ABSTRACT
Terms such as ‘serious and enduring mental health problems and disorders’ or ‘severe persistent mental illness’ have been used to denote a group of people with long-term experience of schizophrenia and related disorders, mood disorders, anorexia nervosa, personality disorder and post-trauma stress disorder. Such terms are most often used in relation to people whose long-term experience of schizophrenia includes: poor treatment response, deteriorating functionality, poor physical health and constant exposure to stigma and social discrimination. Key considerations for people within this group include addressing physical health needs, social isolation and marginalisation and acquiring income support and secure, safe housing. It has been suggested that the needs of people experiencing severe persistent mental ill-health can best be met by a combination of knowledge and interventions drawn from palliative care and psychiatry. Some commentators have suggested the need for a new sub-discipline within psychiatry and mental health care – palliative psychiatry, which would focus on the prevention and relief of suffering through timely assessment and treatment of physical, mental, social and spiritual needs of people experiencing severe persistent mental ill-health. A key consideration of a palliative psychiatry approach would be balancing safety/protection-related needs with personal preferences in a population of vulnerable people. A palliative psychiatry approach to working alongside people living with severe persistent mental ill-health would thus entail both evidence-based and morals-based practice.
