Results clinically-significant psychiatric conditions were identified in 8/18 (44%) high distress subjects consenting to mental health intervention.High distress subjects who refused mental health intervention had more income and housing problems than the other subjects,received the fewest
intervention at baseline,and
progressively more throughout the study,exceeding the other sub-Samples by study completion .Conclusions. Highly-distressed women not psychologically ready to work through emotional
consequences of cancer at treatment onset may obtain support from APNS to manage cancer problems 2s they arise.Additional studies may identify best practices for all highly-distressed women with cancer,particularly those who do not accept Mental health services for distress ,but suffer from its effects.