End-of-Life Care for People with Mental Illness: What Works and What’s Missing

What is it about?

This paper looks at how end-of-life care (also called palliative care) is provided to people who are receiving support in mental health services. Palliative care focuses on helping people live as comfortably as possible when they have a serious or life-limiting illness, by managing symptoms, reducing distress, and supporting emotional and psychological wellbeing. The review brings together findings from existing research to understand what works well, what challenges exist, and how care can be improved. It shows that people with severe or long-term mental health conditions such as schizophrenia, bipolar disorder, or dementia are much less likely to receive good-quality palliative care compared to the general population. This can be due to several factors, including stigma, lack of staff training, and difficulties recognising physical health needs in mental health settings. The paper identifies three main areas that shape people’s experiences. First, access to care is often limited, with delays in referrals and fewer opportunities to receive specialist support. Second, planning for future care (such as discussing wishes for treatment or end-of-life decisions) often happens too late, or not at all, especially if a person’s condition affects their ability to make decisions. Third, the way care is delivered can vary widely, with challenges around communication, coordination between services, and staff confidence in providing palliative care. Despite these challenges, the paper also highlights that mental health nurses are in a strong position to provide compassionate, person-centred care at the end of life. It suggests that earlier conversations, better training, and closer working between mental health and palliative care teams could improve experiences for patients and their families. Overall, the paper calls for greater attention to the needs of this often overlooked group.

Featured Image

Photo by Saulo Meza on Unsplash

Photo by Saulo Meza on Unsplash

Why is it important?

This research is important because people with serious mental health conditions often miss out on the same quality of end-of-life care as everyone else. As people are living longer and more individuals develop complex physical and mental health needs, mental health services are increasingly caring for people who are approaching the end of their lives. If these needs are not recognised and supported properly, patients may experience unnecessary pain, distress, and poorer quality of life. The paper highlights that gaps in training, stigma, and poor coordination between services can prevent people from receiving timely and compassionate care. By drawing attention to these issues, the research helps healthcare professionals and organisations understand where improvements are needed. It also shows that mental health nurses can play a key role in delivering good end-of-life care, if they are given the right support. Ultimately, improving palliative care in mental health settings can lead to more dignified, person-centred care for a vulnerable and often overlooked group.

Perspectives