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Institute of Biomedical Ethics and History of Medicine (IBME) Psychiatric and Psychotherapy Ethics (PAPE) Research Group

Palliative Psychiatry

palliative psychiatry

Short description

Despite the now established involvement of psychiatrists in palliative care, psychiatry does not currently explicitly provide palliative care for patients with mental illness outside the context of terminal medical illness. Based on the WHO definition of palliative care, a definition of palliative psychiatry can be proposed. Palliative psychiatry focuses on mental health rather than medical/physical issues. We propose that the beneficiaries of palliative psychiatry are patients with severe persistent mental illness, who are at risk of therapeutic neglect and/or overly aggressive care within current paradigms. These include long-term residential care patients with severe chronic schizophrenia and insufficient quality of life, those with therapy-refractory depressions and repeated suicide attempts, and those with severe long-standing therapy-refractory anorexia nervosa. An explicitly palliative approach within
psychiatry has the potential to improve quality of care, person-centredness, outcomes, and autonomy for patients with severe persistent mental illness.

Collaboratoring universities – persons

Involved PAPE group researchers

Nikola Biller-Andorno, Sophie Glockler, Anna Westermair,  Manuel Trachsel

Funding

Between 2015 and 2018, this project was supported by the Palliative Care Research funding program of the Swiss Academy of Medical Sciences; the Gottfried and Julia Bangerter-Rhyner Stiftung; and the Stanley Thomas Johnson Foundation. 

Publications

  • Gramm, J., Trachsel, M., & Berthold, D. (2020). Psychotherapeutisches Arbeiten in Palliative Care. Verhaltenstherapie / Cognitive Behavior Therapy. doi: 10.1159/000504455
     

  • Trachsel, M., Hodel, M. A. Irwin, S. A., Hoff, P., Biller-Andorno, N., & Riese, F. (2019). Acceptability of palliative care approaches for patients with severe and persistent mental illness: a survey of psychiatrists in Switzerland. BMC Psychiatry, 19(111), 1-9.    
     

  • Trachsel, M., & Hodel, M. A. (2019). Palliative sedation on the grounds of intolerable psychological suffering and its implications for treatment-refractory mental disorders. Bioethica Forum. Swiss Journal of Biomedical Ethics, 11(2/3), 45-49.
     

  • Trachsel, M. (2018). The ethical importance of assessing end-of-life care preferences in patients with severe and persistent mental illness. American Journal of Geriatric Psychiatry 26(1): 98-99.  
     

  • Hodel, M. A., & Trachsel, M. (2018). Palliative Care in der Behandlung von schweren chronischen psychischen Störungen. In C. Prüter-Schwarte & E. Gouzoulis-Mayfrank (Hrsg.). Ethik in der psychiatrischen Praxis: Prinzipien – Werte – Tugenden. Lengerich: Pabst Science Publishers.
     

  • Trachsel, M., Irwin, S. A., Biller-Andorno, N., Hoff, P., & Riese, F. (2016). Palliative psychiatry for severe persistent mental illness as a new approach to psychiatry? Definition, scope, benefits, and risks. BMC Psychiatry, 16(260), 1-6. doi: 10.1186/s12888-016-0970-y
     

  • Trachsel, M., Irwin, S. A., Biller-Andorno, N., Hoff, P., & Riese, F. (2016). Palliative psychiatry for severe and persistent mental illness. The Lancet Psychiatry, 3, 200.
     

  • Trachsel, M., Krones, T., & Wild, V. (2016). Zwangsernährung oder Palliative Care bei chronischer Anorexia nervosa? Behandlungsstrategien aus medizinethischer Sicht. In T. Moos, C. Schües, & C. Rehmann-Sutter (Hrsg.). Randzonen des Willens, Entscheidungen und Einwilligung in Grenzsituationen der Medizin. Frankfurt am Main: Peter Lang International Academic Publishers.