BH09 Integrating psychological support into an NHS hair clinic; a practical guide

Abstract

Hair loss is well recognized to have a substantial impact on mental wellbeing. Integrating psychological support into routine dermatology care is increasingly viewed as essential for holistic patient management. We describe our experience of incorporating psychological support within a secondary care hair clinic and aim to offer practical guidance for clinicians seeking similar approaches. It is often assumed that ideal integration of psychological services into dermatology requires a formal business case and dedicated job-plan time from a consultant dermatologist with an interest in psychodermatology. Alternative pathways exist and are frequently overlooked. We engaged with our local NHS Talking Therapies team, which is already linked with the hospital from a funding perspective and accepts patient self-referrals. After meeting with the service manager, we established an arrangement whereby one of their cognitive behavioural therapists would accept direct referrals from our department. The therapist is based in a room adjacent to the clinic and provides both ‘drop-in’ assessments for patients attending on the day and prebooked appointments. Initial assessments are offered either face to face or virtually, during which the therapist determines the appropriate level of psychological input. Patients with milder difficulties are referred to a psychological wellbeing practitioner and may receive up to six sessions of guided self-help. Those with moderate anxiety or depression are offered up to 12 sessions of cognitive behavioural therapy, delivered virtually or in person. Where counselling is deemed more suitable, patients are referred to local counselling services. In our experience, many patients require lower-intensity psychological support. We emphasize that this can be effectively delivered by psychological wellbeing practitioners, counsellors, and cognitive behavioural therapists, rather than relying solely on clinical psychologists or psychiatrists, whose involvement can be more challenging to secure. We hope this practical account helps clinicians appreciate the range of psychological resources available to support holistic care for patients with hair disorders.