Good palliative care for people with severe mental illnesses: A Group Concept Mapping study

Area of Science:

• Palliative Care
• Mental Health Services Research
• Health Disparities

Background:

• High-quality palliative care is an international human right.
• Individuals with severe mental illness (SMI) experience significant disparities in accessing and receiving quality palliative care.
• This unmet need highlights a critical gap in healthcare provision for vulnerable populations.

Purpose of the Study:

• To explore the essential requirements for delivering high-quality palliative care to individuals with severe mental illness.
• To understand these requirements from the perspective of diverse stakeholders involved in SMI care.
• To inform the development of improved palliative care guidelines and practices for this population.

Main Methods:

• A Group Concept Mapping study employing a mixed-methods participatory design.
• Included an online brainstorming phase for statement generation and individual statement sorting/rating.
• Utilized multidimensional scaling and hierarchical cluster analysis for data interpretation with 163 stakeholders in the Netherlands.

Main Results:

• A concept map emerged with seven key clusters: Self-care for healthcare professionals, Expertise, Communication in advance care planning, Care chain, Organization and policy making, Advance care planning, and Patient-centered care.
• Communication in advance care planning was the highest-rated cluster.
• "Centralize the patient" was identified as the most important statement.

Conclusions:

• Delivering effective palliative care for individuals with severe mental illness is complex, influenced by stigma and diverse stakeholder needs.
• Current mental health care often fails to meet basic palliative care requirements, increasing the risk of rights deprivation.
• Enhanced care recommendations and professional training, particularly in self-care and interdisciplinary approaches, are crucial.