88 Exploring confidence of palliative care professionals in the identification and assessment of mental health problems and risk

Abstract

Background Patients with life-limiting illnesses seen in palliative care commonly experience mental health problems and suicidal ideation. Mental health problems have a significant impact on quality of life emphasising the importance of assessment and psychological support in holistic palliative care. Practitioner confidence influences competence. This study assessed the confidence levels of palliative care professionals, across the West Midlands, in identifying and managing mental health problems and suicide risk. Methods A cross-sectional survey comprising 16 points was disseminated via a regional research distribution list to palliative care professionals across the West Midlands. The survey was available online for 2 months and comprised of a variety of closed and open-ended questions (some with partial pre-coding), including Likert scales. Qualitative data was analysed thematically. Results Responses were received from 154 professionals evenly spread across hospital, community and hospice settings. The aspect of assessment respondents felt most confident in was being able to differentiate a mental health problem from an appropriate response to illness (54.5%); least confident in completing a suicide risk assessment (34.4%). Confidence appeared to be greater in counsellors, psychologists and social workers. Other factors that increased confidence included 10 or more years experience in palliative care and experience in a mental health setting. Challenges highlighted included difficulties in accessing specialist psychiatric support; lack of experience or training (further training desired in 95%). Suggested training topics included communicating with, and optimising clinical assessment of, patients with mental health problems. Conclusions Further training is strongly desired and should be incorporated into induction processes, curricula and education events. Team members with greater experience are well placed to support fellow team members in care for patients with mental health needs. Creating links with local mental health services, and further research focussed on the experiences of our patients are key priorities.