The perspectives of hospital doctors about end‐of‐life care in people with mental illness: an observational pilot study

Abstract

BackgroundNegative attitudes towards people living with mental illness (PLWMI), defined here as mentalism, are a major contribution to health care inequity, which may extend into end‐of‐life care. There is a clear need for investigation of the attitudes of doctors towards PLWMI at the end of life as doctors may lead processes of care that contribute to this inequity.AimsThe aim of this pilot study is to examine the perspectives of hospital‐based doctors regarding end‐of‐life care and medical decision‐making in PLWMI.MethodsA survey was created to explore whether mentalism is present in the perspectives of hospital doctors regarding end‐of‐life care for PLWMI. The survey included demographic characteristics of participants and questions comprising statements and vignettes that required agree/disagree responses. Descriptive statistics were used to summarise responses, and chi‐square tests examined associations with demographic variables.ResultsThe survey was commenced by 48 hospital‐based doctors and completed by 45. Descriptive statistics indicated that mentalism is present in the attitudes of hospital doctors regarding end‐of‐life care of PWLMI, with 47 of 48 participants (98%) endorsing at least one mentalist response. One significant association found that psychiatrists and psychiatry trainees were less likely to endorse a stereotype response in one vignette.ConclusionsThis preliminary study addresses a gap within the literature on the potential contribution of mentalist attitudes in doctors to the poorer end‐of‐life care outcomes for PLWMI. The findings highlight the need for further study of this topic and suggest a role for targeted medical education in the pursuit of health care equality for PLWMI.