Views of Mental Health Professionals on Palliative Care

Key Message : Mental health professionals play a key role in palliative care delivery, especially in the management of co-occurring psychiatric conditions experienced by those with serious illness. This session highlights a project that surveys mental health professionals on their comfort with discussing palliative needs and views on specialty palliative consultation.

Abstract: Context: Palliative medicine addresses the symptoms of individuals living with serious illnesses such as cancer, dementia or heart failure. Many individuals living with these illnesses experience comorbid psychiatric conditions, whether emerging prior to or during illness.(1,2,3) A recent survey shows that many palliative clinicians display some comfort with managing mood, anxiety, and neurocognitive disorders but less comfort with other psychiatric comorbidities and lower satisfaction with mental health training opportunities.(4) There is minimal research on the views of mental health professionals (MHPs) on discussing palliative needs or referring to specialty palliative care. This project aims to assess the attitudes of MHPs towards specialty palliative care using a 14-item electronic survey.

Methods: A one-time electronic survey will be distributed to MHPs at academic medical centers within the US, including attending psychiatrists, psychiatric advanced practice providers, therapists, psychologists, and social workers. The survey is modified from the Palliative Care Attitudes Scale (PCAS-14)(5) to assess practitioners’ comfort with discussing palliative needs and views on the benefits of palliative care consultation. Participants will also be surveyed about their role, setting and context of practice, years of clinical experience and prior engagement in palliative encounters. The survey will be emailed directly to participants from the investigators’ home institution and will be emailed to chairs of other academic psychiatry programs for distribution to staff. Chairs will be identified through the American Psychiatric Association and/or American Association of Chairs of Departments of Psychiatry directories.

Results: This survey will be distributed to up to 800 MHPs in academic psychiatric programs across the US. Survey distribution begins in late 2025 and results are pending.

Conclusion: MHPs are an important part of palliative care delivery. Further research into the comfort level and perceptions of MHPs are key in informing future generalist palliative care initiatives and support ongoing collaboration.

References: 1. Kozlov E, Dong X, Kelley AS, Ankuda CK. The Epidemiology of Depressive Symptoms in the Last Year of Life. J Am Geriatr Soc. 2020;68(2):321-328. doi:10.1111/jgs.16197

2. Kozlov E, Phongtankuel V, Prigerson H, et al. Prevalence, Severity, and Correlates of Symptoms of Anxiety and Depression at the Very End of Life. J Pain Symptom Manage. 2019;58(1):80-85. doi:10.1016/j.jpainsymman.2019.04.012

3. Sewtz C, Muscheites W, Grosse-Thie C, Kriesen U, Leithaeuser M, Glaeser D, Hansen P, Kundt G, Fuellen G, Junghanss C. Longitudinal observation of anxiety and depression among palliative care cancer patients. Ann Palliat Med. 2021 Apr;10(4):3836-3846. doi: 10.21037/apm-20-1346. Epub 2021 Mar 22. PMID: 33832298.

4. Shalev D, Robbins-Welty G, Ekwebelem M, Moxley J, Riffin C, Reid MC, Kozlov E. Mental Health Integration and Delivery in the Hospice and Palliative Medicine Setting: A National Survey of Clinicians. J Pain Symptom Manage. 2024 Jan;67(1):77-87. doi: 10.1016/j.jpainsymman.2023.09.025. Epub 2023 Oct 1. PMID: 37788757; PMCID: PMC10841817.

5. Perry LM, Hoerger M, Malhotra S, Gerhart JI, Mohile S, Duberstein PR. Development and Validation of the Palliative Care Attitudes Scale (PCAS-9): A Measure of Patient Attitudes Toward Palliative Care. J Pain Symptom Manage. 2020 Feb;59(2):293-301.e8. doi: 10.1016/j.jpainsymman.2019.09.008. Epub 2019 Sep 17. PMID: 31539604; PMCID: PMC12449757.