Facilitators of palliative care provision for people with mental illness: a qualitative analysis from the perspective of mental healthcare staff.

Abstract

Background: Mental illnesses can have fundamental negative effects upon people's quality of life. Whilst people with mental illness require mental health support, their physical health can often be neglected. As a result, they are often denied high-quality palliative care to which they are entitled. This study aimed to identify the facilitators of providing high-quality palliative care for patients with mental illness from the perspective of staff working in mental health services in Iran.

Methods: A descriptive qualitative study was conducted. A total of 32 people participated, including nurses (n = 22), psychiatrists (n = 6), and psychologists (n = 4). Semi-structured and individual interviews were used to collect data. The data collected were analysed using the content analysis approach.

Results: The analysis of participants' narratives resulted in 689 codes, which were organized into 5 subcategories and 2 categories. The facilitators of providing palliative care for patients with mental illness were identified in two categories: (1) expanding organizational support and (2) promoting a team and participatory approach. The first category included subcategories relating to the creation of appropriate infrastructure and educational empowerment of personnel. The second category encompassed subcategories addressing positive attitudes toward teamwork and the preference for collaborative practice over lone working. It also highlighted the importance of recognising the interdisciplinary nature of palliative care and encouraging family involvement, even in the presence of mental illness stigma.

Conclusions: This study is the first of its kind. Findings support policy makers to enhance the provision of palliative care for patients with mental illness in order to improve their quality of life.