Research Topic

Approaches for Severe and Persistent Mental Illness

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Despite all of psychiatry's efforts to prevent mental illness and to promote recovery, some patients will develop severe and persistent mental illness (SPMI). Currently, there exist no established practices or guidelines on how to care for this patient population. This special topic explores the feasibility, ...

Despite all of psychiatry's efforts to prevent mental illness and to promote recovery, some patients will develop severe and persistent mental illness (SPMI). Currently, there exist no established practices or guidelines on how to care for this patient population. This special topic explores the feasibility, potential, and limitations of adapting the concept of palliative care to persons with SPMI. Patients that might benefit from palliative approaches in psychiatry are amongst others patients with severe therapy-refractory depressions with repeated suicide attempts and intent to die; severe therapy-refractory schizophrenia with, from the patient's perspective, insufficient quality of life, advanced dementia, severe therapy-refractory anorexia nervosa, bipolar disorder or substance dependency.

We welcome empirical, theoretical, and ethical papers. Relevant subtopics include (a) the concept of palliative approaches in psychiatry; (b) criteria for palliative approaches in psychiatry; (c) the notion of futility with regard to psychiatric illness; (d) overlap and differences between palliative approaches in psychiatry and the recovery approach; (e) palliative sedation in psychiatry; (f) palliative approaches in psychiatry and suicide prevention; (g) the relation of palliative approaches in psychiatry, forms of assisted dying and voluntary stopping eating and drinking; (h) adaption of goals of care beyond guidelines; (i) models of clinical staging of mental disorder and the relation to palliative approaches in psychiatry; (j) self-determination, coercion,and palliative approaches in psychiatry; (k) ethical and philosophical considerations; (l) international comparison jurisdictions and other regulatory frameworks; (m) patients', healthcare professionals', and lay persons' attitudes with regard to palliative approaches in psychiatry; (n) guidelines for clinical management; (o) outlook on necessary future research.

Topic Image:
Matthias Joachim Maaß (1958­ - 2019)
"Erinnerung" 1.5.2006

Feder in schwarzer Tusche, Wasserfarben, laviert auf Aquarellkarton,
29,7 x 20,9 cm
©Sammlung Prinzhorn Heidelberg, Inv. No 8543/11 (2017)


Keywords: Palliative Care, Psychiatry, Severe Persistent Mental Disorder, Assisted Dying, Ethics


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