End-of-life care for people with severe mental illness: mixed methods systematic review and thematic synthesis of published case studies (the MENLOC study)

Coffey, Michael; Edwards, Deborah; Anstey, Sally; Gill, Paul; Mann, Mala; Meudell, Alan; Hannigan, Ben

doi:10.1136/bmjopen-2021-053223

Cited by 4 publications

(1 citation statement)

References 62 publications

(103 reference statements)

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“…It is not unknown for persons diagnosed with other serious conditions to deny the gravity of their situation, and for people with pre-existing mental health conditions it appears that this is no different. [ Second order data 40 ].…”

Section: Identified Issuesmentioning

confidence: 99%

Challenges and opportunities for improvement when people with an intellectual disability or serious mental illness also need palliative care: A qualitative meta-ethnography

2023

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Background: People with diagnoses of intellectual disability or serious mental illness have higher mortality rates due to physical comorbidities; better understanding is needed to guide best practice in provision of palliative care for these populations. Aims: To identify multivoiced perspectives, drawn from lived experience of: what works, and what does not, in palliative care for people with intellectual disability or serious mental illness; challenges in, and opportunities to improve, palliative care. Design: A systematically constructed qualitative meta-ethnography. Protocol published (PROSPERO: CRD42021236616). Data sources: MEDLINE, PsychINFO, CINAHL PLUS and Embase used without date limitations. Papers published in English, containing qualitative data on palliative care provision for people with a diagnosis of intellectual disability or serious mental illness were included. Global five-point strength score applied for relevance/quality appraisal. Results: Familiarity (of location, people and/or things) is important for good palliative care. Assumptions and misunderstandings about the role of mental capacity assessment to appropriately involve the patient in decision-making are common. Adapting training for palliative care staff to address concerns and beliefs about mental illness is one of the methods that helps avoid diagnostic overshadowing. Proactive identification of service arrangements to meet needs of persons with personality, psychotic, delusional and bipolar affective disorders will help optimise care. Conclusions: Evidence, including the voices of people with intellectual disability or serious mental illness is urgently needed to guide efforts to improve their access to and experience of palliative care. More evidence is especially needed to understand, develop and implement best practice for people with psychosis, bipolar affective disorder, mania and personality disorder.

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Section: Identified Issuesmentioning

confidence: 99%

Challenges and opportunities for improvement when people with an intellectual disability or serious mental illness also need palliative care: A qualitative meta-ethnography

2023

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Preferences for Palliative and End-of-Life Care: A Systematic Review of Discrete Choice Experiments

Xia,

Kularatna,

Virdun

et al. 2023

Value in Health

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Foreseeably Early Deaths in Patients With Psychiatric Disorders

Yager,

Treem,

Strouse

2024

J Nerv Ment Dis

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Patients with psychiatric disorders often have foreshortened lives, attributed both to “natural” medical and “unnatural” external causes of death such as suicide, homicide, and accident. Many deaths are foreseeable due to circumstances linked to patients' psychiatric disorders. These can include illness-associated disparities, adverse treatment effects, lack of self-care, and behaviors stemming directly from psychopathological processes. Whereas some of these processes contribute indirectly to patients' causes of death, others are more directly consequential, causing patients to “die from” their psychiatric disorders. Some patients manifest likely fatal trajectories that may lead to “end-stage” psychiatric disorders. Palliative approaches may optimize their quality of life and potentially alter these trajectories, but patients with psychiatric disorders are less likely to receive optimal end-of-life care. Although assuring a “good death” can be challenging, systematic efforts can assist in providing patients with psychiatric disorders deaths with dignity rather than indignity.

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End-of-life care for people with severe mental illness: mixed methods systematic review and thematic synthesis of published case studies (the MENLOC study)

Cited by 4 publications

References 62 publications

Challenges and opportunities for improvement when people with an intellectual disability or serious mental illness also need palliative care: A qualitative meta-ethnography

Challenges and opportunities for improvement when people with an intellectual disability or serious mental illness also need palliative care: A qualitative meta-ethnography

Preferences for Palliative and End-of-Life Care: A Systematic Review of Discrete Choice Experiments

Foreseeably Early Deaths in Patients With Psychiatric Disorders

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