Assessing Aesthetics Patients’ Mental Health After Lockdown

Aesthetics clinics across the country are preparing to reopen as the end of lockdown nears. You are likely familiar with the requirements regarding physical aspects, such as PPE and social distancing. However, you may be less aware of the need to evaluate the effects lockdown has had on your patients’ mental health.

As healthcare professionals, aesthetics practitioners have a clear duty of care to their patients. This is why conducting a thorough clinical consultation prior to any aesthetic medicine treatment is so vital – now, more than ever.

Due to the impact of lockdown, it is crucial to carry out increasingly rigorous mental health screening. When you are scheduling patient consultations, we highly recommend setting aside more time than usual for this.

If you are not doing these in-person, a video consultation is advisable. This allows you to take both verbal and non-verbal cues into consideration when making your assessment.

You may have read about the “Zoom Face” phenomenon which suggests you could be seeing more new patients after lockdown. However, it’s important to take the time to talk through existing clients’ current psychological state, too.

Pay particular attention to those who had pre-existing mental health issues. The current situation and its many ramifications may have exacerbated these problems.

Get patients to open up to you during the clinical consultation

In addition to your standard pre-treatment questions, use this time to also discuss the pandemic. Try to get them to open up about their lockdown experience during the clinical consultation in order to identify any red flags.

Some leading questions you may consider asking to assess patients’ suitability for treatment, include:

• how are you feeling about the COVID-19 situation?
• who were you in lockdown with?
• how is work going?
• do you have children, at-risk or elderly relatives?
• do you feel you have enough support?
• has this year changed how you feel about yourself?
• how has your lifestyle changed as a result of the pandemic?

This should lead them to talk about any particular worries they may have or tough situations they may be dealing with. It should also lead them to give away signs of stress, such as disrupted sleep patterns, taking more or less exercise and smoking or drinking more than usual.

Use these responses to establish how vulnerable they appear to be. This may be especially difficult to gauge due to heightened stress and anxiety being fairly commonplace this year. Therefore, make sure you allow enough time to explore this subject in as much detail as needed in order to come to an informed conclusion.

When to refuse treatment and when to defer

If there are any warning signs in their responses, take a view as to whether having injectable treatments now is in the patient’s best interests. It may be a question of delaying their treatment until they are in a more positive frame of mind, or it could mean refusing them.

Where a patient proceeds with treatment despite a negative mindset, they may be more likely to be unhappy with the final result. They may also be less mentally prepared to cope with any complications that arise. This can have immense consequences for a patient whose mental health is already strained.

Treating a patient you are not absolutely certain is suitable for treatment can also impact your reputation as a competent and ethical practitioner. As such, always have the patient’s best interests at the forefront of your mind; defer their treatment or, if necessary, refuse to treat them. It is 100 per cent your right to do so and you should not feel bad about this, no matter how persuasive the patient is.

Psychological support and holistic care may be advisable rather than any kind of aesthetic treatment. Knowing when not to treat a patient is a key skill every injector needs.

This is not an exhaustive list as each case should be assessed on its own merit. However, we would generally recommend refusing treatment where the patient has, or is suspected of having:

• body dysmorphic disorder (BDD)
• acute anxiety or depression
• an active eating disorder
• an unwavering desire for a treatment that is not right for them
• unrealistic expectations as to the outcome from treatment.

The following are examples of situations where deferring treatment may be in the patient’s best interests if they have admitted to, or are suspected of:

• having COVID-19 or any other relevant temporary medical issue
• wanting treatments ahead of an event taking place soon after the procedure
• recently experiencing trauma, such as a divorce, bereavement or losing their job
• not being completely sure about the injectable they are enquiring about
• having extremely high stress levels or if they are particularly irritable.

Remember: if there are any red flags that cause you to have doubts about treating a patient, it is best to refuse treatment. Patients can be convincing in their arguments when refused treatment, but don’t be swayed. Be clear when outlining your decision and reasoning.

You may also find it useful to build a relationship with a counsellor or psychotherapist so you can make referrals, where appropriate.

Establish yourself as a trustworthy, ethical injector who puts patients’ best interests ahead of profit. This is the reputation you want and the one which will ultimately bring you a successful business and loyal client base.

Last fact-checked: 17 January 2023