Supporting patient mental health in aesthetics

Approximately one in four people in the UK experience a mental health problem each year, and there is evidence emerging that mental health has worsened substantially, by 8.1 per cent on average, as a result of the pandemic. As healthcare professionals, aesthetic practitioners have a clear duty of care to their patients to support their mental health. We spoke with Kimberley Cairns BSc MSc MBPsS, a specialist psycho-aesthetic consultant, who provided her top tips for supporting patients’ mental health and wellbeing.

Support throughout the patient journey

“Practitioners can support their patients’ mental health in so many ways, and this really is all-encompassing,” says Kimberley. She adds, “From the first contact your clinic has with the patient is the time to start supporting a patient’s mental health. This includes portraying responsible marketing and advertising, ethical offers, and a body positive narrative on social media; all of which is then transmitted authentically, through a sensitive non-assuming tone when speaking to patients during their consultation and throughout the treatment process.”

The Joint Council for Cosmetic Practitioners stated in its response to the All-Party Parliamentary Groups, “For those who seek cosmetic treatments, emotional and psychological needs may also be identifiable at the time of initial consultation. As such, all practitioners should be aware of the need to consider potential consumer vulnerability and prioritise making treatment decisions that reflect the interests of consumer wellbeing and mental health. These considerations should occur jointly with practitioners and consumers, to inform the appropriate treatment, signposting for alternatives and/or ongoing assessment of treatment outcomes and aftercare.”

When it comes to the patient consultation, using a validated psychological assessment tool can help equip both aesthetic practitioners and the patient, providing a wider understanding of their needs. However, there are considerations to bear in mind, “Psychological tools should not be seen as a ‘pass or fail’ to access treatment, but as a beneficial tool to look beyond the primary concern or presenting symptoms,” says Kimberley.

Common mental health conditions in aesthetics

Body dysmorphic disorder (BDD)Supporting patient mental health in aesthetics is a condition which most aesthetic practitioners are likely to have come across in patients, and can affect both men and women and people of any age, but is most common in teenagers and young adults. BDD is a mental health condition where a person spends a lot of time worrying about flaws in their appearance; flaws which are often unnoticeable to others. One study found up to 70 per cent of people with BDD had sought cosmetic procedures, and half had received such interventions. However, BDD is not the only mental health condition that patients may present with.

Kimberley says:

“Statistics tell us that it is more likely that you will see anxiety and depression in your patients. Comorbidities that present alongside BDD such as obsessive-compulsive disorder, social phobias and substance misuse must also not be ignored as their prevalence will be debilitating and can pose substantial risk to those individuals with a diagnosis.”

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How to spot red flags

Mental health conditions are not always visible, and patients can go to great lengths to disguise them, which can lead to practitioners feeling some pressure to identify issues. However, there are some red flags to look out for, including:

Urgency

“‘Why now?’  is a key question that may give rise to red flags,” says Kimberley, adding, “Has there been a sudden, or significant life event? These do not always need to be negatively perceived and can include having a baby, starting a new job, attending a special wedding, or events such as marriage, bereavement, or divorce. Engaging in treatments during these heightened emotional times can result in regret and dissatisfaction if not appropriately supported.”

If patients are seeking short-term, immediate results, it is important to consider a cooling off period to safeguard the patient’s mental health. Kimberley says, “Getting your marketing and advertising right is so crucial, or you risk perpetuating a cycle of harmful aesthetics that give temporary relief and a longer-term discomfort for the patient and your business.”

Medical history

Conducting a thorough consultation into the patient’s medical history is key to any patient consultation and is a key time to identify any red flags. “If a patient has a history of aesthetic procedures, be sure to ask about their satisfaction and why they are not returning to their original or previous practitioner – this will give invaluable clues to their mental health and appearance journey,” advises Kimberley.

Establishing a thorough understanding of ‘red flags’ through specialist training is essential, according to Kimberley. She says, “It is important that you have a ‘red flag protocol’ and are equipped to use this in practice. For example, you need to be able to justify your treatment plan if a red flag is alerted, yet treatment is given.” She adds, “Do make sure you include justification in your clinical notes as to why you believe the treatment was necessary, as it will also support any issues arising with informed consent, complaint management, and potential insurance claims.”

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When and how to say no

If there are any warning signs in patient responses, consider whether having an aesthetic treatment now is in the patient’s best interests. It may be a question of deferring their treatment until they are in a more positive mindset, or it could mean refusing them. Treating a patient who is unsuitable for treatment could impact your reputation as a competent and ethical practitioner. Therefore, always have the patient’s best interests at the forefront of your mind; postpone their treatment or, if necessary, refuse to treat them.

When a patient is not ready for treatment, what is the best way to say no? Kimberley explains, “Ethical practice would encourage a practitioner to say ‘no’ without actually saying ‘no’, as this rigid phrase could be harmful, and patients may get offended. Alternative phrases may include ‘not right now’, ‘how about X instead of Y’, ‘have you considered X’, or ‘let us see you in X weeks instead’.

If concerned about a patient’s wellbeing, referring to a GP is a mark of best practice, however making a decision to act on mental health concerns can be difficult for even the most experienced practitioners, believes Kimberley. She says, “Risk dependent, a practitioner may choose to hold a safe space for the patient who is experiencing a decline in mental health, if this fits within their capacity of training, competency and if there is appropriate supervision.”

She adds, “Alternatively, referring to other expert wellness services such as EDEN wellness therapies of Harley Street London, who assign referrals to accredited psychological and counselling professionals within 48 hours, or the Integrated Practitioners of Aesthetic Wellness can provide specialist psycho-aesthetic interventions to support your patients and your practice.”

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Mental health and wellness support services

From integrating yoga and nutrition into your clinic, to offering psycho-dermatology and personal training, there is an eclectic mix of services practitioners can provide to support the mental health of their patients. Including patient wellness as part of your model of care can help patients benefit from a 360° service to enhance the patient’s health, mental wellbeing and lifestyle to optimise their overall wellness.

Ultimately, practitioners need to ensure they are educated in patient mental health and undertake training that covers a range of mental illnesses, mental health assessment, communication skills and motivations for treatment, as well as patient selection. Having the skills to assess mental illness, and offering mental health services, can help ensure a safe and risk-free experience for both the patient and practitioner.

About the author

Kimberley Cairns

Kimberley is an award winning, dynamic, inclusive published wellness expert and member of the British Psychological Society. Her innovative integrated psychological approach to aesthetics encompasses her combined 16 years of acute mental health and aesthetic clinic management experience. Specialising in psycho-aesthetic solutions, Kimberley has numerous key appointments including that of clinical advisory and fitness to practise within the JCCP. Her contributions to aesthetics in the interest of public health protection are extensive.

Kimberley Cairns