreed that depression had a direct impact on their ability to take care of their physical health. 27% of respondents have considered self-harm or suicide as a result of their kidney disease.

Our member Beverley Mealor has twelve years’ experience as a specialist renal counsellor, and currently leads the small counselling team at Imperial College NHS Trust’s renal service in London.

Depression

Unsurprised by the high rates of depression among kidney patients reported in the survey, Beverley believes it’s vital specialist renal counselling should be accessible to everyone living with kidney disease.

Beverley said: “Kidney disease can have a profound, traumatic and enduring impact on people’s lives, triggering issues related to identity, loss, relationships, control, body image low mood and anxiety.

“For many patients there is a long lead up to them requiring dialysis, whilst for others kidney failure happens suddenly and without warning, turning their life upside down in an instant.

“A specialist renal counsellor has an understanding of how kidney disease and its treatment affects many aspects of physical and mental wellbeing, so our clients don’t have to go through explanations of their condition and have confidence that their counsellor has an understanding of the hopes and fears that they bring into the therapy room.”

Many of the service’s clients are older people whose contact with the specialist renal counsellor is their first experience of talking therapy, and Beverley notes that this can present challenges and opportunities.

“It’s vital that we’re flexible in the way we work with clients and that we allow them the time they need to comfortably engage with the counselling,” she said.

“This might mean slightly more small-talk at the beginning of session than we’d expect with other clients, but it’s what’s needed to establish a trusting therapeutic relationship.

“We’ll also work with whatever the client brings into the room. It’s not uncommon for a client to bring issues that are seemingly unrelated to kidney disease into their therapy, sometimes traumatic events or past experiences that are troubling them, but that we can work with to improve their emotional wellbeing.”

Mental health support

Despite the close links between kidney disease and depression highlighted by the Kidney Research UK survey, 68% of respondents said that they hadn’t been offered any mental health support.

Alison Railton, head of policy and external affairs at Kidney Research UK, said: “Kidney patients face huge challenges; their conditions can become worse over time and treatments designed to keep them alive can be physically gruelling to the point of exhaustion.

“But nothing really prepares you for the harrowing personal accounts kidney patients have shared with us and the mental health struggles they experience throughout their journey.

“We cannot allow our community to struggle on in silence, which is why we’re calling on politicians to give all kidney patients access to specialist mental health support at the point of diagnosis.

“We often focus on the physical symptoms because they’re the most noticeable, but it’s vital we commit to transforming treatments to improve patients’ mental health as well.”

Beverley is alarmed by the high numbers of respondents reporting that they have not been offered mental health support and said that increased provision of specialist renal counsellors is vital.

“We know from our own service that demand outweighs what we can immediately deliver” she said. “Even with an offer of six sessions, after which each client is reviewed and need for further sessions assessed, we’re running with a waiting list.

Counselling

“The figures from survey suggest that the service offered within our NHS Trust is not replicated across the country and that people are missing out on vital counselling support at a time in their lives when they need it most.”

Kidney disease disproportionately affects people from marginalised and racialised community backgrounds who are known to experience barriers in accessing psychological support.

Kidney Research UK is inviting its members and supporters to contact their MPs to raise concern about the gaps in mental health support for people experiencing kidney disease and to call for every kidney patient to have access to a specialist renal counsellor at the time of their diagnosis.