Mental Healthcare Delivery in Palliative Care: Patient and Caregiver Perspectives
Access to this document is restricted. Some items have been embargoed at the request of the author, but will be made publicly available after the "No Access Until" date.
During the embargo period, you may request access to the item by clicking the link to the restricted file(s) and completing the request form. If we have contact information for a Cornell author, we will contact the author and request permission to provide access. If we do not have contact information for a Cornell author, or the author denies or does not respond to our inquiry, we will not be able to provide access. For more information, review our policies for restricted content.
BACKGROUND: Palliative care aims to improve quality of life for individuals with serious illness, yet mental health needs in this population often remain under-addressed. Currently, little is known about how patients and caregivers perceive the role of mental health services within palliative care. OBJECTIVES: To explore patient and caregiver perspectives on (1) current delivery of mental health support in palliative care for serious medical illnesses and (2) preferences for integrated specialty mental health services. METHODS: We conducted semi-structured interviews with 23 patients receiving ambulatory palliative care and 11 caregivers at an academic medical center. Interviews explored experiences with mental health care, perceived roles of palliative care, and preferences for integration. Transcripts were analyzed using thematic analysis. RESULTS: Participants described strong therapeutic relationships with palliative care clinicians, who offered informal mental health support through conversations, medication management, and referrals. However, many were uncertain whether mental health care formally fell within providers' roles. Both patients and caregivers expressed broad support for integrated mental health services, citing benefits such as improved care coordination, streamlined logistics, and access to clinicians with knowledge about serious illness. Caregivers emphasized their own emotional burdens and advocated for inclusion as recipients of mental health support. CONCLUSIONS: Patients and caregivers view integrated mental healthcare as a valuable addition to palliative care. Integration models should include specialist mental health providers, address caregiver needs, and offer flexible delivery formats. Palliative care's transdiagnostic scope, interdisciplinary structure, and psychosocial orientation make it a strategic site for integrated care.