It is estimated that from 2001 to 2011 the number of newly diagnosed cases of cancer will increase by 29% in women and 32% in men [
1]. Cancer is the leading cause of burden of disease and injury in Australia, accounting for nearly one-fifth of the total disease burden [
2]. The diagnosis and subsequent treatment of cancer is a major life stress that is followed by a range of well described psychological, social, physical and spiritual difficulties [
3]. While over time most people diagnosed with cancer go on to adjust effectively to their changed life circumstances without clinical intervention, approximately 35% will experience persistent clinically significant distress such as anxiety and depression, adjustment disorders, fears about cancer recurrence, and post traumatic stress reactions, that for some will worsen over time [
4,
5]. As well, many partners of cancer patients report high levels of psychological distress, sometimes even greater than that of the patients [
6,
7]. The most powerful prospective predictor of longer term distress is current distress [
8,
9], hence there is a clinical imperative to identify patients and family members experiencing high distress and refer those people to accessible targeted psychosocial therapies [
10].
A range of measures are available to screen for high psychosocial distress. Memorial Sloan Kettering Cancer Center, New York developed a simple single item Brief Distress Thermometer (BDT) and accompanying Problem Checklist [
11] that has now been incorporated into clinical practice guidelines for psychosocial care after cancer and relevant consumer materials [
12,
13]. The BDT is free of charge; and easy to administer and interpret; and has comparable accuracy with longer distress screening instruments such as the 14 item Hospital Anxiety and Distress Scale and the 18 item Brief Symptom Inventory [
14,
15]. As such, the BDT is well suited for large-scale and repeated distress screening. There is also a well-established body of evidence demonstrating that psychosocial interventions increase wellbeing, improve adjustment and coping and reduce psychological distress in people affected by cancer [
10,
16]. A range of effective intervention approaches have been described using varying delivery formats, and these include cognitive behavioural therapy, relaxation techniques, psycho-education, supportive psychotherapy, and family and couples therapy. As well, in North America and Australia clinical practice guidelines for psychosocial care have been developed that provide recommendations for intervention [
10,
12,
13,
17]. However, despite the availability of guidelines and tools, evidence-based psychosocial care is the exception rather than the norm. Clinicians tend to overlook patients' psychosocial needs, often do not recognise depression and other psychiatric illnesses in their patients, and have limited response skills for managing patients' distress [
8,
18‐
21]. Routine screening for psychological distress is uncommon in acute treatment centres reducing the likelihood of detecting highly distressed patients and providing them with timely support [
8]. Compounding this, while
some psychosocial care is likely to be delivered to patients at diagnosis, it is uncommon at the time of treatment completion and will seldom include family members. For example, in a sample of 439 cancer patients treated at a tertiary cancer centre in Queensland, psychosocial care information was provided to only half of patients at diagnosis, and at the completion of treatment to less than one third [
21]. Psychosocial care services that are responsive and accessible across the illness experience and beyond the acute treatment setting are urgently needed.