End-of-life care and mental illness: A model for community psychiatry and beyond

Document Type

Journal Article

Publication Date

2-1-2004

Journal

Community Mental Health Journal

Volume

40

Issue

1

DOI

10.1023/B:COMH.0000015214.24404.cc

Keywords

Chronic mental illness; Decision-making capacity; End-of-life care; Healthcare preferences

Abstract

End-of-life care is often influenced by the stereotyping of patients by age, diagnosis, or cultural identity. Two common stereotypes arise from the presumed incompetence of many patients to contribute to end-of-life decisions, and the fear that the discussions themselves will be de-stabilizing. We present a model for end-of-life discussions that combines competence assessment with healthcare preferences in a psychiatric population that faces identical stereotypes. The model, which draws on clinical research in competence and suicide risk assessment, has important implications for all patients in the community who are marginalized or stereotyped during discussions of end-of-life treatment.

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