Psychiatry trainees’ views and educational needs regarding the care of patients with a life-limiting illness

Abstract

Participants generally feel unprepared to care for patients with a life-limiting physical illness and have contrasting views on the role of psychiatry in this setting. Targeted education is required for psychiatry trainees in order to equip them to care for these patients.

A Focus Group Study of Palliative Physician and Consultation-Liaison Psychiatrist Perceptions of Dealing with Depression in the Dying

“…This is echoed by the perception that psychiatrists who are skilled and experienced in palliative care are lacking, with some avoiding this field. 2 , 23 , 35 In fact, one previous psychiatry survey respondent reported “ Very few psychiatrist are comfortable working in the clinical space” ( Supplemental Material 1 ). To improve care, there needs to be an increased awareness of the importance of palliative care psychiatry with funding prioritised.…”

“… 40 , 42 , 43 Palliative physicians and psychiatrists should learn both psychiatric and palliative care skills relevant to this field. 11 , 23 While evidence informing effectiveness of specific training strategies is scant in this setting, the postulated strategies reinforced by the literature include: informal education through integrative MDT meetings, clinics and ward rounds; and building formal integrative training opportunities such as joint educational seminars, clinical placement of trainees in the other specialty, and mandatory teaching in college training curricula. 22 , 24 , 40 , 44 – 46 As postulated, training content may include skills for both disciplines to work collaboratively to deliver depression screening, assessment and management in low-burden manners, facilitating potentially effective psychotherapies as foundation (eg, dignity and meaning-centered therapies), complemented by rapid-onset pharmacological agents (eg, methylphenidate, and esketamine) as required.…”

The Creation of a Psychiatry-Palliative Care Liaison Team: Using Psychiatrists to Extend Palliative Care Delivery and Access During the COVID-19 Crisis

“…7 Currently, there is no Accreditation Council of Graduate Medical Education-mandated palliative care training for psychiatrists, although psychiatry residents are interested in such training. 14 During the COVID-19 crisis, the need for palliative care services surged rapidly, overwhelming the existing workforce. We present a model psychiatry palliative-care liaison team in which advanced psychiatry trainees received rapid training and just-in-time supervision and functioned to provide supervised primary palliative care services at a relatively high volume and acuity.…”

End-of-Life Care in Individuals With Serious Mental Illness

“…44 However, because psychiatrists and other mental health clinicians working in mental health settings may receive little training in palliative care, many may not be aware of the need or feel able to participate in advance care planning conversations with their patients. 45,46 C-L psychiatrists are well positioned to serve as teachers to less medicalized colleagues in community mental health. 10 Such teaching should be aimed at empowering community mental health providers to invite their patients to engage in appropriate advance care planning discussions.…”