Delivering Palliative Care in Mental Health Nursing Settings: A Systematic Review

Palliative care can provide comfort, alleviate suffering, and improve quality of life; however, access to palliative care for people with mental illnesses at the end of their lives is extremely poor. As the need for palliative care is expected to rise significantly in the future, palliative care must be considered a global health priority.

To examine the provision of palliative care within mental health settings and explore the factors that influence the experience of patients receiving palliative care in these settings.

This systematic review draws on peer-reviewed qualitative, quantitative and mixed-methods primary studies, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered online. A total number of 61,782 studies was identified after a comprehensive search of five academic databases. After rigorous screening, only nine studies met inclusion criteria and were selected.

Thematic analysis identifies three major themes and three subthemes: access to palliative care, advance decisions and treatment, and care in palliative care settings (palliative care settings, palliative care professionals and palliative care/medical interventions).

Access to palliative care for people with complex mental illness is very low when compared to the general population. Advance care planning should be initiated early in the development of palliative care needs, rather than at the point of mental illness diagnosis.

Although care for people with complex mental illness is complex while dying, conversations around palliative care need to be as part of a therapeutic relationship and engagement. Also, palliative care staff have an important role in communicating end-of-life planning to patients' families and carers.