Despite death being part and parcel of human life, it is usually treated as an illness. That is why there are the palliative care services that aim at increasing and improving the quality of people living with serious terminal and chronic illnesses. The focus of this particular unit of healthcare is to minimize the effects of the symptoms, and the stress suffered when one is seriously distressed. Like other medical services, the care also comprises of the palliative psychiatry, which in this case focus on people with mental illnesses rather than the general illnesses. Primarily, the services are offered by a team of professionals comprising of the nurses, doctors, and other specialists; who work together to ensure that the patients receive support. They guarantee that individuals under their observation have access to an extra layer of support despite their age and the stage of disease they are in.

Running head: PALLIATIVE PSYCHIATRY 1

PALLIATIVE PSYCHIATRY 9

Palliative Psychiatry

Aileen Gonzalez

West Coast University

Introduction

Despite death being part and parcel of human life, it is usually treated as an illness. That is why there are the palliative care services that aim at increasing and improving the quality of people living with serious terminal and chronic illnesses. The focus of this particular unit of healthcare is to minimize the effects of the symptoms, and the stress suffered when one is seriously distressed. Like other medical services, the care also comprises of the palliative psychiatry, which in this case focus on people with mental illnesses rather than the general illnesses. Primarily, the services are offered by a team of professionals comprising of the nurses, doctors, and other specialists; who work together to ensure that the patients receive support. They guarantee that individuals under their observation have access to an extra layer of support despite their age and the stage of disease they are in.

Background of Palliative Psychiatry

Psychiatry and palliative care are said to have a common medical ground. The two are interrelated in that a large portion of patients receiving the palliative care tend to suffer from mental-related issues like anxiety and depression. Thus, the proposal by the World Health Organization for all the mentally ill patients receiving psychiatric medication should be introduced to the long-term residential care that resembles the palliative care (WHO, 2016). Palliative Psychiatry was introduced to care for the people who suffer neglect due to persistent mental illnesses as well as the aggressive people within their current mental status (Keszte et al., 2013). The high number of people suffering from Schizophrenia and inadequacy of quality life expectancy, those living with therapy-refractory depression, and the severe and constant suicide efforts were the drivers for the interaction between the two. Palliative care is necessary for not only improving the quality of life of an individual but also the outcome of their treatment, personal centeredness, as well as the autonomy of the patient in making their personal decisions.

Mainly, 30% of the people receiving the palliative care services suffer from anxiety. Also, 38% of them have issues related to depression while 20-45% of the population suffer from other mental illnesses globally (Billings & Block, 2009). For that reason, over the last two decades, the collaboration between the two fields of psychiatry and palliative care has greatly increased in the developed countries. As outlined in the guidelines established by the Swiss Academy of Medical Sciences, there is a need for the people with Severe Persistent Mental Illnesses to get more attention from the field of palliative care. According to the institution, most of the mentally ill patients tend to be overlooked even when they are suffering from physical diseases. Thus, there is a need for the close attention from the palliative care to the mentally ill this reducing the occurrence of suicide.

Role of Psychiatrists in Palliative Care

Psychiatrists are the people responsible for the assessment and the analysis of the mental status and progress of people suffering from mental diseases. In the palliative care setting, they are helpful in giving medical support to the patients. However, although this is their primary role in their career, they are as well helpful in ensuring that the patients enjoy and feel happy during their remaining part of life. Irwin & Ferris (2008), they offer the psychotherapy services to help the patients explain themselves. In doing so, the patients can find happiness and satisfaction especially when they understand that people do care about them. This ensures that there is minimal pain experienced during their departure time. In addition, they counsel the family members who might be traumatized and depressed due to the condition of their family members. A psychiatrists’ role at this particular moment is to ensure that life is easier for both the patients and their relations. Also, when the patient dies, the family is faced with a difficult time when they need the emotional support. A psychiatrist is the most appropriate to comfort them and give them the support they need.

As well, they educate people and especially the families on how to best handle the patients in their current status. In most cases, people suffering from the terminal illnesses and the mental diseases tend to be stubborn and aggressive (Trachsel et al., 2016). Therefore, it might be difficult to associate with them because of the harm they are likely to cause. However, psychiatrists tend to understand and know the best approaches to use and persuade them. Unlike others in need of the palliative care, people with mental disability need more than care and the state of their mental capacity may cause pain to those around them.

To ensure the total well-being and improve the quality of life for people suffering from terminal diseases and in their final days in the world, it is necessary to ensure general assessment and analysis of the patients. Palliative care focus on the physical, psychosocial, and the spiritual aspects of an individual’s life. Nonetheless, there is a need for mental well-being which can only be enhanced by the availability of psychiatrist (Mitchell et al., 2011). This creates a special place for the psychiatrists in the care centers just like it is the case with the nurses and doctors. Sometimes, mental issues that may be hard for other professionals to recognize and treat might be the cause and source of pain for a patient. They are responsible for ensuring that the staff remains in their right mental state while providing their care.

