Case series of introducing palliative care consultation in psychiatry

Background: The significance of palliative care consultation in psychiatry is unclear. Actual case series: Analysis of the introduction of palliative care consultation in a large psychiatric hospital. Possible courses of action: Continue without offering, survey the need for or offer palliative care consultation, and analyse its introduction. Formulation of a plan: Palliative care consultation was established and details including patient age, department, diagnosis, main problem, solution and discharge were analysed during the first 2 years. Outcome: Two consultations in the first year and 18 consultations in the second year were requested (18 geriatric, 2 addiction, 0 general, clinical social and forensic psychiatry) involving two domains: delirium associated with dementia or another condition (75%) and mental illness (e.g. alcoholic psycho-syndrome, psychosis, suicidal tendency, schizophrenia, depression) and cancer (25%). Recommendations of consultations were realized in 95%. Lessons from the case series: Implementation of palliative care consultation in psychiatry is one possible method of how to introduce palliative care in a field of medicine with lack of palliative care. View: Future research should focus on reasons for reservations about palliative care in psychiatry, include more patients with severe persistent mental illness and assess the value of palliative care consultation in resolving this problem.

[1]  N. Biller-Andorno,et al.  Acceptability of palliative care approaches for patients with severe and persistent mental illness: a survey of psychiatrists in Switzerland , 2019, BMC Psychiatry.

[2]  G. Helgesson,et al.  Towards a palliative care approach in psychiatry: do we need a new definition? , 2018, Journal of Medical Ethics.

[3]  Marina F Englesakis,et al.  The “surprise question” for predicting death in seriously ill patients: a systematic review and meta-analysis , 2017, Canadian Medical Association Journal.

[4]  N. Biller-Andorno,et al.  Palliative psychiatry for severe persistent mental illness as a new approach to psychiatry? Definition, scope, benefits, and risks , 2016, BMC Psychiatry.

[5]  R. Arnold,et al.  The Next Era of Palliative Care. , 2015, JAMA.

[6]  R. Morrison,et al.  Palliative Care for the Seriously Ill. , 2015, The New England journal of medicine.

[7]  M. Lloyd-Williams,et al.  Supportive and palliative care for patients with chronic mental illness including dementia , 2014, Current opinion in supportive and palliative care.

[8]  S. Irwin,et al.  Palliative Care Psychiatry: Update on an Emerging Dimension of Psychiatric Practice , 2013, Current Psychiatry Reports.

[9]  D. Schuyler Roles and goals of a palliative care psychiatrist. , 2010, Primary care companion to the Journal of clinical psychiatry.

[10]  K. Willison,et al.  Palliative Care for People with Severe Persistent Mental Illness: A Review of the Literature , 2008 .