Park, Tanya, Hegadoren, Kathy, and Workun, Bernadette (2022) Working at the Intersection of Palliative End-of-Life and Mental Health Care: Provider Perspectives. Journal of Palliative Care, 37 (2). pp. 183-189.

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Abstract

Objective: Palliative, end-of-life care (PEOLC) providers are poorly resourced in addressing the needs of patients with mental health challenges, and the dying experiences of this cohort—particularly those with a comorbid, chronic and persistent mental illness (CPMI)—are poorly documented. We sought to explore the experiences of PEOLC providers with regard to caring for patients with mental health challenges, and gather insights into ways of improving accessibility and quality of PEOLC for these patients.

Method: Twenty providers of PEOLC, from different disciplines, took part in semi structured interviews. The data were coded and analyzed using a reflexive, inductive-deductive process of thematic analysis.

Results: The most prominent issues pertained to assessment of patients and differential diagnosis of CPMI, and preparedness of caregivers to deliver mental health interventions, given the isolation of palliative care from other agencies. Among the assets mentioned, informal relationships with frontline caregivers were seen as the main support structure, rather than the formal policies and procedures of the practice settings. Strategies to improve mental health care in PEOLC centered on holistic roles and interventions benefiting the entire palliative population, illustrating the participants saw little point in compartmentalizing mental illness, whether diagnosed or not.

Conclusions: Continuity of care and personal advocacy can significantly improve quality of life for end-of-life patients with mental health challenges, but bureaucracy and disciplinary siloing tend to isolate these patients and their caregivers. Improved interdisciplinary connectivity and innovative, hybridized roles encompassing palliation and psychiatry are 2 strategies to address this disconnect, as well as enhanced training in core mental health care competencies for PEOLC providers.

Item ID:	82254
Item Type:	Article (Research - C1)
ISSN:	2369-5293
Copyright Information:	© The Author(s) 2020. Article reuse guidelines: sagepub.com/journals-permissions
Date Deposited:	21 Feb 2024 23:04
FoR Codes:	42 HEALTH SCIENCES > 4205 Nursing > 420504 Mental health nursing @ 100%
SEO Codes:	20 HEALTH > 2003 Provision of health and support services > 200309 Palliative care @ 100%
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