Mental health and palliative care : exploring the ideological interface

People with a mental illness have an excess mortality, a reduced life expectancy and die from ten to fifteen years earlier than the general population In the face of such sobering facts about the difficult end-of-life issues in relation to mental illness, there is a ?loud silence? in the literature on palliative care and hospice services for individuals in the mental health system. This paper seeks to address this hiatus by presenting findings from a qualitative research project on end-of-life care for patients in a mental health institution called The Park, Centre for Mental Health, located in Brisbane, Queensland, Australia. In particular, this discussion will focus on the findings from the project which highlight the similarity in philosophy between palliative care and mental health practice. The similarity which includes a person centred practice, relationship- based connectedness, a belief in compassionate, holistic care, respect for autonomy and choice, quality of life issues, family as the unit of care and need for a democratic and multi- discipline work team , will be described. It will be argued that the common philosophical meeting ground is an excellent foundation for integrating palliative care, now recognised as best-practice end-of-life care, into mental health service delivery. In short, the shared practice values and vision between these two disciplines provide an optimistic starting point from which to plan to address the lack of hospice and palliative care service delivery in mental health.