Akinlotan, Oladapo, O'Connor, Allen, Seetharamdoo, Ruben and Ghoorun, Mo (2026) Delivering Palliative Care in Mental Health Nursing Settings: A Systematic Review. Journal of Psychiatric and Mental Health Nursing.

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Abstract

Rationale
Palliative care can provide comfort, alleviate suffering, and improve quality of life; however, access to palliative care for people with mental illnesses at the end of their lives is extremely poor. As the need for palliative care is expected to rise significantly in the future, palliative care must be considered a global health priority.

Aim
To examine the provision of palliative care within mental health settings and explore the factors that influence the experience of patients receiving palliative care in these settings.

Method
This systematic review draws on peer-reviewed qualitative, quantitative and mixed-methods primary studies, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered online. A total number of 61,782 studies was identified after a comprehensive search of five academic databases. After rigorous screening, only nine studies met inclusion criteria and were selected.

Results
Thematic analysis identifies three major themes and three subthemes: access to palliative care, advance decisions and treatment, and care in palliative care settings (palliative care settings, palliative care professionals and palliative care/medical interventions).

Conclusion
Access to palliative care for people with complex mental illness is very low when compared to the general population. Advance care planning should be initiated early in the development of palliative care needs, rather than at the point of mental illness diagnosis.

Recommendations
Although care for people with complex mental illness is complex while dying, conversations around palliative care need to be as part of a therapeutic relationship and engagement. Also, palliative care staff have an important role in communicating end-of-life planning to patients' families and carers.

Accessible Summary

What is known on the subject?

People with complex mental illness including those with dementia often have poorer access to palliative and end-of-life care compared with the general population. Barriers include lack of training for mental health staff in palliative care, stigma, and challenges in identifying physical health problems in psychiatric settings. Most previous research has focused on palliative care in general health or community settings rather than within mental health wards or hospitals.

What the paper adds to existing knowledge

This is the first systematic review to specifically examine how palliative care is delivered within mental health settings. The review synthesises findings from nine studies and identifies three key themes: access to palliative care, advance decision-making, and treatment and care within palliative care settings. It highlights examples of good practice as well as gaps, including the need for better staff training, improved advance care planning, and more consistent communication with families.

What are the implications for practice?

Mental health nurses are likely to be increasingly involved in palliative care due to rising life expectancy and complex health needs amongst mental health service users. Training and support can help nurses manage physical symptoms, have sensitive conversations about care wishes, and work closely with families. Mental health services should be equipped to deliver compassionate, person-centred palliative care that integrates both physical and psychological needs.

Item Type:	Article
Identifier:	10.1111/jpm.70115
Additional Information:	Gold OA
Subjects:	Medicine and health > Mental health Medicine and health
Date Deposited:	18 Mar 2026
URI:	https://repository.uwl.ac.uk/id/eprint/14771
Sustainable Development Goals:	Goal 3: Good Health and Well-Being

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