Psychiatry Plays an Important Role in Palliative Care, Experts Say


Mental health specialists are often eager to participate in the care of seriously ill and dying patients, and there are rich areas for collaboration between palliative care and psychiatry, according to Nathan Fairman, M.D., M.P.H., and Scott A. Irwin, M.D., Ph.D. In a session at today’s Annual Meeting, Fairman and Irwin described the expanding interface between palliative medicine and psychiatry and laid out several ways that mental health expertise can enhance the care of seriously ill patients and their loved ones.

Fairman is an assistant professor in the Department of Psychiatry and Behavioral Science at UC Davis School of Medicine and a former fellow at the Institute for Palliative Medicine at San Diego Hospice. Irwin is the director of supportive care services and an associate professor in the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai Health System. Both practice in settings that bridge psychiatry and palliative medicine, including inpatient psychosomatic medicine and palliative medicine consult, outpatient psycho-oncology and palliative care, and home-based hospice clinical settings.

Describing the historical emergence of hospice and palliative care, Fairman and Irwin argued that the alleviation of psychological distress has always been one of the central tenets of comprehensive, person-centered palliative care, but that mental health specialists have not always found space to collaborate in palliative care settings.

Participants in the session discussed some of the diagnostic challenges that confront mental health experts who provide care to seriously ill and dying patients; for example, distinguishing depression from other affective states near the very end of life. Novel treatments for depression and anxiety were also debated. The session concluded with a dialogue about future areas for collaboration in palliative care practice settings, with efforts aimed at “bridging the gap” between experts in psychiatry and palliative care.

Fairman and Irwin are coauthors, along with Jeremy Hirst, M.D., of the Clinical Manual of Palliative Care Psychiatry, from APA Publishing. APA members may order the book at a discount here.

(Image: iStock/Barcin)