Need for Psychiatry

The growing evidence proves that with the advanced life-threatening illnesses, there is an increase in the psychosocial and psychiatric issues. The need for a psychiatric in palliative care also increases with the advancement of the acute and complex issues that result in threatening illnesses (Knopf & Head, 2012). With the need to care for the patients and their families. Despite the expertise and capability of the professionals involved in providing the care services, including most of the psychiatric issues, they still do not have the best understanding of assessing analyzing, as well as managing the complex psychiatric issues (Breitbart & Dickerman, 2008). As a result, the psychiatrists are required to help in such issues. Macleod (2013) argues that it is difficult for the care providers to identify depression among the patients suffering from terminal diseases. As a result, if they are not recognized in time, they lead to a reduced life expectancy.

The Scope of Palliative Care in Psychiatry

As defined by WHO (2014), Palliative Psychiatry is the approach used by the healthcare practitioners to increase the worth of the life of patients as well as supporting both the patients and the family in facing the problems brought about by the threatening and persistent severe mental illness. It involves the ensuring relief and prevention of the sufferings through the treatment and assessment of mental, physical, social, and even the spiritual state of the patients (Stoddard et al., 2011). Besides, it focuses on avoiding and reducing the burden associated with the mental problems. Essentially, it ensures that all the processes conducted revolve around making life better for the people but not increase their suffering.

Besides, the scope of the care is quite broad. It ranges from the short-terms aimed at reducing the impact of the diseases and the targeted measures that the team are using to alleviate and minimize the patients’ mental pain. Usually, psychiatrists ensure the mental well-being of the mentally ill patients, as well as their overall welfare to ensure that they receive ultimate happiness. In most cases, the psychiatric activities are not aimed at establishing the corrective measure but to ensure the control of the current illness (Deodhar, 2016). Thus, the psychiatrists are responsible for the stabilizing their current life without interfering with the disease progression in the long-term.

Benefits of Psychiatry in Palliative Care

According to the previous research, about a fifth to a third of the total population of people receiving palliative care also suffer from mental illnesses (Dunlop et al., 2013). This comprises of between four and seven million people who have the Schizophrenia; a mental disease that is capable of making one to develop impaired life (Miyamoto et al., 2015). In such a scenario where people tend to have a disrupted social life, they need the help of the psychiatrist who can convince them to accept medical assistance.

In addition, they also act in place of other professionals by helping maintain all the various domains in palliative care that are essential (Trachsel et al., 2016). For instance, they enhance a good relationship between the family, patients, and the professional by ensuring that happiness around the patients are as per their wish or that of the family. For example, showing respect for one’s culture by allowing them to practice their traditions and rituals. Also, respecting the spiritual beliefs of the person by ensuring that they get all the spiritual support they need. Although it does not postpone death, happiness enhances longer life.

Risk of Palliative Psychiatry

Despite the well-established positions of the field of psychiatry and their services in the palliative care, they have not yet been fully accepted in practice. The major reason being lack of the necessary knowledge on palliative care (Sexton et al., 2016). Most of them lack the training that allows them to conduct themselves as palliative psychiatrists. So far, only a pilot has been used to increase exposure of the psychiatric patients to the end-of-life care. As a result, this has kept a distinct difference between the two fields.

Besides, the professional themselves lack exposure to palliative care. According to Irwin et al. (2011), unlike other specialists in the healthcare industry, psychiatry schooling does not include the introduction and training on palliative care. As a result, they enter their careers with no experience or mindset that relates to the end-of-life care. For that reason, the mentally challenged patients are considered eligible for the care only in the instances of severe persistent anorexia nervosa and dementia (Irwin, 2013). Nonetheless, with the increasing number of people suffering from terminal diseases, the level of mental illnesses has also increased. As a result, the psychiatrists are taking their positions in enhancing quality life through the reduction of pain in the patients’ lives.

Conclusion

Palliative care is concerned with the patients’ well-being and pain. Their main focus is to improve the lives of those living in pain of the terminal diseases before their day to rest arrives. The patients are usually under intense pain which demands not only their physical and spiritual sustenance but also the mental. Although psychiatrists do not seem to be appreciated in this service, they have a critical role they uniquely play in palliative care; bearing in mind that most people under the care have mental challenges. Besides, the training they receive also plays a role in closing them out. They are not introduced to end-of-life care in time. Thus, they lack the necessary exposure as well as mindset required in the field.

References

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