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SAGE Palliative Medicine & Chronic Care

Oct 9, 2023

This episode features Dr Nivedita Ashok, (University College London, London, UK).


What is already known about the topic?

  • Individuals with intellectual disability or serious mental illness have high rates of mortality due to physical comorbidities.
  • These populations have specific needs that should be met to provide optimum palliative care and maintain optimum mental healthcare at the end-of-life.
  • While research exists describing the problems these populations face, little is known about how to improve care for them.


What this paper adds?

  • By focusing on lived experiences of patients/service users, carers and healthcare professionals this paper synthesises existing evidence into multivoiced perspectives on what works, does not work, plus challenges and opportunities for improvement.
  • Assumptions and misunderstandings about the role of mental capacity assessment to appropriately involve the patient in decision-making are common, while adapting training for palliative care staff to address concerns and beliefs about mental illness helps to avoid diagnostic overshadowing.
  • Professionals need help to work across divides between physical and mental healthcare services, so people can receive palliative care in familiar locations and/or from familiar people.


Implications for practice, theory, or policy

  • A significant research deficit exists regarding provision of optimal palliative care to people with psychosis, personality disorders, bipolar affective disorder and depression.
  • Assessing capacity may be optimally achieved by involving professionals across specialities and organisations.
  • Proactive identification of service arrangements for care needs of persons with serious mental illness will help optimise care.


Full paper available from:


If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: