Mental healthcare and palliative care: barriers

O'Malley, Kelly; Blakley, Laura; Ramos, Katherine; Torrence, Nicole D.; Sager, Zachary

doi:10.1136/bmjspcare-2019-001986

Cited by 20 publications

(21 citation statements)

References 20 publications

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“…The teams are supposed to help and support the FPs-a practice explored in a Canadian study focusing on "institutionrelated barriers (i.e., the healthcare system), interest-related barriers (i.e., motivations of stakeholders) and Idea-related barriers (i.e., values of stakeholders and information/ research), on sociopolitical barriers" (60). Research on barriers in palliative care has found that patient well-being is improved by palliative teams where psychologists and psychiatrists are core members of the treatment team (61). That is why integrated care teams are needed to ensure high quality palliative care at home.…”

Section: Barriers To Home Palliative Carementioning

confidence: 99%

Narrative review of home care for palliative patients in general practice

Despotova-Toleva

Toleva-Nowak

2021

Ann Palliat Med

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The need of palliative care is constantly growing worldwide and the spectrum of patients and diseases, leading to the need of palliative care is very broad (1). According to recently published data in the "Letter for National Palliative Care Advocates to send to government lead on Universal Health coverage, and UN negotiations" (2) by 2060, an estimated 48 million people (47% of all deaths globally) will die each year with serious health-related suffering, and 83% of these deaths will occur in low-income and middleincome countries.Due to the phenomenon of the so-called "silver tsunami" (the increasing number of elderly, and those of them with severe, incurable, life-limiting and life-threatening diseases) the problem escalates dramatically. Thus, significant and urgent changes should be made in some basic documents, including "Suggested language changes to zero draft 'Political Declaration of the High-level Meeting on

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Section: Barriers To Home Palliative Carementioning

confidence: 99%

Narrative review of home care for palliative patients in general practice

Despotova-Toleva

Toleva-Nowak

2021

Ann Palliat Med

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“…A high comorbidity of mental illness is present in most patients with chronic medical problems, providing many opportunities for clinical training sites. Current evidence supports integrated models for primary care, 43 HIV, 44,45 cardiology, 46 oncology, 47,48 women's health (obstetrics and gynecology), 49 transplantation, 50 weight loss surgery, 51 epilepsy clinics, 52 palliative care, 53 and pain clinics. 54 There are other clinical sites where patients are known to have high comorbidity of psychiatric issues, but to date, there are no reports on colocation or collaboration; these include rheumatology, 55 endocrinology, 56 dermatology, 57 and plastic surgery.…”

Section: Training Sitesmentioning

confidence: 99%

The Educational Value of Outpatient Consultation-Liaison Rotations: A White Paper From the Academy of Consultation-Liaison Psychiatry Residency Education Subcommittee

et al. 2020

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Background: As mental health services in outpatient medical clinics expand, psychiatrists must be trained to practice in these settings. Objectives: The Academy of Consultation-Liaison Psychiatry residency education subcommittee convened a writing group with the goal of summarizing the current evidence about outpatient consultation-liaison psychiatry (CLP) training and providing a framework for CLP educators who are interested in developing outpatient CLP rotations within their programs. Method: MEDLINE (via PubMed), Embase, and PsycINFO (via OVID) were reviewed each from inception to December 2019, for psychiatric CLP services in ambulatory settings that involved residents or fellows. The CLP education guidelines were reviewed for recommendations relevant to outpatient CLP. We also searched MedEd portal for published curriculums relevant to CLP. The group held 2 conferences to reach consensus about recommendations in setting up outpatient CLP rotations. Results: Seventeen articles, 3 Academy of Consultation-Liaison Psychiatry-supported guidelines, and 8 online didactic resources were identified as directly reporting on the organization and/or impact of an outpatient CLP rotation. These manuscripts indicated that residents found outpatient CLP rotations effective and relevant to their future careers. However, the literature provided few recommendations for establishing formal outpatient CLP training experiences. Conclusions: Outpatient CLP rotations offer multiple benefits for trainees, including exposure to specific clinical scenarios and therapeutic interventions applicable only in the outpatient setting, increased continuity of care, and the unique experience of providing liaison and education to non-mental health providers. The article outlines recommendations and examples for developing outpatient CLP rotations which CLP educators can incorporate in their programs.

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“…In the UK, national guidance recommends four levels of psychological support (Figure 1), with those with more complex needs requiring support from counsellors, psychologists, psychotherapists, mental health nurses or psychiatrists (National Institute & for Health & Care Excellence, 2004). This is seen as best practice both nationally (National Institute for Health & Care Excellence, 2017) and internationally (O'Malley, Blakley, Ramos, Torrence, & Sager, 2020; Payne & Junger, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…This means patients and family carers may not receive the type of support they require (Oechsle, 2019; Wang, Molassiotis, Chung, & Tan, 2018). Psychological symptoms can be underestimated as they are assumed to be expected in this population (O'Malley et al., 2020). Symptoms such as fatigue may be mistaken for side effects of underlying disease or treatment (Boakye et al., 2019), and it can be unclear whose role it is to provide psychological care (Kozlov et al., 2018).…”

Section: Introductionmentioning

confidence: 99%

Exploring the psychological impact of life‐limiting illness using the Attitude to Health Change scales: A qualitative focus group study in a hospice palliative care setting

2020

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Psychological distress is common in patients and their family carers receiving palliative care or those living with advanced progressive disease (Boakye et al., 2019; Hofmann et al., 2017; Rodin et al., 2018). There are higher rates of distress seen in patients with increased symptom burden (Fitzgerald et al., 2015). At its most severe, distress may lead to disabling symptoms such as depression and anxiety, with high prevalence of major depression (14.3%), adjustment disorders (15.4%) and anxiety disorders (9.8%) in palliative care settings (Mitchell et al., 2011). The psychological needs of patients and family carers may range from information giving and compassionate communication to more formal or specialist psychological interventions such as counselling (Kozlov, Niknejad, & Reid, 2018). In the UK, national guidance recommends four levels of psychological support (Figure 1), with those

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Mental healthcare and palliative care: barriers

Cited by 20 publications

References 20 publications

Narrative review of home care for palliative patients in general practice

Narrative review of home care for palliative patients in general practice

The Educational Value of Outpatient Consultation-Liaison Rotations: A White Paper From the Academy of Consultation-Liaison Psychiatry Residency Education Subcommittee

Exploring the psychological impact of life‐limiting illness using the Attitude to Health Change scales: A qualitative focus group study in a hospice palliative care setting

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